TJ Parker returns as CEO of General Medicine to fix healthcare's missing retail layer

Speaker 2: We got TJ Parker back on the show. Four timer club. He's joining the four timer club. This is his fourth time on the show. TJ Parker,

Speaker 7: welcome

Speaker 1: Here he is.

Speaker 2: To TBPN. How are doing? Good. How are you? So you really you really said you really said take this job and shove it. Is that what you said?

Speaker 3: You know, I think I'd focus more on what I'm excited to go do now Okay. Which is general medicine. Yeah. Okay.

Speaker 1: Which is the Nikita beer of healthcare.

Speaker 2: Is that it?

Speaker 1: Yep. Is that is that kind is that kind of fair? I mean, some ways it feels like going going obviously going back to your roots and taking another crack at a similar problem in some ways.

Speaker 3: Yeah. And you probably know this, but ironically Nikita and I shared desks at Techstars in Boston in 2013, so it's particularly apropos.

Speaker 1: Gotta find that desk. We gotta put it in the Museum of Yeah.

Speaker 2: The most profitable...

Speaker 10: That's a

Speaker 1: billion dollar desk right there.

Speaker 2: A great desk.

Speaker 1: Yeah. I I had actually had no idea.

Speaker 2: That's crazy. Wow. But, yes, restate the mission, then we'll go into the decision to step in, what you're planning to do, where the company is now. But walk us through it.

Speaker 3: Yeah. I mean, I think our vision is super simple. We wanna make it just as easy to shop in health care as it is to shop for anything else in your life. Yeah. I think today, it's super convoluted. You have no idea what the price is for things. You don't really know what makes sense for you. And so we're trying to follow all the modalities in retail that we know works super well Mhmm. And apply those to health care. And so you can come to Gena Medicine for anything. It could be as simple as just need a renewal of a prescription or as complex as you've got this thing you can't figure out what's going on and you want advice, you want to go see an offline specialist. We just want to be the one stop shop for health care.

Speaker 2: Yeah. The front door. Is is there a... Like a secular trend here around consumers taking more initiative with their health care and actually knowing what paths they want to go down versus an annual checkup or just being responsive to there's a problem and my doctor handled it from start to finish. Has like the pattern of engaging with the medical system changed or is it changing right now?

Speaker 3: Yeah. I think there's two trends there that make sense. The first is that obviously in certain pockets of health care, consumers have gotten very accustomed to a much more seamless CX. Right? So it could be GLP ones. Yeah. It could be your annual wellness test. Like, there are these kind of very specific categories where consumers have gotten used to this, they've started to expect it across the spectrum of health care. And then the other obvious trend is that with the advent of LLMs, consumers are just far more, they far better understand what they might need at any given time. And so it's gotten them much farther down that curve. And the challenge right now is that the output of an LLM is still just giving them advice. It's saying, like, you probably should call the doctor and ask them this question or you should get someone to write you this prescription or you should go get this x-ray or this MRI or these labs. Yeah. And you're back to dealing with the health system as it's always been, is that's a super complicated process. And so I think that trend is is really important here where we're trying to close that gap from I know what I wanna do to actually being able to immediately execute that.

Speaker 2: What is your view on the AI models, the agents, like, just, you know, cloning your voice and setting up a Twilio account and calling the doctor for you and like basically just interfacing with the old system just as an AI.

Speaker 1: Creating as you. You're describing creating a deep fake of yourself.

Speaker 2: Basically. I mean that's kind of what's happening in some pockets of commerce. We're talking about a few million people testing this stuff out right now. It's pretty niche. But is that something where you think it's like that's going to be slower to take off more early adopter niche or you still have a plan and that will actually be accelerator for you?

