Pod Insights Summation with Auren Hoffman Hello Patient CEO Alex Cohen - SaaS sprawl and meme culture About this episode Alex Cohen is the co-founder and CEO of Hello Patient, a healthcare AI company that streamlines scheduling and patient management for medical practices. In this episode of World of DaaS, Alex and Auren discuss: The hidden costs of SaaS sprawlWhy specialized tools beat all-in-one solutionsBuilding relevancy through niche contentThe future of health data and personalized medicine Looking for more tech, data and venture capital intel? Head to worldofdaas.com for our podcast, newsletter and even...
Transcript 11,656 words · 2 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:02 Auren Hoffman? Hello, fellow data nerds. Welcome to World of DAS. I'm your host, Orin Hoffman, CEO of Incubate and GP of Flex Capital. Discover more episodes, get weekly data as a service news, original content, articles on data and more at worldofdaas.com. That's world of DAS, D-A-A-S, dot com. Hello, data nerds. My guest today is Alex Cohen. Alex is the founder and CEO of Hello Patient, a healthcare software company that uses AI to agents to automate patient scheduling and communication. You've probably also seen his tweets under another Cohen on Twitter, which I'm a huge fan of. Alex, welcome to World of DAS.
0:43 Speaker 01 Thank you for having me. I'm excited to always chat things Twitter related or whatever, wherever we get into today.
0:49 Auren Hoffman? Super excited. So you write a lot about SaaS and SaaS sprawl and stuff. What are some of the worst examples you've seen of SaaS sprawl?
0:57 Speaker 01 Yeah, it's interesting. I don't know if many people know this, or maybe they do, if they follow me on Twitter, but before going into Hello Patient, I was working on a side project called Spendoso while I was at Carbon Health. It was our nights and weekends thing to basically go and build a self-service way for a company to go actually see all the different SaaS tools that they were using and spending on and all this fun stuff. And I'm hoping, talking to a friend about reviving it and maybe doing some stuff with it at some point.
1:24 Auren Hoffman? It's a great idea. I kind of wish you built that as a real company. It's like so, so awesome.
1:29 Speaker 01 Yeah, there's many companies doing it. And that was actually the impetus for doing it. At Carbon, we were going through a big exercise of cutting costs, and I'll talk about the SaaS sprawl there. But all these companies wanted enterprise contracts to cut your enterprise contracts. And I was like, I don't understand why we're going to pay more money to cut money. What are we doing here? And so we ended up doing the entire exercise ourself internally. And that's what led to the idea, let's go build this as a productized way that anyone can just pay a couple hundred bucks a month as a company and the VP of Finance can now go in and see exactly how much you're spending on SaaS tools. It's pretty amazing to me. The biggest, most memorable SaaS sprawl experience from at least onboarding customers
2:11 Speaker 01 to that company was we had one company that signed up, and I think they had 700 apps that they had had connected to different accounts across the organization.
2:19 Auren Hoffman? And is the best way just mining emails?
2:22 Speaker 01 We mined the Google OAuth logs and the Okta logs.
2:25 Auren Hoffman? Got it. Okay.
2:26 Speaker 01 Emails are actually probably more accurate, but then you have to know what emails you're looking for.
2:31 Auren Hoffman? Yeah, good point. It's a lot harder.
2:33 Speaker 01 We saw 700 unique apps connected to their Google accounts across all their employees. And the funniest thing was we had to let one of the companies know because we were still figuring out at the time what we were going to build. But apparently people on their team had been logging into Grindr using their work accounts.
2:49 Auren Hoffman? That seems a little weird. Okay.
2:51 Speaker 01 Yeah. And so they were like, yeah, we don't want that because that's another piece of this. If you have employees signing up for every tool under the sun, what are those tools of access to in terms of company data?
3:02 Auren Hoffman? Yeah, exactly.
3:03 Speaker 01 There becomes a bit of an information security risk, but yeah, 700 apps. And I think they were spending a couple of million dollars a year on SaaS alone. And I'm over here like, this is pretty crazy and insane. Also fun to see that our tool is actually finding all of that for them. It's very easy if you're a company to just let it get out of control very quick.
3:21 Auren Hoffman? Yeah, it's really interesting. Now, there are probably a million books on how to hire and manage people. Every MBA has all these very, very detailed courses on it. We all talked about it. We've all had all these interesting discussions about it. But there's no good book that I know of about how to select and manage your vendors. There's no MBA course that I know of that is taught on that. Rarely do people ever even have a discussion about that. Yet, almost every single company has way more vendors than they have people. They are managing way more tools, whether it be SaaS tools or their law firm or, you know, whatever it might be that's out there. How do we get more competency about that side of the world?
4:05 Speaker 01 It's a really interesting point, actually. No one knows how to evaluate vendors and vendors don't make it easy to evaluate them for the most part. I think is part of the issue too, is if I want to go sign up for a new HR workplace tool, Workday is not going to go give me a trial.
4:22 Auren Hoffman? Yeah.
4:23 Speaker 01 You're just going to end up talking to the sales team for two months before you ultimately commit your life savings away to go sign up for them. It's really hard. Even when I was at Carbon and we were evaluating vendors, we didn't have a process for it. We didn't have a good structured way. I ended up ripping out our entire call center software and putting in an entirely new call center system while I was there. And I went through a two-month evaluation period going and looking at Five9 and Talkdesk and Genesis and UJet and AWS and all these. And I made up my own thing. I made up my own spreadsheet to say, what are we looking at? How does this company rank for this category? And how am I supposed to rank them when I've never used the product? So I'm just going off of what I think they're good at.
5:07 Speaker 01 I think it's like trying to stiff-arm vendors into letting you do trials or in the contractual period, the ability to get out and trying to do as light of a lift as possible with a vendor, I think is probably what it comes down to. And then when you have every self-service tool under the sun, I think you just have to have really, really good monitoring and infosec policies in place to be able to say, it's fine if you want to share your email with this company. It's not fine if you're giving some random company access to your drive folder and your docs and your sheets and our finance tools. It's hard and the average company has hundreds of tools that they use because no one is that good at one particular thing. And we'll get into my banned apps list.
5:47 Auren Hoffman? And also for a couple hundred bucks a month, why not? If it's going to help you in some sort of way, be marginally better, why not?
5:55 Speaker 01 Yeah. And this is a dilemma that companies get into. ClickUp is on my banned apps list and they have tried to do everything. They're the everything app. And it turns out if you try to do everything, you become really shitty at every single thing that you try to do.
6:09 Auren Hoffman? Yep.
6:10 Speaker 01 You kind of need specialized apps.
6:12 Auren Hoffman? The six best at each thing or something.
6:16 Speaker 01 Yeah, it's like Notion. It's the same thing for me. It's like you're not that good at being a CRM. You don't have real spreadsheets inside of your app. You don't have file management. So what am I using for? Pretty notes, basically. When you have these everything apps, that's my frustration is I actually want the specialized tools.
6:31 Auren Hoffman? Interesting. I love your list of banned apps that you won't use. What are some of the other cardinal sins there?
