Is the traditional healthcare system broken? Hims & Hers is betting on it. In this episode, we do a deep dive into the disruptive Hims & Hers business model, a vertically integrated virtual care platform that has grown from a niche startup to a profitable public company with millions of subscribers. We explore how their approach to direct-to-consumer healthcare challenges the brick-and-mortar system by prioritizing access, affordability, and consumer convenience. We're also joined by Hims & Hers' Chief Medical Officer, Dr. Patrick Carroll, who shares an inside look at how the company is scaling its next-generation care model.
From treating stigmatized conditions like hair loss and erectile dysfunction to expanding into complex chronic care, Hims & Hers has built a powerful flywheel of services. We break down how their full-stack system, complete with a proprietary EMR, in-house pharmacies, and custom-compounded medications, creates a seamless patient experience. A cornerstone of this is the asynchronous care model, which allows for efficient, high-quality, 24/7 interactions between patients and a network of nearly 3,000 providers. Dr. Patrick Carroll explains how this model is fundamental to providing affordable care and achieving high patient satisfaction without the friction of traditional appointments.
We also explore the company's strategic expansion, particularly with the Hims & Hers for weight management program. Dr. Carroll reveals compelling data on their personalized GLP-1 program, which has shown remarkable patient retention and efficacy thanks to a combination of custom dosing and high-touch clinical support involving millions of patient messages. Looking forward, we discuss Hims & Hers' plans to tackle menopause, men's hormone support, and at-home diagnostics, further pushing the boundaries of the direct-to-consumer healthcare landscape. Finally, for clinicians and aspiring entrepreneurs, the conversation concludes with invaluable career advice, as Dr. Carroll shares insights from his journey and offers a roadmap for a successful physician career in health tech.
Introduction
Dr. Tim Showalter: Good morning, guys.
Dr. Paul Gerrard: Hey, good morning.
Dr. Trevor Royce: Good morning, good morning.
Dr. Paul Gerrard: Let me get this straight. I was looking at the notes and saw references to hair loss, low testosterone, and weight management. Are we talking about a company today or our personal lives?
Dr. Tim Showalter: This is a self-help group for us.
Dr. Paul Gerrard: Okay, I'm in the right place.
Dr. Trevor Royce: Well, we should dive in then.
Dr. Tim Showalter: Paul, do you have a special kickoff phrase for this?
Dr. Paul Gerrard: Well, this episode might not cure male pattern baldness, but hopefully the company we talk about will.
Dr. Trevor Royce: Welcome to HealthTech Remedy, the show where three physician leaders in health technology break down the stories behind today's most innovative health companies and speak with leaders shaping the future of care. I'm Trevor Royce, radiation oncologist and researcher with experience in real-world evidence, informatics, and AI diagnostics.
Dr. Paul Gerrard: I'm Paul Gerrard. I started my career in PM&R before focusing on reimbursement policy, molecular diagnostics, and market access for AI-driven products.
Dr. Tim Showalter: And I'm Tim Showalter, a radiation oncologist and former med device entrepreneur who's now focused on scaling AI technologies to improve care for cancer patients.
Understanding the Hims & Hers Vertically Integrated Business Model
Dr. Trevor Royce: And this week, we're diving into Hims & Hers, a consumer health company known for a fast-growing virtual care platform.
Dr. Paul Gerrard: Then we'll speak with Dr. Patrick Carroll, the chief medical officer of Hims & Hers, to hear how the company is scaling its care model and navigating the intersection of clinical quality, consumer expectations, and regulatory scrutiny.
Dr. Tim Showalter: Let's maybe start with a quick overview. I think Hims & Hers is a company where there's a lot of name recognition. Certainly, a lot of folks have used their services or have seen their commercials. If you watched the Super Bowl last year, of course, there was a commercial. But I think it's important to think about where they started and where they are now.
And of course, they started back in 2017 as a direct-to-consumer telehealth company. So they haven't been around that long. And then they were initially focused on targeting more stigmatized conditions like erectile dysfunction and hair loss. And then over time, they've really expanded their offerings and are now in a much more broad range of services, catering to consumers really across the healthcare spectrum.
Dr. Trevor Royce: So a bit by their fundraising history, they went public via SPAC in January of 2021 and has been growing rapidly since then. So perhaps a notable standout in the SPAC world for a success story here. As early as 2024, Hims & Hers had over 1.4 million subscriptions and have basically established a path to profitability.
They've grown from a niche telehealth brand focused on stigmatized conditions like erectile dysfunction and hair loss, and now is mentioned into this profitable, multi-conditioning, vertically integrated virtual care platform. In a Q1 of 2025, their earnings showed over 2.4 million subscribers and nearly 50 million in net income.
Dr. Paul Gerrard: So what makes them stand out is this hybrid model of tech-enabled convenience and vertically integrated care. They have a telehealth platform, but they're not just a telehealth platform. They've developed their own electronic medical record, custom clinical tools, and in some cases even now have their own branded medications and formulations. So it's a true flywheel of various service lines. Each one driving its own stickiness, giving them a competitive edge and offering value across a broader customer base.