Speaker 3: Yeah. I think AI and LEMS and agents are like very good at replicating things humans already do. I don't think there's a single human that would tell you this is a particularly good experience, and it's just administratively annoying. Right? And so I think if... Even if you take the AI doctor side of this or the agent booking side of this, like, I think that output results in replicating the current system, which I don't think anyone thinks Mhmm. Is particularly good. And so... And I think if you compare this category to all the other retail categories, like, we've had two decades of building marketplaces and infrastructure and booking experiences, none of that exists in health care. And so to actually make this work as elegantly as other categories, that's the thing you actually have to go build is what is this interface between digital and the traditional health care system. Is it

Speaker 2: going to be harder to scale the top of funnel without a hero killer product? I'm just thinking about the the previous companies that were like known as like the hair loss company. And then they did a couple other things like the ED company and then they did a bunch of... Or the peptide company and then they did a bunch of other things. Do you need like a beachhead offering to onboard people or is there a message that's resonating that's more broad?

Speaker 3: Yeah. I think if you asked me a decade ago and I think if you asked most people in the ecosystem, everyone assumed that these very vertical focused companies would eventually just chip away at category by category and ultimately go horizontal. So Amazon starting with books and then just like increasing selection.

Speaker 2: Yeah. It has to be an category of the early stage decks of like HIMs, Rome, and all those companies. Yeah. They all probably will will eventually be the Amazon of healthcare. Right? I imagine

Speaker 3: Yeah. That obviously hasn't happened. Right? So part of the theory here is that you actually have to be horizontal from day one. So customers can come to you for anything.

Speaker 2: Interesting.

Speaker 3: And I think there's a couple reasons for that. Like, if you just take the current version of offline care with a GP, like a primary care provider

Speaker 1: Yeah.

Speaker 3: Like, they serve everything, right? Like, you don't have to go to 12 different places to get everything you need. Like, you have... Like, you're used to going to one place for whatever you need. And I think the other vector that's relevant is that oftentimes customers, like, don't actually know what's going on. And like if you take ED drugs Mhmm. In particular, probably half the customers on those meds should be on something else treating the underlying issue. And so you end up with kind of a hammer nail problem Yeah. Versus being able to actually get customers to exactly what's most effective for them at that moment.

Speaker 2: At what level of abstraction can you interface with the healthcare system as a relatively new company? Like, if you're building a Fintech company, like, you'll just use Stripe for a lot of the, card processing and whatnot and then you do something fancy on top. Right? If you're building like an e commerce site. And with healthcare, there are there are companies that help with booking doctors and there's, you know, healthcare record systems. Like there has been a v like first generation, if not like a first and second generation of like med tech, health care tech companies. And I'm wondering like are those natural integration points? Or is the technology at a point where you can go deeper and interface directly with doctors or directly with insurance companies and you don't need to aggregate aggregators?

Speaker 3: Yeah. I think probably an unpopular opinion is that the data is actually out there now and the healthcare in many ways has the most open data because it's been federally mandated. And so as an example, when a customer sends up for general medicine, on average we're getting eleven years worth of medical records and they don't have to go log in to 12 different and go find everything. We just... We get it automatically. Yeah. And the other thing that's happened is the federal government mandated open open pricing files a handful of years ago, so providers have to contribute what their reimbursement rates are, to this central repository. And so when you combine these things, we can effectively give customers a clear cash and insurance price for any procedure or service with any provider and that doesn't require us having gone and done a bunch of deals with a bunch of offline systems that can do that on our own. I think then if you take the pharmacy side of this is a good example. We just launched our pharmacy experience. You can check out on general medicine like you're on Instacart or Uber Eats at 50,000 pharmacies across the country. So you can see like what is exactly my price going to be and just click buy like you do everywhere else and get the prescription at whatever pharmacy you want. And so we've, you know, we've really accelerated our ability to allow you to interact with anybody in the system. And I do think a lot of that is a byproduct of regulatory work that's been going on for a decade coupled with the capabilities of LLMs. And so I just don't think this would have been possible to build five years ago.

Speaker 1: What are your strengths and weaknesses as a CEO?

Speaker 2: Job interview, mister

Speaker 3: Drake. Really good at tweeting. I had a really good day on the on the timeline today, so that's that's my biggest strength for sure.

Speaker 2: Pretty important these days.

Speaker 3: Yeah. Weaknesses. I don't know. I try not to talk about those too much. I mean, I think, like, for me, like, I was so excited to get back to building partially because it's a bunch of people I've worked with for ten, fifteen years. And, like, we've built an amazing team across the org. And so, yeah, in many ways, an amazing team and getting to work with that team to to build stuff.