6:37 Speaker 01 I think Karta is on that list now and hopefully they're not a sponsor of the podcast, but everything around their managing of customer information and client information, all the things that got leaked about them doing marketing campaigns to folks to try to get them to sell secondary.
6:55 Auren Hoffman? What does Hello Patient use for their cap table management?
6:59 Speaker 01 Angel List Equity. Yeah. And they've been great. I mean, I can't say good enough things about them, but Karta's reached out. I'm like, never.
7:06 Auren Hoffman? Oh, wow. Okay. You don't want to say that. You need to say you'll consider Karta so you can keep your Angel List bill low.
7:13 Speaker 01 That's true. That's true. Well.
7:14 Auren Hoffman? If you're listening to this podcast, yeah, yeah.
7:16 Speaker 01 Dan at Angel List knows that I'll tweet meanly about them if they try to get me into a higher tier. But yeah, look, that's one of the cardinal sins is don't do shady practices.
7:27 Auren Hoffman? Yeah.
7:27 Speaker 01 If I own stock in a company and you now are telling people that and you're leaking confidential information, even if I agree to it in some deep terms of service that you hit it in, that to me fits into the cardinal sin.
7:41 Auren Hoffman? Okay. Interesting. What about some of these UIs are so bad that they don't care about the user clearly. Salesforce, it's just clearly doesn't care about the users. They might care about their ultimate customer who's running the report somewhere, but they don't care about the average user. They couldn't care less. LinkedIn couldn't care less about the average user. They make it so hard. They make everything so slow. What about those types of things?
8:08 Speaker 01 So at some point you have to make a decision and choose between the worst of all the options and say, well, it works. I'll deal with it.
8:17 Auren Hoffman? Workday also is just terrible. They clearly don't care about anybody at Workday. By the way, this is why we don't have any sponsors on World of Desk. Nobody would sponsor this podcast because we're shitting on everybody.
8:28 Speaker 01 Yeah. Salesforce, it's so interesting when you have a company built and it's so complex and hard to use that you have to have an entire business built around consultants to make it work. You then have to ask the question, is it us or is it everyone else?
8:42 Auren Hoffman? Yeah, it is literally probably the worst product I've ever seen. And it hasn't changed at all. I don't think since 2004, 2005, maybe 2006, they made a major upgrade or something. I'm not sure.
8:53 Speaker 01 Yeah. SAP Concur is the same way.
8:56 Auren Hoffman? Yeah, luckily I've never used Concur, so I have no idea how it is. I've never worked for government or something.
9:02 Speaker 01 We had it at Carbon. Someone decided that Concur was going to be our expense management tool.
9:07 Auren Hoffman? Oh my God.
9:08 Speaker 01 Yeah, they switched to Brex. They switched to Brex. Fire them.
9:12 Auren Hoffman? Please let me know that name of that person so I can make sure that none of the companies are worth it ever hire that guy. That's just clearly a bad employee.
9:20 Speaker 01 I know. And then you look at these tools and in my case, I had a company Brex card for if I were traveling and stuff. And I was like, you guys chose to use Concur. Now I'm not going to do expense reports and they're on the company card. So it's your problem. Not my problem now. It's so hostile. You don't even want to go into the tool and it's really funny. Every time I tweet about one of these companies and I'm like, I will never use ClickUp or Concur or Notion. The CEO or an exec reaches out like, oh, sorry to hear that. Can we brainstorm and pick your brain and learn how we can do better? And I'm just like, no, it's going to be a waste of both of our time. You are not changing your product strategy because one shit poster told you that your app doesn't work for them.
10:00 Auren Hoffman? Plus it's not easy to change your product strategy. That is a super hard thing to go do. Now you are a big fan of a linear.
10:07 Speaker 01 Yeah, purpose built, fast, eye for design and works. I mean, generally I like tools that work. I use granola. Granola is a new tool everyone's talking about.
10:16 Auren Hoffman? Love it. They're amazing. I use it too.
10:19 Speaker 01 Yeah, it just works. It's in the background.
10:20 Auren Hoffman? Simple. They do a good job.
10:22 Speaker 01 I wish they had some more stuff like maybe team notes or you could tie it to projects and stuff, but they'll get there.
10:29 Auren Hoffman? Yeah, of course, the more features you add, then it'll eventually just you'll have the sprawl or something.
10:34 Speaker 01 Yeah, I mean, we use Figma, another great tool. I don't, I'm not a designer, but I make memes in Figma occasionally and the tool works. It's really funny, too. I used to never pay for apps or never wanted to on a personal preference. And then as someone who built consumer apps, my entire mentality shifted. I was like, support the developers. And that actually has translated into my personal relationship where my wife will be like, do I buy this fitness app or do I buy this nutrition app? And I'm like, will it make your life better? And she says, yes, I'm like, just spend the $10 a month. Who gives a shit? Spend the $10 and support the developers. I have so many subscriptions now.
11:10 Auren Hoffman? Yep. So do I. If I could see all of the applications that your company uses, it is kind of like a DNA.
11:19 Speaker 01 Yeah.
11:20 Auren Hoffman? There's no two companies that are the same. It's a clear fingerprint of your company. But unlike many fingerprints or DNA, or maybe some DNA, you could learn, okay, you've got roots from this place, or you have this kind of prevalence to disease. Like that, you can learn quite a lot. If you, all I saw was a company's vendors. I can probably tell you almost the year they started. I could probably tell you all these others. I can tell you roughly the number of employees they have in the company. I could tell you how international they are. I could probably even benchmark the revenue from that. I could tell you so many things and then I could tell if I want to invest in that company or not.
12:02 Auren Hoffman? Today, if you're not using one of these AI-enabled IDEs, if you're a software developer, okay, well, you're probably not a company I'd want to invest in.
12:10 Speaker 01 Yeah.
12:12 Auren Hoffman? Can we just somehow get that information and then just decide how we want to invest in companies based on it?
12:17 Speaker 01 That's so interesting. Yeah. One of the due diligence pieces is send us your SaaS stack so we can evaluate.
12:22 Auren Hoffman? Well, or just send us your off, same thing.
12:25 Speaker 01 Yeah.
12:25 Auren Hoffman? We'll use another service to go do that. And based on that, well, we'll change your valuation.
12:29 Speaker 01 Maybe I need to repurpose Spendosa now for underwriting, but it's interesting. I get investor updates from companies and they're in Notion. I'm like, oh, you fucking use Notion. And I lose some level of confidence in the company. Cause I'm like, you're managing your whole company on Notion.
12:43 Auren Hoffman? Interesting. Now, one of the best companies I'm an investor in does do that. They send investor updates in notions. I don't know if there's a perfect
12:50 Speaker 01 No.
12:50 Auren Hoffman? correlation or anything.
12:51 Speaker 01 But if you're a three-person company using Teams, maybe I reevaluate your judgment on what tools you're going to go, like what you use.
12:58 Auren Hoffman? That's true. That's true. And by the way, I've literally never seen a three person company using Teams. But you're right. If I did see that, I probably would reevaluate really quickly.