What's striking now is that they've built the infrastructure to support it all themselves. So it's not just a health care company taking advantage of existing infrastructure. It's they've had to build a lot of it from the ground up.
Direct-to-Consumer vs. Traditional Healthcare: Pros, Cons, and Regulatory Hurdles
Dr. Tim Showalter: Yeah, exactly. And I think it's important to pause here and reflect on how really fundamentally different this is than the traditional brick and mortar healthcare system. And we've certainly heard a lot in the companies we've covered already about how a lot of health technology is focused at making the whole process of being a patient and interacting with the healthcare system much more seamless and making it easier for providers to provide that care to patients.
And so this is a really interesting example where they've essentially looked across the landscape of an increasingly fragmented system and really just reinvented the whole experience where receiving care is simple. The prescriptions are delivered directly and where you don't have to take a day off of work and wait in a waiting room and have some of a challenging clinical encounter just to receive the care that you want. And I think that model has the potential to reach a lot of people who might not otherwise engage with routine health care at all. It's pretty promising in that regard.
Dr. Trevor Royce: Yeah, they've definitely leaned into affordability, consumer loyalty, access to care for these outsized conditions amongst Americans. Millions of Americans with issues like weight loss, hair loss, erectile dysfunction, anxiety, smooth skin. And now they've packaged it in this way where they're delivering these medicines to your doorstep and sleekly packaged prescriptions. And so there's a real access and affordability thing. Very clear pricing. It definitely has challenged the traditional drug prescription model with a different philosophy than traditional health systems and a totally different model.
Dr. Paul Gerrard: And anytime you bring something new, you bring changes, of course, you're going to have pushback. The practice of medicine in the U.S. is regulated at the state level. So just the first challenge is you try to have a national platform, but you're delivering care to patients in many states. So you have to deal with issues of managing a network of physicians, matching them with patients, state licensure laws. Additionally, you're going to have the Issues related to things like compounded medications and what are the rules on compounding.
In general, compounding is only allowed for medications that have a shortage or medications that are being developed or being assembled and compounded for individuals. So a compounding pharmacy is not supposed to be a large-scale drug manufacturer. But of course, if you want to operate at scale, how do you walk that fine line? And then just overall trust. Even aside from the regulatory scrutiny, it's really inconvenient to go in, see a doctor. But at the end of the day, a lot of patients do like having that in-person experience with their doctors, somebody who's a member of their own community, who they trust. So certainly that can be a headwind, even just on the commercial model.
Dr. Tim Showalter: If you step back, there's been plenty of coverage in the popular press about the GLP-1 controversies and everything. But if you just step back, I think what's really interesting about the Hims & Hers model is that it's really full stack. And so it really goes all the way down to they're doing some of their own compounding in manufacturing in a sense.
And so if you look at their overall product portfolio, they've found a way by putting the patient really at the center as the customer that if you just look at what they're offering in terms of generic drug availability, they've definitely reinvented or disrupted some products. They've got some chewable erectile dysfunction medicine and some hybrid products for hair and sexual health. And I can imagine for a particular customer base that that approach can be really compelling and feel responsive to their needs.
And so you can see how there are some real advantages to having that end-to-end experience for pharmacological therapy. And of course, the controversy that is playing out currently, I don't think we have a resolution for it with GLP-1 pertains to some of the patent considerations. But if you think about it more broadly, I think it's a really flexible approach that they've adopted overall.
Dr. Trevor Royce: Yeah, I think the natural tension between the establishment care delivery models and innovative care delivery models are often illustrated by what Hims & Hers is trying to do. Things like drug advertising is not without controversies. Some nations outlaw it and it's tired. In fact, that's more common than being able to advertise for pharmaceuticals. And then here you have a company that has a very prominent Super Bowl ad, which is the biggest platform for advertising. It was one of a couple of healthcare related advertisements at the Super Bowl this year.
I think it's very smart on their part, clearly a great target audience for weight loss where part of watching the big game is eating a lot of fried chicken and eating nachos and drinking beer. And I assume it's a good target audience for weight loss. So I think these are the discussions that come about when you have this type of innovation in a traditional care model. And of course, some of the trade-offs that we should also mention are things like the correct diagnosis. How does a virtual care platform make an accurate diagnosis? How do they manage the side effects for prescriptions that are being delivered to your doorstep and you're not necessarily seeing a physician in person for? So there are lots of things to consider with this.
Dr. Tim Showalter: Paul, I'm curious to get your thoughts on, you mentioned this earlier, how states regulate healthcare licensure. And I'm curious to get your thoughts about what the Hims & Hers moat is. They built this infrastructure and they're offering care at a national level. And how do you see for a company like Hims & Hers that competitive advantage of the regulatory infrastructure that they've built?
