Dr. Jonathan Slotkin breaks down MedVee: fake doctors, oral GLP-1s with zero evidence, and regulatory gaps enabling bad actors

Summary

Jonathan Slotkin, a practicing neurosurgeon and co-founder of Scrub Capital, argues that a celebrated New York Times profile of MedVee was a tech story that should have been a health story — and that the framing obscured a constellation of serious red flags.

The piece, Slotkin says, omitted that the FDA had sent MedVee a warning letter six weeks before publication. Several of MedVee's supply chain partners are named in an active RICO lawsuit. Multiple class action suits are pending. And a reporter at Maggie Harrison had documented fake patients, fake testimonials, and AI-generated photos more than a year before the Times piece ran.

Then there were the fake doctors. MedVee's platform reportedly listed physicians under names including "Albus Dongledore" and "Tucker Carlzinn" — spelled with a z. Slotkin's read is that any one of these issues might be explainable in isolation, but together they shift the burden of proof firmly onto anyone celebrating the company.

The oral GLP-1 problem

Slotkin's sharpest clinical critique targets MedVee's oral tirzepatide offering. The day before the Times profile ran, Eli Lilly received FDA approval for an oral GLP-1 — but it was an entirely different molecule, not a peptide at all. Slotkin says oral tirzepatide has zero published human studies, and quotes Lilly itself to that effect. Selling an oral version of a peptide that cannot survive digestion, he argues, has no biological plausibility of working. That specific product is the subject of the RICO lawsuit.

This matters beyond the legal exposure. Patients given a product that doesn't work lose metabolic time and are set back in their treatment. Slotkin is explicit that many compounds in this category do work — he describes GLP-1s as among the most powerful agents medicine has ever seen, capable of effectively curing obesity in a subset of patients — which is precisely why bad actors undermine the category.

The regulatory gap

The structural problem enabling companies like MedVee to operate is a federal-state split. The FDA regulates substances and devices but is statutorily prohibited from regulating the practice of medicine — that sits with the states. Compounding and formulation decisions fall into that gap, giving operators room to maneuver between federal substance approval and state medical practice oversight. Slotkin thinks closing that gap requires coordination at the HHS level, naming senior figures there as the right people to work through it.

On the pharma side, Slotkin acknowledges that Lilly was slow to build direct-to-consumer e-commerce infrastructure, giving venture-backed telehealth platforms a meaningful head start. That lead is narrowing. Lilly's cash-pay workflow now delivers Zepbound to patients' doors the next day via a simple text-link checkout, and its price is converging toward what compounders charge — compressing the arbitrage that funded much of the telehealth boom.

Enforcement

The FTC, not just the FDA, is already active on marketing enforcement in this space, and Slotkin sees a joint FTC-FDA approach as the most likely enforcement mechanism. He draws an analogy to illicit vape devices distributed through corner stores — the FDA lacked the field capacity to play whack-a-mole retailer by retailer — but argues that online peptide distribution is more amenable to desk-based enforcement. His prescription is straightforward: if a company claims oral tirzepatide works, it should publish the evidence. Until then, the field has zero human studies to point to.