13:08 Speaker 01 Yeah.
13:09 Auren Hoffman? It's like imagine if somebody, yeah, if they're emailing you from AOL.com email or something, you're probably not going to invest in them.
13:15 Speaker 01 No, or they're still using a Yahoo email. I question their security practices and judgment.
13:20 Auren Hoffman? Yeah, everyone says you got a resume and it's at Comcast.net. You're like, seriously? You want me to hire you at a tech company? No, I don't know. Can you see some discrimination? I'm not sure. So I'll probably get eight lawsuits coming in after this podcast.
13:33 Speaker 01 That's funny. I know the tools definitely make up our DNA though, as a company. It's pretty interesting. We use Google Meet and G Suite for everything. And maybe that shows that we're capital efficient because we won't pay for tools that we don't need.
13:46 Auren Hoffman? Yeah, exactly.
13:47 Speaker 01 You know, my doc right now, I've got Superhuman Slack, Spotify, Granola. I don't even know what app that is. Figma, Outline.
13:57 Auren Hoffman? What's Outline? Never heard of that one.
13:59 Speaker 01 It's internal wiki software. So we use it to basically create a super fast wiki for all of our internal customers that the QA team, when they're reviewing conversations, can go look up information about that company.
14:10 Auren Hoffman? That's your answer to Notion or something?
14:13 Speaker 01 Yeah. And I guess Notion would have solved this for us, but Outline was 10 bucks a month, up to some absurdly cheap amount. And it just works. All I wanted was give me a wiki with markdown editing and super fast search. And Outline did that. It is really interesting, the stack that you set up when you first start a company. And there's a whole checklist now of what to go through. Who do I need for incorporation and for filing and for business banking and for security and all that stuff?
14:39 Auren Hoffman? Yeah. I mean, just the UI of Mercury as opposed to an SVB is nine day or something like that.
14:45 Speaker 01 Oh God, yeah. We use Citizens right now. And I love Citizens because there comes a point where you say, fuck my bank account. I need someone who can give me a load when the time comes.
14:54 Auren Hoffman? Yeah.
14:54 Speaker 01 So we use Citizens and they're amazing from a relationship perspective, but it is painful sending wires and doing anything inside their tool.
15:01 Auren Hoffman? Why do you need a loan? Is this more capital efficient to do that?
15:04 Speaker 01 No, they'll give me a mortgage as a founder. Because now I have an unprofitable tech startup. The traditional bank is like, you're very risky and Citizens is like, no, you're good. You bank with us.
15:16 Auren Hoffman? Ah, I got it. But you gotta bring your business stuff over or something like that.
15:19 Speaker 01 Yeah, exactly. So we do all of our business banking with them. They have a whole startup program and Mercury was great, but Mercury doesn't do mortgages.
15:28 Auren Hoffman? Yeah, makes sense. Okay, it's a new product they've got to add on. How do you think about all these new coding tools, dev tools, these cursor bolt dot new? There's just new things that are coming up every single day.
15:40 Speaker 01 Yeah, it's interesting. I think everyone tries to equate these tools to a coworker. I have this coworker AI assistant or have this coworker finance assistant. And generally someone who is building the coworker for patient engagement, if you were to use that same analogy. And it's sexy marketing, whether that's the real thing, I'm not entirely convinced yet. You just have to treat these things like interns, frankly. If you don't discreetly define the work that you want the agent to do and this scoped way of the output that you're expecting, I think you end up with really poor results, frankly. And it's worse than just hiring someone. And so with these coding assistants, and I'm not a software engineer, but from everyone I've talked to, they're great.
16:25 Speaker 01 If you're like, I need this thing, it has to look like this, use this stack, go do this thing. And you give it enough instructions that it's operating within the constraints of what you want. If you were to build an app from scratch, I'm sure one of the tools could do it. Is it going to be the right way to build? Probably not. You just have to treat it like it's a junior level employee that just takes tasks. You're micromanaging your tools, basically.
16:53 Auren Hoffman? And the nice thing is that over time you make quick modifications and all the future ones will use that. Your prompts are going to get better and better over time at looking at, oh, don't do this or take this thing out. Whereas with the, I guess it's the same thing. If you had a junior employee or even a more senior one, you're going to give them feedback over time and they're going to internalize it. It may not be necessarily written down, but and then over time they're just going to get better and better. It's kind of like the same kind of thing, except if that employee leaves, you have to do it all over again with an employee. Whereas here you've got it all, you've got the prompts all down and you could probably move to three other tools if that one's not working as well. It starts to get more expensive or something.
17:33 Speaker 01 Yeah, that's a fair point for sure. I think you just have to go in with the expectation to be more productive. I have to tell it what to do and that's totally fine. I write SQL queries using chat GPT and I just tell it what I need and exactly what I want. And it will produce the thing and it saves me the 80% of the work to go write the entire query. And the last 20%, I'm happy to do, which is refining it in the way that I need it. And that's generally true, I think, for most AI assistants so far. These AI SDR tools have incredibly high churn because they can't do the last 20% that well. They're fine at the first 80%. But even with what we're seeing at HelloPatient, we're learning every single day, something new with the conversations that are happening with real patients.
18:16 Speaker 01 And then we are refining the prompts and those apply, we call them global prompts, but across all the different practices. There's two parts to this. One is how good are you at prompting? The other is how smart is the model?
18:27 Auren Hoffman? Yeah.
18:27 Speaker 01 Both of those things will get better over time and hopefully eventually you don't even have to think about good prompting. It's just the model is so smart, but I think we're kind of far from that.
18:35 Auren Hoffman? Yeah, I agree. I've had results where things where I'm doing many times, you can get good at it. The problem is a lot of times you're using these things for things you need right now. It's a new thing, never really done it before, so research this or do this type of thing. And then it takes so long to think of all of the prompts, all that, at least for me, I'm not super well trained. That it's just a lot easier either to tell someone else to do it or do it myself rather than like have it get done. But if you're doing it over and over and over again, then it kind of makes sense to invest, just like having an employee. A lot of times you just do it yourself, but at some point you're like, okay, actually the way to get real leverage is to have someone. And in that case, it makes sense that I can do it over and over and over again on that.
19:18 Speaker 01 For sure. We have to invest heavily in the prompts of what we're doing because it's an agent that's operating without us in the middle for all these conversations. So we just have to get really, really good at teaching the team. Here's all the things that go into all these prompts. And as the prompts improve, the conversations improve and you start to learn how the agent responds to different ways of giving it information. And it's just so interesting, the world in which we're going into is the people who are really good at writing and communicating will probably win because that is the way that you interact with your LLM.
19:49 Auren Hoffman? Now, you're an amazing meme poster slash shit poster. What advice would you have for someone who wants to get better at this? I think this is almost like the key skill of our age.
20:02 Auren Hoffman? What advice would you have for someone who wants to get better at this?
20:05 Speaker 01 That's interesting. I've been writing a document for myself and to share, we'll see, I'll share it to you when I'm done with it. If you want to read it.