Dr. Paul Gerrard: I am going to guess that part of it, and I don't know this for sure, but part of it is going to start with really the IT infrastructure that they've created. So most of the IT built for healthcare is built for the conventional healthcare model. People get seen in person. You don't have to worry about things, who's licensed in which state. But when you want to start managing a large network of physicians, you do have to think about these things. You may have physicians licensed in multiple states.
If Hims & Hers is concerned about this, then what they need to do is match the location of the physician and the licensure of the physician to the location of the patient. And I guess it depends on somebody's risk tolerance. But in the past, that's how I've seen a lot of companies that are thinking about telehealth, and even hospitals doing telehealth in multiple states manage their networks. The difference is most of them are not doing it in 50 states, whereas Hims & Hers is. Just managing that infrastructure and operations, I could imagine is a challenge. So somebody else now, they would have to go get the same network of physicians and then have an efficient way to handle that matching, which is possible to do, but I'm sure it's tedious to build the system that works.
Dr. Tim Showalter: Yeah. To me, that seems like one of the hugest advantages. They're well-positioned to really expand their offerings over time and be interesting to see where that goes next, because I think there are a lot of unmet needs. Trevor, I'm curious to get your thoughts on how you think about this from, we, of course, both still have a clinical practice and how you view this as a physician, because I do think there are pain points along the way in terms of health system access, overcrowded emergency rooms, and inadequate availability of primary care. Your thoughts as a practicing physician for what the presence of Hims & Hers means for serving the American population?
Dr. Trevor Royce: Yeah, I'm all for increased access. And if we can break down some barriers to care, relieve some of the burden on our overworked primary care docs, if there are ways to get drugs to the patients that need those drugs seamlessly, I'm all for it. I think it's balancing giving the right drug to the right patient at the right time, managing those side effects and maintaining that valuable patient physician relationship in this virtual environment that we now live in. So I think as long as we can strike the right balance there, what they're doing is fantastic in getting care to patients that need it.
A Physician’s Perspective: Integrating Hims & Hers into Specialty Care
Dr. Paul Gerrard: Let me ask, the two of you are radiation oncologists and part of the population you treat are, say, patients with prostate cancer, obviously a group of people that could have problems with some of the issues that Hims & Hers treats, either the disease causing the problems or the treatment to the disease causing the problems. Do you think that this is the kind of thing that can serve this patient population well or, once somebody has a serious disease like cancer, does that complicate things in a way that, you'd say, makes it a little trickier in terms of where they're best managed.
Dr. Tim Showalter: I can go first. And Trevor, maybe you can say something smarter after I say what I have to say. But I'll say one common clinical discussion I have and how I think a service like Hims & Hers could help. So often patients of the age of prostate cancer or related to prostate cancer treatment will have problems with erectile dysfunction. And so I'm very often the situation of prescribing Viagra, which is Sildenafil is generic now. However, prices can still be quite high for a prescription depending on the particular pharmacy where it's filled.
And so I have a detailed discussion about, print out this coupon from GoodRx, shop around the pharmacies near you and I print out the prescription for them. But there are many steps involved and it's a long conversation. You can imagine that if a patient has a subscription at Hims & Hers, that medication could be provided in the format that they prefer it, a pill or a chewy or whatever it is, and could even be a dual medication in one pill. And it could be provided seamlessly with male delivery. And so I can imagine that that thing could be helpful for a prostate cancer patient as part of their overall care plan, outside of the healthcare system. And Trevor, I'm sure you have something smarter to say too.
Dr. Trevor Royce: No, I think it's a great question, Paul. And it's useful to think with some very practical examples of how this interacts with specialty care. And one thing that I think about a lot, as you mentioned, Tim and I are prostate physicians, and we follow the PSA very closely. It's a great biomarker for treatment response for a prostate cancer tumor. It helps with diagnosis and screening, and it's a simple blood test. So anyways, it's an integral part of following how prostate cancer patients have responded to treatment.
And that PSA value can interact quite closely with hair loss medications, where you have to make adjustments for that PSA value if they're on some of these medications. And so this is a good example where maybe that medication that they're taking is not in their electronic health record because they're getting it through some other platform like Hims & Hers, and you want to be able to account for that PSA value. And so I think it just goes to show that you have to have an awareness of where patients are getting medications. You can't necessarily make assumptions based on what's the EHR. You have to actually listen to the patient, have a discussion with them about their, in this case, genitourinary health more broadly than what might be evident in a simple electronic medical record.
Dr. Tim Showalter: Yeah, Trevor, that's a great point. I think ultimately connecting what happens in a health system like Hims & Hers, it's really important to have that connected to the traditional health system. Although I'm sure that we mentioned before they've started off with some stigmatized medical conditions. I'm sure the patients may have something to say about that and may not actually want that information shared, potentially.
Dr. Paul Gerrard: I think that's one of the other things that really gives him an advantage. Some of these are stigmatized conditions. Patients may not feel that comfortable talking with the physician. They've been seeing for years about it. And so that stranger over the internet who you know is going to keep your secrets might be easier to talk to, both because you know it's confidential with them and you're never going to see them outside of the context of talking about this one condition.