Speaker 2: Do you see yourself in five years?

Speaker 1: I I... I'm curious, like, what... You know, from from PillPack, there's certainly like 10 massive mistakes that you made and then you did probably like a thousand things right and that worked out to an amazing outcome.

Speaker 2: Yeah, totally.

Speaker 1: Are there like this time around, is it really you're just sharper, more knowledgeable? You probably know that you can actually go way bigger this time than the last time because why? What's the point of of, you know, running it back with the team if you're if you're not gonna reach even higher highs? But is there any any anything that that stands out as, like, we're definitely not gonna do that even from, a, you know, hiring standpoint, mistakes that you made building the team the first time around?

Speaker 3: Yeah. I mean, the the the thing that I definitely wouldn't replicate that we did at PillPack is we were just fundamentally misaligned with other partners and participants in the ecosystem. Right? We had this big battle with incumbents. That was just being young and naive, and obviously, it worked out in our favor. I think that there's a big difference with general medicine, is I think we are ultimately trying to refactor the system around the consumer. And in many ways, that solves a bunch of problems for other participants in the ecosystem. So that's probably the biggest strategic difference. I think tactically, like we've spent fifteen years like in the guts of the healthcare system, like deeply understanding all the underlying rails, like what's truly possible and not possible. And so in many ways, it's... That is probably the biggest difference is that you've got a decade and a half of understanding of what you can really do in health care. Then coupling that, like, really niche expertise with how does that manifest as, a differentiated customer experience, I think is what we're we're uniquely good at is sort of being in the weeds over here, but then abstracting it away so that for the customer it's just got... It was super simple and they don't really need to understand, like, how hard it was to make it that simple.

Speaker 2: The Jaguar type o one has leaked. Is this a good car for the modern healthcare CEO?

Speaker 3: I think I'm out. I'm going to stick with my Raptor R which is probably the right healthcare CEO car.

Speaker 1: Yeah. Like that. Truck. Truck. Is there any type interesting why now because people are spending... Like it is such a better experience using an LLM to understand a health issue you might be having versus historically you know, Google to WebMD to Reddit and you're like trying to find somebody else who's had like a similar experience or whatever it is, and now you can have a conversation about it. Now you can involve, you know, whatever it is, like images. Now it even has like memory, so it can it can sort of tie things together. But it feels like that like you're... It feels like you're exactly the kind of business that should be advertising in LLMs, is like... Yep. Because it can be done in a way that's not even personalized, which I think people are gonna be a little bit wary of. But you can just, like, if somebody's using a free version of of ChatGPT, you could just slot in and say, like, hey, like, we know you're kind of... Like, you can... Here's how you actually solve your issue versus just staying in the sort of digital realm learning.

Speaker 3: Yeah. I mean, I think, obviously, the first iteration of this product is our storefront on generalmedicine.co. I think we assume that there's gonna be all sorts of different ways consumers get access to these products and services. And going back to the the retail example, like, know exactly what that looks like. Right? The Shopify SKU pops up in an LLM. You can immediately add to cart and purchase in one click. Like, there's no reason that same CX shouldn't exist in health care once you have this infrastructure layer built. And I... So I think consumers are gonna... Whether it's an agent and they're literally never really interacting with us or it's like Shopify and it's a SKU that pops a model, like, we're... I think we're building the hard part of that CX, which is the underlying infrastructure to make that work. Amazing news. Well, congrats on the new

Speaker 1: Glad to see you back in the game. You had you had you had a good few years as a capital allocator just just hanging out, begging people to let you give them money, but you're back back in the driver's seat.

Speaker 3: Yeah. We're... The problem is I wasn't a good enough golfer. It's pretty depressing to play golf like three days a week and still sucks, so I had to get back to operating. Here we go.

Speaker 1: Back at it. Back at board room. Awesome. Super super excited for you and Yeah. And the whole and the whole band. Yeah. It's gonna be a a great run.

Speaker 2: And so much for coming. Great to see you. We'll talk to you soon. Let me tell you about public. Investing for those who take it seriously.