20:13 Auren Hoffman? Hundred percent I want to read it.
20:14 Speaker 01 It's like, I forgot what I officially have it called, but I think it's something along the lines of how to become a Twitter shit poster. And I'm not planning on sharing it broadly and widely. It's mostly.
20:28 Auren Hoffman? Just share with your friends, name, or.
20:30 Speaker 01 Yeah.
20:32 Speaker 01 Anyone whose name starts with an A will get it.
20:34 Auren Hoffman? Yeah, okay, perfect.
20:35 Speaker 01 But I've been thinking about this a lot, why I got into posting, how I started doing it. And ultimately, I reflect, I mean, I've been on Twitter since 2011 or whatever, but not actively. It wasn't until 2019 that I became active on Twitter, at least not posting super cringey replies. I was a reply guy for a while and I deleted most of those tweets, I think. I started in this niche circle. And so I think ultimately what it all comes down to is relevancy. It's how do we stay relevant on the internet? Because that's the most important thing. The next time you want to go sign a deal or go meet someone, they remember you and they've seen you online. So there's this aura of relevancy and it is a lot easier to
21:16 Speaker 01 stay relevant within a niche than it is to be a mass market. You have to be a celebrity.
21:21 Auren Hoffman? So if you're just about basketball in the NBA or something like that, it's a lot easier to stay in that niche than if you're like, oh, by the way, I'm also going to talk about politics. Oh, I'm also going to talk about the environment. I'm going to talk about science. Oh, by the way, I'm going to spring on some venture capital.
21:33 Speaker 01 Correct. Yeah. And eventually you get to a point where you are posting across everything. But even now, today, I would consider my content niche tech content, VC related startups, whatever. When I started, it was all fintech related. The people who I engaged with online were fintech. The people who read my content were all fintech related. I was working in financial services at the time. And I reflect back on why the content worked. And it was because I actually had original thoughts. The thing that I was best at and in my zone of genius was not just the posting, but it was the content that I was posting.
22:06 Auren Hoffman? Yep.
22:07 Speaker 01 I think you have to have original content that people care about to start becoming relevant. And then to stay relevant, you continue to post.
22:13 Auren Hoffman? That's the hard part. I'm hoping for the easy things, like making original thoughts that are super interesting and relevant. That's not an easy thing to do.
22:22 Speaker 01 I was at a dinner last night and someone asked similarly, do you plan all your content? I was like, no, I just fire from the hip. I don't know what I'm going to post on any given day. Some days I don't post anything. Some days I send out eight tweets. I literally don't know. It's however my brain is functioning that day. There's no rhyme or reason to it. For me, it's been an outlet. I don't write blogs online or anything. I just tweet. Twitter became my personal blog and 60 second dopamine hits and I'm fine with that. And I think people who try to plan their content and write these very elaborate, strategized posts with just the intention of gaining followers. Just go to LinkedIn. What are you doing on Twitter? That's my approach to Twitter. Find a niche that you love and that you're good at.
23:03 Speaker 01 Write content, shoot from the hip, engage with other people who you find interesting. And don't really focus on the outcome. Just focus on great inputs into your twittering or X-ing, whatever we call it these days.
23:15 Auren Hoffman? I don't have nearly as good of a Twitter presence as you, but every once in a while I'll have a tweet that'll blow up and I'll have 200,000 views, which is for me a lot of views. I don't usually get that many. And I'll get three new followers from it. It just doesn't seem like they convert at all to new followers.
23:31 Speaker 01 It took me a long time to get to 200,000. I was stuck at 150 forever. Again, I don't know what actually converts people to following. Elon, if you're listening to this, make it easier.
23:43 Auren Hoffman? To understand. Yeah, exactly.
23:46 Speaker 01 I don't know how many views I get in a particular month or year on Twitter, but it doesn't really convert either to a ton of followers. A lot of the laying off tweets do, for whatever reason. Whenever I joke about getting fired, for some reason, people like that. In the last four weeks, we've had 22 million impressions with a 4% engagement rate, 236,000 people visited my profile and I probably gained a couple thousand followers. It's not super high conversion.
24:18 Auren Hoffman? Not a lot, right?
24:20 Speaker 01 But in the last year, I've done 330 million, that seems wrong, 330 million impressions in the last year. I think that that's low.
24:28 Auren Hoffman? Twitter doesn't even do a good job of helping you find where your stats are.
24:31 Speaker 01 No, I had to go find this in a setting buried somewhere.
24:34 Auren Hoffman? Exactly. It's in some really buried setting. It's like, they don't really want you to know about it. Isn't that something people would want to find out about?
24:42 Speaker 01 So 80% of my followers are male, 20% female.
24:45 Auren Hoffman? That's not a surprise, right?
24:47 Speaker 01 Majority are between 25 to 44 years old. That checks out. 65% are in the United States and 5% follow me in the UK. So I probably need to shit on the UK a bit more, actually, saying this.
25:01 Auren Hoffman? Okay.
25:03 Auren Hoffman? You're looking at your four week stats, right?
25:06 Speaker 01 I looked at four weeks and even the last year, it says I've had a million and a half people visit my profile in the last year.
25:13 Auren Hoffman? From there, they don't even tell you how many followers you got from that?
25:16 Speaker 01 Not that I can tell.
25:18 Auren Hoffman? Which also is weird. You would think that's an obvious thing that they would be able to tell you from.
25:22 Speaker 01 Yeah. They tell you which of your tweets have the most impressions, which is pretty interesting. That's Twitter, though. So again, I don't have the answer to what actually converts people. I just recommend firing from the hip and seeing what lands and continuing to double down on content that you're good at.
25:40 Auren Hoffman? If you saw someone who's starting to have a ton of engagement on Twitter, I think it's clearly someone I want to back if I'm investing in an entrepreneur. But would you want to hire this person?
25:52 Speaker 01 That's a great question. I think there, at some point, they become a bit of a brand risk, for sure. We just saw this with the payroll company. I think they're called Warp. And one of the people who worked for Warp went on this super racist rant online or on Twitter. And then the CEO got called out and then all the stuff started to leak in their Slack messages. And there's only downside to that. I think you can definitely hire great people who have Twitter personas. I haven't yet. So I don't, I don't, I don't know.
26:25 Auren Hoffman? Got it. Now you're an entrepreneur, but you were working for companies before. You clearly already had a Twitter persona when they hired you. But would you really make a better founder than an employee?
26:36 Speaker 01 I think that there is definitely this element of you want to build your public brand. They might go one in the same. If I'm an employee, I may be a little bit more constrained to the content I can post online. And because I'm restricted, I don't end up posting what I want to. That's why a lot of people have anonymous accounts. When you're a founder, you can have a bit of free for all. It is risky. We've seen founders get canceled and everything tarnished because of their personal brand. I think what it tells me when I see a founder who's got an audience. It's very black or white either. They're going to be a terrible founder. They have a crippling addiction to Twitter. All they care about is their online brand. Or they're an incredible storyteller and communicator. It unlocks the superpower that they have. I don't really think anyone falls in the middle.