Dr. Tim Showalter: Yeah, it feels more anonymous.
Dr. Paul Gerrard: That's interesting.
The Future of Hims & Hers: Expanding into Chronic Disease Management
Dr. Trevor Royce: One thing that I'll be super interested to see over the next five to 10 years with these platforms is what areas of medicine they expand into. I think everyone has an awareness of their current focuses off the top of my head: weight loss, hair loss, sexual dysfunction, anxiety, dermatologic conditions. But even though these are massive problems affecting millions of Americans and they have tried and true prescriptions for that lend themselves well to these types of platforms, where will they expand? And how far will they push into specialty care? It'll be really interesting to see where that goes.
Dr. Tim Showalter: That's a great point. And to follow on that a little bit, My perspective on them is that I really like the Hims & Hers branding. So I think they've done a really good job of establishing themselves as being patient first and interested in health overall and reaching people and caring directly about those people and putting the consumer in charge of their health.
And to pull it into your comment as well, Trevor, I think where this really makes a huge impact is when you start to get into major health care challenges for the entire country. A good example of that is their work and obesity. So I think giving people the tools to take control of their weight and to be more active, even that commercial, I understand there's controversy about the super bowl commercial, but on some level I think the focus on a very active lifestyle and being in movement can be viewed as a positive thing. And so I would love to see, over time, Hims & Hers or similar platforms move towards chronic disease management, in terms of things that would be associated with weight loss as well, like diabetes management and things like that, where it could be helpful to have some online support for that as well.
Dr. Paul Gerrard: Riffing off of your point, Tim, I think that right now they've focused on being that direct consumer cash pay model, but dealing with these chronic diseases, especially things like diabetes, heart disease, is a major challenge for payers, especially if you're a payer like Medicare that is going to have patients at a time in their life when they're likely to have these conditions and may be on Medicare for 10, 20, 30 years.
I could very well imagine that Hims & Hers starts to branch out into that model where they get involved in the management of chronic conditions and that they start to have engagements with payers who say, hey, if you guys have a good, efficient, and consistent way to address this, for patients across the country. We're interested in talking with you about it and how we can make sure that is accessible to our beneficiaries.
Dr. Tim Showalter: Well, great points, guys. I think this is a perfect transition to hear more about what's in the future for Hims & Hers. So coming up, we have our interview with Dr. Patrick Carroll, who's chief medical officer of Hims & Hers, and we'll have a chance to hear what's in store for them. Welcome back to HealthTech Remedy. We're thrilled to welcome Dr. Patrick Carroll, Chief Medical Officer of Hims & Hers. Pat, welcome to the show.
Dr. Patrick Carroll: Glad to be here, guys.
From Traditional Practice to Health Tech: Dr. Patrick Carroll’s Career Journey
Dr. Tim Showalter: Well, I'm looking forward to hearing about your career and what's going on at Hims & Hers. Maybe let's start with your career journey. What brought you to Hims & Hers and what motivated your move from traditional healthcare into digital health? And I know you've had a lot of different tours along the way, So I would love to spend a little time on this and hear about your early medical career and how this transitioned over time.
Dr. Patrick Carroll: Super. Look, when I get asked this question fairly often after people look at my CV and get a headache, what I explain is it's really been a nonlinear career path, but it's very much focused on a background as a primary care physician, board certified in family practice and adolescent medicine that practiced in the trenches for over 30 years with the 30 patients per day, a patient panel of 3,500 patients. I did most of that career in Concord, New Hampshire.
But a big part of what really informed my career was my six years with the Indian Health Service. I did four years after my residency, working in two different reservations, one in Shiprock, New Mexico, in the Nava Reservation, then the Cherokee Reservation in North Carolina. And then I actually circled back 2009 to 2011 to do a two-year project with Indian Health Service back in Shiprock, New Mexico. So why it informed my career, it really teed up what I saw as the challenges in healthcare, which is really access to affordable care. Native Americans are fortunate in the respect that they do have guaranteed healthcare through federal treaty, but access is a huge issue, as you can imagine, just from geography and access to specialists and primary care providers. After doing four years initially with the Indian Health Service, I hitched on with a primary care practice in Concord, New Hampshire, worked for a large medical group affiliated with the hospital, practiced there right up to 2009.
And then I did my second stint with the Indian Health Service, which really was involved with setting up school-based health clinics, identifying high-risk adolescents and getting them the mental health care that they needed. I also helped set up the electronic medical record in the Navajo area, which was fascinating. All of this data was floating around out there and helping in our region to get us on an EMR.
Unbeknownst to me, that work with the Indian Health Service, particularly my second stint, garnered some recognition such that I was offered a position as a chief medical officer for a really large multi-specialty medical group in Boston, Atrius Health. And I was a CMO of a region of Atrius. In some ways, I didn't really have the qualifications for the job, but they really liked the population health work I did with the Indian Health Service. I worked at Atrius for two years. A lot of their work was around risk-based care, particularly the Medicare Advantage product.