27:21 Speaker 01 I think you're on one side of the equation.
27:23 Auren Hoffman? When I'm on Twitter, it is taking away time from my company. Maybe it's good. It's always hard to know. Is this a net good or net bad for a company? I mean, it's fun. I'm having a good time, but I also have a good time hanging out with friends. Which mean I'm not doing enough because I'm on Twitter.
27:39 Speaker 01 I think Twitter has only been a net positive for the work that we're doing. Our ICP is not really on Twitter as much. They're more on LinkedIn. Probably have to go flex the LinkedIn muscle a bit more. But if you go look at my tweets while I was an employee, I was tweeting a lot more than the last nine months in starting a company. Cause you just lose the time and you lose the focus, you lose the motivation. For me, it's never been about follower counts or X pays like shit. So it's not about money. It's not like YouTube where you become a celebrity off of Twitter. But I just enjoy the love of posting. It's my writing outlet. I don't really write anywhere else.
28:15 Auren Hoffman? It's creative. Yeah. It's interesting because where I'm a small investor in your company, I got to know you because I followed you on Twitter. That's where I knew first, even before you did the company. And the main thing I got to know you first, well, you make me smile. I laugh and you make me smile. You say interesting things and stuff like that. But I do think it must be good for business at a certain point, especially at your level. And you're not at the Elon Musk level, of course, but at the 200,000 follower level, it must be a good thing for business.
28:45 Speaker 01 Yeah. Basically, what I would say is 99% of the people that I want to get in touch with will respond to me now because of Twitter. Elon won't write me back. I've tried DMing him. The majority of people will engage back and I've met so many people I would never have met had it not been for Twitter. For example, the CEO of ZoomInfo gave us a year of access to the product because he just follows me on Twitter. And I didn't even know he followed me. It's random things like that where all of a sudden, this goes back to the relevancy point. It's actually very beneficial staying relevant on the internet. If you can do it in a way where you just continue to not piss people off or alienate them. And that piece has been amazing.
29:27 Speaker 01 We have direct access to the majority of people that we would need access to, so long as they use Twitter primarily. It's funny, though, do you want to know where I first became familiar with your content?
29:38 Auren Hoffman? Okay, tell me.
29:39 Speaker 01 Can you guess?
29:40 Auren Hoffman? Quora?
29:41 Speaker 01 Yes. Yeah.
29:42 Auren Hoffman? Okay, yeah. Back in the day, I was big on Quora.
29:46 Speaker 01 Yeah, you were a prolific Quora poster, if I recall.
29:49 Auren Hoffman? Yeah. I wish they were still popular. I just stopped posting because no one's there anymore, but I would have kept doing it. Then I only got people in India. No one in America was there. And then no one in India was there anymore. I was like, I'm not even getting people in India anymore.
30:02 Speaker 01 That's amazing. Yeah, life comes full circle because when I was, I think even in college, I would use Quora to look up answers. And again, that goes back to your profile photo, the black and white one has stuck it ingrained in my memory from Quora, from all the questions that I read. I mean, because you used to write about all the venture capital and fundraising and stuff.
30:21 Auren Hoffman? Yeah, I followed your strategy, that niche-y thing.
30:24 Speaker 01 Yeah, exactly. And then you become relevant and people are like, oh, who do I go race from? Who do I go ask questions to? I gotta go talk to Orin. I gotta go ping him. It's easier to stay relevant within that niche or several niches because that's the content that you know and that you live in and people love that stuff. R I P Quora, but.
30:40 Auren Hoffman? The reason I did that is I copied Jason Lemkin. He was on Quora. And I was like, oh, I like his content. I'm just gonna copy him. So I went on there myself. I just had to exit. So I was like, okay, well, I don't have any boss now. I can just go do my thing.
30:53 Speaker 01 And he has great content, even on Twitter. So he's the person who I point to.
30:57 Auren Hoffman? Oh, he's amazing.
30:59 Speaker 01 I'm like, you have questions about hiring sales staff? Go read one of Jason's posts. If you want to go learn about SaaS, he's the guy to go talk to. And that's his brand. That's his niche. He knows everything about SaaS. Going back again, bringing this theme back to how do you get better at posting online? You might not know that your content is originally in your head. It's very simple. It's the thing that you know. It's not that creative. Everyone knows about this, but most people really don't know about those topics.
31:26 Auren Hoffman? It's interesting because there are some people that you I follow that lots of people follow, but there's also some people I follow who have a few thousand followers who write some pretty niche stuff. And they're in my feed every day. To me, they're famous.
31:39 Speaker 01 Yeah.
31:39 Auren Hoffman? I think that they're famous because I really value their content. They're writing something very interesting. I care about, but maybe not enough people care about, or they're not discovered yet, maybe. But sometimes I'll see who else is following them. And they'll have eight billionaires that follow them. They only have 2,000 followers or something. And you're like, oh, my gosh. So they are influencing people in a very interesting way.
32:02 Speaker 01 Yeah, you don't need hundreds of thousands of followers to really have influence online. I do think, again, it's all what's important. What category do you want to stay relevant in? For me, I just post a bunch of dumb tech content, tech adjacent content. I try to avoid politics and religion and all the other things.
32:19 Auren Hoffman? Got a decent number of politics ones too.
32:21 Speaker 01 Memes, but memes. I'm not trying to share my conspiracy theories or what side of the spectrum I'm on. Because none of it matters. There's some stuff where it's only downside. You could think about a number of folks recently who have gone very deep into the political content posting. I'm sure it's working great for them, but in the group chats, it's getting annoying after a while is the theme that you start hearing. And even October 7th, I got a lot of backlash for posting. It's the one thing I've posted is support for Israel. And then the amount of backlash you get in the comments. I'm not making a difference generally. So why am I posting about this stuff? It's only downside.
32:56 Auren Hoffman? Yeah, yeah, it's a good point. Now, we talked about vendors. One of the more, I would say, hated vendors in healthcare is Epic Systems. When you poll people in healthcare, they're probably the number one hated vendor, I presume, or I'm not sure.
33:12 Speaker 01 Maybe Cerner. Cerner might be above them.
33:14 Auren Hoffman? Okay, Cerner, yeah, good point. Yeah, there's a few up there, but they're incredibly successful company. How do you just integrate this hated, yet still super successful thing?
33:26 Speaker 01 I secretly love Epic as a company. My brother-in-law works for them, actually, in Wisconsin, but Julie, their founder and CEO, is just a legend in healthcare. And you think about everything that they've built, there's a reason why every hospital system in America uses Epic. There's a reason why every intensive specialty uses Epic. The amount of ingrained deep integrations across hardware and devices and just the hospital network and operations that they have, you just can't switch from them. And that's why they're hated and they're loved because you use them and they work and they get the job done. You hate them because it's so goddamn expensive and you don't have an alternative.
34:03 Auren Hoffman? Yeah, they won't integrate with other apps and stuff like that, try to innovate on top of it.
34:09 Speaker 01 Yeah, and they don't buy companies either. It's in their values. We don't acquire, we only build. And so
34:14 Auren Hoffman? Oh, wow.
34:15 Speaker 01 It's a really fascinating company. They've never taken outside capital.
34:19 Auren Hoffman? I mean, look, it's an amazing company, yeah.
34:21 Speaker 01 And I think everyone is like, we're gonna go build a better Epic. I'm like, no, you're not. You just, you can't. You gotta go back to 1990, go integrate with all the random MRI devices inside the hospital. There was like one person at Epic who's maintaining device integrations from the year 1995. You are never going to replicate that. And the only way that you will be able to, I think, go up against Epic is you have to own the hospital. You're basically saying, I'm Ascension-Ced and I'm building new hospitals.
34:51 Auren Hoffman? HCA.
34:52 Speaker 01 Yeah, yeah. But is that their core competency?
34:55 Auren Hoffman? Probably not, no.
34:56 Speaker 01 They're good at charging people for hospital stays. They're not great at building software. And we like to sit kind of agnostic downstream of all these vendors. Use whatever EHR you want.
35:07 Auren Hoffman? Yeah.
35:07 Speaker 01 Use whatever patient management system. We essentially want to become the CRM, though. And so I'd like to be the engagement CRM layer on top of all of these systems.
35:17 Auren Hoffman? Kind of an interesting position to see how all these different medical practices operate. And they have their own very different suite. If you look at their DNA, very, very different suite of vendors.
35:28 Speaker 01 Yeah.
35:28 Auren Hoffman? And almost every single stack is very different. Even ones doing the things you would expect like text messaging, emails and stuff like that. They're often their specialty type of vendors that are there. Why has it evolved to such a different parallel path? Is it the regulation? Is it the buyer is so different?
35:47 Speaker 01 Yeah. Healthcare is one of the weird categories where you've got a bunch of tech illiterate buyers on one side. You have a bunch of medical illiterate builders on the other side. And then you have every healthcare practice does things differently. And so over time, I think what's happened is you've had all these software companies go build bespoke things for the specialty that they landed in. And they almost became half consulting shop or half dev shop, half SaaS company. And so you just end up with this fragmentation of all these different tools that do a whole bunch of different things.
36:27 Speaker 01 So try to adapt to a whole bunch of different processes that the healthcare entity has decided that they want to go do. And to some extent, because you're the software provider, you're downstream of we need to build that feature for them. They're a customer, they're paying us money to do it. It's a little bit different than true SaaS where you can say, take what you get and here's what it is. There's very few companies in healthcare that actually do a standardized model. Simple practice is the one that comes to mind. They're like, you're an independent provider or physician will charge you 99 bucks a month or whatever. You get access to our chart, our scheduling, you make it work for us versus us making it work for you.
37:10 Speaker 01 And they've been quite successful with that approach because they work with independent, smaller SMB providers.
37:15 Auren Hoffman? They're like the Zoho for doctors or something. Okay.
37:20 Speaker 01 On the other hand, you have Athena who is in the middle where they're a bit more standardized, but it still has to all be custom built to meet how the hospital that's using them or the big gynecology chain is using them. It depends on who you serve in the market and the big customers unfortunately have a lot of leverage over the software vendors at that scale. Until you become epic.
37:40 Auren Hoffman? Interesting.
37:40 Speaker 01 They just charge you to do all the custom things. They're like, we're fine building you all the custom things. It's just going to cost you $10 million.
37:47 Auren Hoffman? Yeah. And then how do you think about there's all these consumer health apps, obviously devices, et cetera.
37:53 Speaker 01 Yeah.
37:54 Auren Hoffman? And then you've got the data that flows to them. Sometimes it's not clear how you evaluate the data or how you access the data or could you bring the data into some other types of things? How do you think that evolves?
38:04 Speaker 01 Yeah, I think that there's a couple of different categories of data that are important. There is your medical health records that you went to your doctor, they charted.
38:12 Auren Hoffman? Yep.
38:12 Speaker 01 They have soap notes. You want access to those. You want to have this historical log of what happened based on what a physician.
38:18 Auren Hoffman? Yeah, ideally I want to be able to log in somewhere and have my own copy and be able to manipulate it.
38:24 Speaker 01 Yeah.
38:24 Auren Hoffman? And see, right now I have PDFs on a Google Drive or something. Yeah.
38:29 Speaker 01 Healthcare data has been inherently non interoperable for a long time. You just can't get it out of the system. On the other hand, you have wearable data, which I think is more of what we're talking about. Like the Oura rings or your Apple watch or your levels or whoop or whatever. And that stuff is, I would say to some extent also closed off, but they've made the app and the experience better around that data. So you're less unhappy because you have access to it. It's self-service, but it's still within the constraints of what that team has built. I mean, I think frankly, Apple Health will win the battle here if we're talking about who's going to win long-term of, I want access to one single point of longitudinal healthcare data and seeing all the different markers and metrics and all these things related to my care.
39:13 Speaker 01 Apple's probably the company that wins there. Frankly, Apple Health is pretty good. It's not amazing, but it gets the job done. And there's a lot of companies that are trying to be this middleware of this and say, oh, we integrate and we source all your data and we build you all these charts and flows. And it's been tried so many times. I think problem is that consumers just don't want to pay that much money for that data. They believe it should be free, that they should have access to it and they don't care that much about the software interpretation layer. They want a provider to interpret the data.
39:43 Auren Hoffman? Yeah, interesting. It's super cool. Do you think in the next five years it will change dramatically? Or do you think it'll be just more incremental?
39:50 Speaker 01 I think we're going to move to a world where you have a concierge doctor. You have someone who's a health coach or a doctor, somewhat medically trained, and they are the ones who have access to all your data. And within the platform, you do see things, but you're not interpreting them. You can get ChatGPT or Claude to interpret your medical data in a way that-
40:08 Auren Hoffman? Yeah, I've done it multiple times. I've uploaded, what does this mean? Or I've had friends who've had issues and uploaded, what does that mean? And it's actually pretty good.
40:16 Speaker 01 Yeah, and it's surprisingly accurate. They just can't say this is advice. They can just say, based on what I'm seeing here, this is what it looks like. You should always consult a medical professional. And so I think we get this blend of everyone has access to a concierge longevity style doctor that they pay, I don't know, a thousand bucks a year for, or something like that. In that system, you have this style of here's your AI companion to ask questions to. It's based on all this data. I think someone will build that company here. I think there's not a company to be built if you're just the data layer trying to say, here, get access to all your vitals-
40:53 Auren Hoffman? Yep.
40:53 Speaker 01 -in a cool chart.
40:55 Auren Hoffman? Yeah, some of you, I have a concierge doctor, but it's significantly higher price than a thousand dollars a year. And I love that I can benefit from that, but it would be great if we could push that down to a large number of people who could also benefit from that same, maybe it's not super white glove, but still quite good service. And a router too, to help you, oh, you gotta go do this. And also a nagger. I would say the number one thing that this guy does is he nags me to do things that I know I'm supposed to do. You gotta go get this test, or you gotta go do this thing, or whatever. Let's do the full body MRI. Now, I know you don't want to do it, but whatever the nag is that you didn't want to go do.