And then I got poached from Hartford Healthcare, which was an integrated delivery network in Hartford, Connecticut. I worked there two years as the chief medical officer of the Integrated Care Network, which is really a CIN, a clinical integration network that was set up with Hartford. Again, risk-based care, kind of bringing Hartford from fee-for-service into value-based care. I enjoyed the work there, but I realized that health system leadership role was really not for me. And out of the blue, I got recruited to be a chief medical officer at Walgreens, initially running their retail clinics. I started there in 2014, and eventually I was the full chief medical officer there, leading a lot of their primary care, digital health, retail health strategy, worked there from 2014 to 2019, and then got recruited to Hims & Hers.
And why would I go from an established company to literally a startup? At the time in 2019, I think there were 30 or 40 employees. I was their first chief medical officer. The reason was I really liked their model, which was direct-to-consumer care, disintermediating payers and PBMs, passing that savings on to consumers, and then the need to provide access to care at affordable price. And that, I saw, was a challenge throughout my career in terms of our modern American healthcare system. And I've been there since 2019, and I've enjoyed the work. We've expanded into five different verticals, going from derm, primarily hair loss, sexual dysfunction, mental health, weight management with both oral medications and GLP-1s, and looking at a few other verticals that we're developing this year.
So again, what attracted me, it's really solving this problem, which is access and affordability. And we have a fundamental problem with our current healthcare model. It's a failed model. Let's face it, we spend $4 trillion. It's extremely hard to get a primary care access. And it's very confusing to the average customer. So I love the transparency, both in terms of price and the ability to access care, as well as the opportunity to build what we would call the next-generation healthcare model. So that's kind of the long and short of my career journey, which is a bit nuanced, but everything kind of fits together for me, from primary care base to working for underserved populations to trying to solve that access and affordability challenge in American health care.
And that challenge has not gone away. If you actually look at where we are today with high deductible health plans, most folks have catastrophic type insurance. They don't get their insurance coverage until they reach a deductible of $1,500 to $2,000. Today, we have a shortage of 50,000 primary care physicians, which is going to actually in the next five to 10 years predicted to go to 100,000. So we have access and cost issues that remain.
Dr. Trevor Royce: That's an amazing journey. And something tells me that a young Dr. Carroll would not have foreseen that exact path.
Dr. Patrick Carroll: Not at all. Again, nonlinear, Trevor, is the way I describe it. I speak externally a fair amount for the company. And I did it even when I was at Walgreens. And I've had young physicians come up to me and say, hey, I'd like to do exactly what you're doing. How do I do that? And I say, there's not a playbook for this, guys. What I recommend is you get into your field, actually see patients, right? Just don't go out and get the MBA and say you're going to run the healthcare world because you don't have any credibility at that point with other providers particularly. And then figure out what the problems are and how you actually can help solve some of those bigger issues.
The Core of the Model: How Asynchronous Care Drives Efficiency and Quality
Dr. Paul Gerrard: So as you described, this very nonlinear career, Indian Health Service, private clinics, Walgreens, those are all unified by, they have a lot of in-person component to the care involved. But when you went to Hims & Hers, it was a very different model. It's virtual first. Did you take anything with you from what you learned in the models that were very in-person, physical location-based to this virtual online platform? Or was it kind of you had to rebuild everything from the ground up?
Dr. Patrick Carroll: Yeah, that's a great question, Paul. And what I took with me, particularly from my years at Walgreens, is, being very customer or consumer focused. Walgreens, we didn't call folks who access our healthcare service as patients. We turned them, they were customers, they were consumers. And Walgreens was extremely customer focused. I remember one of my first executive meetings, they put up a slide and they talked about NPS, net promoter score. I had no idea what that was. And I turned to one of the vice presidents and said, what's an NPS? And they said, And you better learn that pretty quickly because that's what we function off of here at Walgreens.
So coming to Hims & Hers, one skill I brought in, it was really that consumer focus, which Hims & Hers does day in and day out. What does the customer need? Are we serving their needs? And how do we bring personalized treatment that actually solves problems for them? But you're right in terms of going from an in-person brick-and-mortar environment into virtual was new for me. And I had some skepticism to start with, particularly when I started at Hims & Hers. I think we were only in 20 states. And my role was to expand to 50 states to really build a robust quality platform, which we've been able to do.
So build the bones where we could add on these other verticals. But as importantly is to understand this entity called asynchronous care, which is what we use as our primary model in every state that allows it. Now, that being said, there are some states that still require synchronous virtual visits, and we comply with that. But what we mean by asynchronous is actually it's a back and forth interchange conversation between a provider, whether that be a physician or nurse practitioner, and the customer, the patient, and answering their questions, making sure that they could qualify for what we have to offer, and then filling their needs in terms of a solution. And that could be medication, or maybe it's not medication.