41:36 Speaker 01 Yeah.
41:37 Auren Hoffman? I mean, VO2 max, whatever it is.
41:39 Speaker 01 That's what we do now.
41:41 Auren Hoffman? Okay. Well, that's great. I think that's awesome.
41:43 Speaker 01 Yeah.
41:43 Auren Hoffman? People need annoying person to remind them
41:46 Speaker 01 Right.
41:47 Auren Hoffman? to guilt them into doing it. And sometimes it's a spouse who's like guilting you in, or it's a sibling, or it's a parent, or a child, or a good friend who might guilt you into it. But that's not a fun thing to do. So I love just paying someone to guilt me into doing the things I'm supposed to do for myself. And the number one thing my doctor guilt me into doing is he's like, you gotta lift more weights. He's like, that's really important. And he'll just get on me. You know, that's a board. I'm like, I know, I just hate doing it. But yes, I know. Yes, you're right. And I gotta go do it. And then at least for the two weeks after talking to him, I do a good job of it.
42:20 Speaker 01 Yeah. And I think maybe we figure out there's a class of workers who we train to become health coaches. They're not licensed medical professionals, but they have enough information. They work under the supervision of a provider where they can tell you to do things without giving you medical advice. And it brings that cost of that package lower because now you only have to pay $30 or $50 an hour to someone and not $500 an hour to that person.
42:46 Auren Hoffman? That's right. And by the way, for most people, it's pretty obvious because they haven't done those things. So it's pretty obvious. Okay, here's the 20 things you need to do, or you need to do better at. Let's just start with those first before we do the long tail of stuff. How are you sleeping? Oh, you're getting that five hours of sleep? Yeah, let's try to get six. Okay. Yeah, it's kind of obvious.
43:07 Speaker 01 Yeah. There is a baseline. There's just things that you need to do. I think, you know, one company that might become big, depending on the route they go down, is Function Health. If you've seen them.
43:16 Auren Hoffman? No, I haven't.
43:17 Speaker 01 They're $500 twice a year. You get access to 80 biomarkers or something. And they do all the testing. They visualize it all. So they have a partnership with Quest. I think it's Quest to go get all your labs done. And my guess is they eventually move out of the low margin lab testing business into the coaching, the membership, the subscription, the hardware, the wearables, the upsells, whatever it is.
43:40 Speaker 01 Labs are just, unless you own the lab itself, it's just not that profitable of a business.
43:44 Auren Hoffman? Yep.
43:45 Speaker 01 But now they've got access to hundreds of thousands of consumers who care about their health enough to say, okay, should I get access to a health coach or a longevity doctor? Or should I buy this supplement?
43:55 Auren Hoffman? Yeah, yeah.
43:56 Speaker 01 We're going into interesting times, I think, between Maha with RFK, Brian Johnson trying to get us all not to die and measuring his nighttime boners, and then all the consumer apps. We'll get into a really interesting world in the next five or 10 years where everyone cares about this stuff.
44:14 Auren Hoffman? It's interesting, I remember Brian on this podcast, Brian's a longtime friend of mine, and when I ask him advice on stuff, for the 90% solution, he's like, you don't have to get to me, which is the 99.9999. The 90% solution is just stop doing these four things and start doing these two things. And it's all basic stuff. It's like, just do that first. He's like, before I did this, I just had to stop eating pizza at 2:00 a.m. I'm like, okay, yeah, stop eating like bags and bags of Doritos. When I met him back in the day, we were friends and he was like overweight guy.
44:46 Speaker 01 He looks great now.
44:47 Auren Hoffman? He looks amazing.
44:48 Speaker 01 He gets a lot of hate online. I think what he's doing is quite amazing. If I had the money to go experiment with everything, I absolutely would.
44:55 Auren Hoffman? I think he's a hero for our society. Even if he gets most of it wrong, we learned so much from him. He's putting himself out there. I wish more people did that, rather than go buy a winery or yacht or something, do something actually meaningful for society.
45:10 Speaker 01 Well, I'll tell you this, if hello patient has a big outcome one day and I become rich enough to just spend all my time on longevity experiments, I will absolutely go do that. I would love nothing more.
45:20 Auren Hoffman? That would be so awesome to have more of those. I think that's great. All right, we asked two questions to all of our guests. One of them is, what is a conspiracy theory that you believe?
45:31 Speaker 01 Okay, I was actually just talking about this last night with someone.
45:35 Auren Hoffman? Oh, okay, good.
45:36 Speaker 01 So I guess it's a little spicy. I genuinely believe that there is big food, which is controlling our food supply and putting all the toxins and everything into our food.
45:47 Auren Hoffman? Yeah.
45:47 Speaker 01 And they know that it causes cancer because they have a relationship with the big pharma companies who then sell the kids. Pharma companies don't make money if people are not getting sick and needing their drugs. And so I believe that there's, God, someone's gonna come to my house and shake me down after this, but.
46:04 Auren Hoffman? They're gonna come to Bobby Kennedy's house first.
46:06 Speaker 01 Yeah, that's true.
46:07 Auren Hoffman? He's probably talking about this stuff too.
46:08 Speaker 01 I just think a lot of pharma incentives are misaligned, especially when I think we know that food is the source of our issues. We should not be eating corn syrup. I learned last night from someone that there's this process that food companies can go through to get labeled as we think that this is generally safe and then they're allowed to put it in their food and it only needs one study and it can be closed off. You don't have to make those records public for the study. And then that food ends up in our, we're just eating that all day. And I believe that food's probably the main factor why people are getting sicker and getting cancer younger. And then I believe that big pharma doesn't want that to stop. So that's my current conspiracy theory.
46:45 Auren Hoffman? In the Peter Tia, he used to talk a lot about diet and now he's moved to much more, yeah, diet's great or whatever, but it's way less important than exercise. So he's really trying to change his tune.
46:58 Speaker 01 Yeah.
46:58 Auren Hoffman? On that. How do you think about that?
47:01 Speaker 01 I listened to his most recent podcast on nutrition and I think he just doesn't like to talk about nutrition because it's so individualized for everyone. At least that's what my takeaway was.
47:12 Auren Hoffman? And people change their mind about it. Every year, new data comes in.
47:15 Speaker 01 And to some extent, our food supply is out of our control versus the amount that you exercise is in your control.
47:21 Auren Hoffman? That's right. I'm not gonna read every label. It's just too hard. Maybe with AI it'll help me in the future.
47:28 Speaker 01 Yeah, I mean, you literally have specialty grocery stores and only get grass grown, you know, fed meat and to avoid plastic. And that's when I'm like, I just, I don't care.
47:35 Auren Hoffman? And who knows if it's even true.
47:38 Speaker 01 I think exercise is, I mean, I don't know, I'm not a doctor. I can't say what's more important, nutrition or exercise, but I think poor nutrition is probably killing more people than lack of exercise would be my general.