And that fulfillment of the medication we actually do today through our own pharmacies. And so really fascinating model, asynchronous care, virtual, entirely vertically integrated. So the customer comes on our platform. Many times it's from reading content that we have online. We answer their questions. They get connected with provider after they go through a rigorous intake process, all standard of care questions.
We gather a lot of data on each customer, past medical history, medications, what their current condition is, and how we can possibly solve it. And then that gets put in a queue for a provider, whether it be a physician or nurse practitioner to review, ask further questions to the customer, and then see if they qualify for medications. Through that whole journey, the customer makes an informed decision in terms of if I'm going to go on medication. What are the side effects? What are the upsides? What are the downsides? What can I expect? And then really after the fulfillment that comes through our pharmacies, we actually do frequent outreach, which really is the quality baseline for asynchronous care. Emails every two to four to six weeks. How are you doing? We have care coaches that reach out to them. So high touch once they're involved with our program and a subscription model.
You have to do that for asynchronous care, though, because you're not seeing them in a brick-and-mortar environment, or in many cases, even face-to-face. So I became a true believer in asynchronous care. Again, it helps solve a lot of problems. One, it can offer really affordable care because it's a very efficient model. The second is you can use a provider in a very efficient manner, just taking out the friction of having to schedule a face-to-face visit as opposed to having 24-7 access to that kind of asynchronous chair with the provider customer chat. It allows us to use providers a lot more efficiently and then still have the same quality visit that we've seen in brick and mortar, as well as even on a synchronous visit.
Different model. I'm a true believer in it because I've seen the quality data over the years. I've seen our customer satisfaction. I've seen our NPS scores. So it works. And I think that's what I mean by a next generation of a care model. And in addition to that, you folks are a tech platform. We built our own EMR that serves very, very well in the asynchronous environment, particularly. The traditional EMRs, the five different ones that I practice on over the years, really are not designed to provide this type of care.
Dr. Tim Showalter: On the subject of net promoter scores, I would think that Hims & Hers is one of the most well-recognized healthcare brands in the United States right now. I think that people, if you were to pull people in the street, they're pretty familiar with it. And I'm curious as you think about how that's received by U.S. Healthcare consumers, what do you think is core of the branding for Hims & Hers? As you think about growing new lines of business or serving patients, how would you articulate the brand identity?
Dr. Patrick Carroll: Yeah, from my standpoint, we put a lot of time and money in building the brand. But the foundation of that is trust and safety and quality. No one's going to come on and receive care from us, particularly in that asynchronous modality, unless they trust that the brand and the quality of care they're going to receive is top-notch. This is healthcare. Even though we're high-tech, we do a lot of neat things. We do fantastic marketing. At the end of the day, it's around quality of care. And so people trust what they're getting from us. We see that time and time again, and they trust us to manage some fairly complex conditions with them.
For example, anxiety and depression, weight management. This is not as simple as prescribing a PDE5 or a Viagra type medication or a hair loss medication. We've tackled the increased complexity of conditions because we're convinced we can do it in the same high quality manner as you could do in a brick and mortar type practice. But again, the brand underlying that is the trust and the safety and the quality they feel like they're receiving from us.
Dr. Trevor Royce: Yeah, I think it's kind of worth doubling down on that. And, as Tim mentioned, I think most folks have heard of Hims & Hers and if they didn't hear of Hims & Hers before the Super Bowl, they heard about it after because you guys had that great ad. And all of that can't stand on its own without the quality. And so that's what keeps the patients coming back and that's how they ultimately benefit from your service. So I think it's a great point.
Inside the Hims & Hers Weight Management Program and GLP-1 Offerings
Dr. Patrick Carroll: Yeah, absolutely. And one of our newer verticals, of course, is weight management. And we feel it's very important not just to say that we think we do high quality care, it's actually to validate it through research. And so we've seen, Huge number of patients on weight management, both for oral medications, which is the combination of on naltrexone, bupropion, Topamax, and metformin.
But also if they qualify by those FDA standards at BMI 27 to 30 with a comorbid condition or greater than 30 without a comorbid condition, they qualify for a GLP-1. We've been able to offer those medications. We give customers choice. They can come on our platform. they can get branded medications or they can get a compounded medication, which is the pure molecule of the semaglutide. And what we've been able to gather is a great amount of data in terms of side effects, retention, efficacy, through the 12-month journey that we've had. We started in May of 2024 with the GLP-1s. And what we've seen is some really tremendous results. We do personalized dosing.
If you come on our platform, you'll see that you, as a rule, when you answer questions and you're a customer that has had side effects from medications, you get put in our personalized dosage pathway. Not everyone gets put in that, but if you have those experiences with GI side effects and are concerned about that, we'll put you in the compounded personalized dosing, which actually starts at a very low dose And then at maintenance, gets up to about 1.4 milligram for the higher dose. And what we've seen is that the average weight loss is pretty comparable to other higher dosages. We've seen an average 20-pound weight loss at six months, which translates to about 10%. And that's only at six months. We're not sharing yet data at 12 months. We are collecting that.
More so than that, what we've seen is really unbelievable retention. Only 25% of folks on our platform starting GLP-1s actually stopped the medication, whereas the data out there for other larger studies, it could be up to 80% of folks stopped the medication by six months. And we think it's because of our low side effect profile that we have like 10% of folks get side effects, but only 4.5% get intolerable side effects. And I think it just as importantly as the slower titration up with personalized dosages, we have a huge clinical support team. We have a whole team of care coach nurses. Since the inception, we've had over 6.7 million messages that go between our providers and our care coaches and the customer. And so that kind of support is pretty robust.
In my primary care practice, I just didn't message patients that much. They'd come in, they'd get a medication, I'd see them at three to six months. If I never, GLP-1s weren't a big player when I was in primary care. But if I was back in my practice, I wouldn't have that whole support network doing constant outreach to customers. I think that contributes to our retention and our customer satisfaction. It's personalized dosing, but it's also a pretty robust support network. Very, very compelling clinical results.
Dr. Tim Showalter: You mentioned making sure to engage people and improve outcomes. As you're talking about Hims & Hers, I really do see that thread of a connection. It seems to me, I know that you've mentioned the individualized dosing plan for part of the success, but it really seems like some of the asynchronous engagement with with the team and that exchange of messages back and forth is part of the secret sauce as well. How do you think about frequency of touch points with the health care team as really a way to reach more patients?
Dr. Patrick Carroll: Yeah, absolutely. You're able to do that, Tim, in the asynchronous modality. You don't have to set up appointments, although patients can. You don't have to set up appointments to have face-to-face meetings. So it allows us to do frequent outreaches and gather a lot of information in terms of side effects, what folks are battling with the GLP-1s in terms of side effects of the medications, and then really to offer them that holistic program with the stress, not just on the medication, but also on movement, which is exercise, sleep, which is a big part of weight gain, and really looking at diet too. What are they eating? So there is more to it than the medications.
But going back to my informative years of the Indian Health Service, you're right, it's all about high touch. I was always impressed with the Indian Health Service there, the visiting nurse program. In the different communities, they had a lot of health coaches that actually were high-touch to patients. And it was very much a population health approach before anybody ever coined that term population health. So they were using that model before it even became popular. So you're right, there is a thread that goes through my career in terms of what are the challenges, the high customer touch, the high patient touch points, and then addressing concerns of patients and customers.
Dr. Paul Gerrard: So you've talked a lot about asynchronous care and everyone thinks about Hims & Hers, or at least I think about Hims & Hers as largely being the platform that deals in things like sexual health, weight management, hair loss. But when you talk about asynchronous care, nothing that I'm hearing you talk about is necessarily specifically applicable only to what is conventionally considered men's or women's health. Do you think that this telehealth model has a application that is more broadly available and could broadly be used in primary care or even specialty care?
Dr. Patrick Carroll: Absolutely, Paul. So we are not the patient-centered medical home, but what we see is a huge gap in the inability for folks to access care, particularly for some conditions. We very thoughtfully look at the verticals where we think we can provide high quality care. And then we build out the guidelines using advisors and specialists to give us direction on specifically what questions we can ask, what medications would be beneficial, what kind of follow-up we have to do.
And then having that quality system already built out, we have nurse practitioners that every day review visits, encounters between providers and our customers. So we know if you're a new provider on, you're going to get reviewed. If we get any complaints or any issues that come up, you're going to get reviewed and you're going to get reviewed randomly. So we're able to look at our folks following guidelines. Are they prescribing appropriately? Is the messaging appropriate in the EMR?
And once you have that quality structure in place and you've identified a vertical where you can provide really high-value care that in many cases has not been addressed well, we're going to do it. And so we've recently hired a Dr. Jessica Shepherd. She's a board-certified OBGYN menopause specialist. We've publicly announced we're going to be doing a menopause, perimenopause treatment in that asynchronous modality, offering those hormonal support that women have not gotten great access to.
Jessica shared with me that probably less than 10% of women actually access hormonal treatment as they go through menopause and perimenopause. There was a big misconception out there because of a faulty study, quite honestly, that came out a few years ago linking hormone treatment with increased risk for breast cancer. Now that that's been refuted time and time again, we just don't see that women are able to access the type of care they want. So we're going to do that on our platform. In addition, we're going to do hormone support for men around testosterone, testosterone-like products because men have not been able to access that if they qualify for it.
And then we're also looking at getting into the diagnostic space. We purchased a lab called Trybe Labs, which is a fascinating lab. They do blood collection through, it's almost like a stick-on device, it's almost like a CGM-type device where it draws an aliquot of blood off, serum, process it, and we'll be able to do all our hormone panels that allow us to do the hormone support for both men and women based on the labs that people can get at home.
The serum from those devices gets sent to the labs and get processed. So it's really, again, providing access to care for conditions that a lot of folks haven't been able to get care for.
Building the Tech Stack: The Proprietary EMR and the Role of AI
Dr. Trevor Royce: I'm going to just shift gears a little bit because I know we're coming up on time and would love to hear just a little bit about the tech side of things. I'm particularly kind of curious to hear more about the EHR. Tim and I both were previously at Flatiron Health, which has an oncology-specific EHR. Tell us what you guys have built there and how that's enabled you to have the incredible scope you all have.
Dr. Patrick Carroll: You guys as physicians know that the tyranny of EHRs. There's no providers I know that actually like the EHR they practice on. And believe me, I've been on five or six of LASCOM different EMRs. A lot of it is basically just a coding and documentation vehicle. And we realize since we don't submit to payers and we don't have to have PBMs looking at us in terms of setting prices for the medications we deliver, it gives us quite a bit of freedom.
And so what we've done is kind of eliminated the unnecessary information you have to collect, really double down on getting the critical information, and then making that provider-patient interaction really seamless, get rid of all that friction point, and allow our providers to actually see patients in that, particularly the asynchronous environment, 24-7. And almost all of this are done off a mobile device.
And so if you actually look at our now approaching 3,000 providers, many of them are part-time. So they have day jobs working as family physicians, internists, ER docs. We have over 90% physician retention. And the feedback we get is, I love your EMR. It's not a land of a thousand clicks. It's essential information is given. We can actually make a good medical decision. And then that pharmacy fulfillment is done internally. Which is a huge advantage too. They don't have to send off a script to an outside pharmacy, and that saves a lot of problems for them. And so our EMR is designed for this type of really efficient, high-quality process. It allows us actually to do a lot of tracking on the type of visits that occur and the information we gather.
Our next frontier on it, and we've already done some work on it is AI. When I talk about 6.7 million messages on weight loss alone, a lot of those are the same questions that come up again and again and again. And so we recently hired two really high-level leaders for the company, one in product and then one as a chief technology officer. His prior role was as a CEO and chief technology officer at Cruise, a self-driving car company. So it's fascinating. He solved some really complicated problems then, there. And when he looked at what we're doing, he goes, a lot of AI applications here at him's and hers. You folks have the data, you have just that, the lowest hanging fruit, just the messaging to have a consistent messaging that's AI driven will be a huge advantage to our customers. And we'll be able to tack that on to our EMR.
And when you actually build your EMR internally, it gives you a lot of flexibility to do that. We don't have to ask permission from a mega EMR vendor to do anything. We can build it all internally and we can do all the tweaks and changes that, as you know, Trevor, you need to do with EMRs without getting external permission from them. It gives you a great deal of freedom to pivot and to increase the quality of what you do, and particularly around the AI world.
Dr. Trevor Royce: It's a little tongue-in-cheek, but EHRs are often framed as tools for billing and less tools for actual clinical care. And boy, it sounds nice to have a system that is focused on clinical care and less on inner engagements with pharmacy benefits or with the payers or whatever third party it may be that gets between the physician classically and the patient.
Career Advice for Physicians Entering Health Technology
Dr. Tim Showalter: Well, before we wrap up, I'd like to turn the conversation back to you directly in your own career. A lot of our listeners are physicians who are interested in entering health technology or people earlier in their career and are looking to make an impact in healthcare. What advice do you have at this point for those who are early in their career and may look to you for guidance?
Dr. Patrick Carroll: Really solid question, Tim. Again, what I encourage the younger physicians in med school or going to residency, good Lord, practice for a few years. Understand what the problems are. I don't think you're going to solve problems or have the credibility if you go on the MD, MBA tract and immediately go into consulting or go into physician leadership. I think it's really important that you roll up the sleeves and get in there and start practicing and then recognize the problems. And for me, those years of practice have been invaluable because it really crystallized that access and affordability issue that my patients struggled with day in and day out.
So that's my first point is get in there and practice. And then as you practice, you're going to identify big issues, things that are really solvable, but you need to understand that you're not going to change everything overnight.
And then you have to look at, is there an opportunity to work with a company like a Hims & Hers or in a model that's actually can solve a big problem, but also as a business case to do that? And you can have a great idea and you're solving a good problem. But if there's no business case, it's really hard for that company to grow. So bring in clinical experience, identify problems, and you're going to, because we many of them in healthcare. And then network and choose to work with an organization or a company that not only is solving a problem, but has a business case to be sustainable going forward. And there's plenty of those opportunities out there. I think it's ideal for younger physicians, particularly, or even mid-career physicians to actually work part-time at some of these companies to understand how they work, even before you decide to make that full leap out of clinical practice. Those are my words of advice. And it's served me very well in my career.
Dr. Tim Showalter: That's a great way to close. Thank you so much for your comments and for sharing your experiences. And that's it for this episode of HealthTech Remedy. Don't forget to subscribe, rate, and share the show. See you next time.