47:49 Auren Hoffman? Interesting.
47:50 Speaker 01 If I had to bet on one of the two things being true, more true.
47:53 Auren Hoffman? And how big a factor you think will be GLPs in some ways, a lot of it is just people have too high BMIs or something like that.
48:00 Speaker 01 Yeah, I think GLPs are amazing. I think we're all going to have custom formulated peptides for us long-term that we inject to regulate our hormones and other markers.
48:10 Auren Hoffman? Oh, really? So you think it's going to be a common thing we'll all have, which will be based on our own genetics slash age slash other types of body characteristics?
48:20 Speaker 01 I know nothing about the science, but my current future thesis is that they already have a pill version of a lot of these drugs for the GLP-1s. They're going to invent a custom formulated peptide vitamin or pill or whatever that you take once a day that is specifically formulated for your gene makeup and for everything. And so I'm doing some supplements. I'm at the mid-range of testosterone. We're trying to boost it to the higher top 5% range of testosterone.
48:49 Auren Hoffman? And you take orally or do you cream or you inject or what do you do?
48:53 Speaker 01 Inject at the moment.
48:54 Auren Hoffman? That's annoying.
48:55 Speaker 01 Yeah, it's fine. You get over it. I'm doing per week about 10 different injections right now.
49:00 Auren Hoffman? Oh, wow. So not just testosterone?
49:02 Speaker 01 No, I'm doing peptides five nights a week, HCG. I just actually started today. It'll be twice a week and then testosterone three times a week.
49:12 Auren Hoffman? And I don't know that much about HCG. Can you let us know what that is and why do you do it?
49:17 Speaker 01 In the crudest form, it can be used to get your body to naturally produce more testosterone. It tells the balls to produce more, but when you take it with testosterone, it prevents the infertility side effects of testosterone so that your body continues to produce sperm on its own and you don't rely on just external testosterone, basically.
49:38 Auren Hoffman? Ah, got it. So if you're in the, I'm still having kids phase of your life.
49:41 Speaker 01 Yeah. Or if you don't want your balls to shrink, because that's what they do on testosterone is they just get tiny because they're like, I don't need to go make testosterone anymore. It's coming from an external source.
49:50 Auren Hoffman? Oh, what's the downside of shrinking balls? You're just more reliant on this drug going forward?
49:56 Speaker 01 Yeah, you end up reliant on testosterone for life and most guys probably should be on it frankly, with the way testosterone trends have come down over time. Two hundred to a thousand is normal range or something. It used to be five hundred plus. And now they're like, well, if you're in the two and three hundreds, you're normal. It's not really normal when you compare it to our old testosterone levels. And then downside to some of the drugs is if you're not really working with a doctor, not getting your markers done, higher HCG can lead to your estrogen levels getting higher. And then you have to take a estrogen blocker. There's just things you have to do to regulate all the stuff you're taking. So.
50:33 Auren Hoffman? That it becomes a whole thing where you have to figure all this out.
50:36 Speaker 01 Yeah. So I'm working with a doctor to do all of that. And I don't have to think about, hey, chat GPT, like, how much should I be taking today?
50:44 Auren Hoffman? And your doctor will change things over time. So I assume you have to do a lot of blood work as well.
50:49 Speaker 01 I did a lot of blood work to start and I'll do blood work every three months or so.
50:53 Auren Hoffman? And it's another super annoying thing, too, is that some phlebotomist come in and.
50:58 Speaker 01 Yeah, they miss. Although I gotta say, the last few have been surprisingly painless. Maybe I'm just less sensitive to needles now after injecting almost every night. But the insulin needles are so small that you don't really feel them. I feel like I'm a drug addict in the fridge. Take out the vial and I pull it and I flick it. That's the cost of wanting to experiment with biohacking your hormones.
51:21 Auren Hoffman? Yeah. All right. This is awesome. Okay, last question we ask all of our guests. What conventional wisdom or advice do you think is generally bad advice?
51:29 Speaker 01 I might need a second to look up some conventional advice and see what I disagree with.
51:35 Auren Hoffman? You definitely have something where I've heard you say, there's some advice. People say everyone should start a company and you often say, well, this is terrible advice. I've heard you say that before.
51:45 Speaker 01 Yeah, I'm an N of one, so I always try to preface anytime I give advice with, it's just me. I'm your only sample size. I don't have any data to support this, but I think my career path would have been different had I had not started a company right out of college and joined a company to learn. I've missed that learning experience and learning on your own is a lot harder, I think, than had I had joined hopefully like any company that was growing pretty quickly at the time. I don't think being a founder is for everyone for sure. I think there's a lot of conventional things I disagree with. I do believe that physical performance absolutely impacts your mental performance. For the most part, executives should be in shape. I feel like it translates to all parts of your life. And so. And obviously, there's reasons why some people aren't, and I'm not talking about the
52:28 Speaker 01 medical related things, but generally, I think people should be working out and lifting a lot harder than they do. They should be really focused on optimizing. Just like we optimize other parts of our life, you should be optimizing your markers. You should be trying to optimize for mental clarity. Your brain is another muscle. Why are we not trying to do the things that get us the highest level of clarity and focus and all that? And some people, they're like, I don't need to focus on it, or our food impacts it. I think more people should probably take longevity care a lot more seriously.
53:00 Auren Hoffman? You do a lot of things to stimulate your body. Maybe some things also stimulate your brain, but there obviously is caffeine that stimulates brain.
53:07 Speaker 01 I drink a lot of caffeine.
53:09 Auren Hoffman? Yeah, nicotine might be a brain stimulant, or these other types of things that are out there. Have you thought about that more? And, okay, I want to increase my cognitive performance? Or do you think, okay, I'm increasing my physical performance, which will also have some benefits to my cognitive?
53:25 Speaker 01 No, I definitely think about what supplements I can take to help increase cognitive performance. I think working out and creatine is probably the biggest supplement. Every single person should be on creatine.
53:36 Auren Hoffman? Okay, I'm on creatine. So I'm drinking the creatine Kool-Aid. And I think it's interesting, I was like, my wife thinks I look better because I'm on it.
53:45 Speaker 01 Interesting.
53:46 Auren Hoffman? Because it makes your muscles look a little better.
53:48 Speaker 01 Yeah, puff up a little.
53:49 Auren Hoffman? It's not clear to me that it has benefits, but I'm on it. I'm on it. Well, how do you convince people are a little bit more skeptical of it?
53:57 Speaker 01 I just don't think there's any downside to taking it. The only thing is you might put on a little bit more water weight and retain a little bit more water, but it's shown now to increase, and there's different creatines and sources and vendors that you should buy. If one's making you sick, try a different one or whatever. But there's studies where after a traumatic brain injury, you should basically have that person drink an excessive amount of creatine, and it reduces the inflammation in the brain immediately following.
54:23 Auren Hoffman? Now, do you take more than, I just take the one scoop a day from the thing. Are you triple scooping it or something?
54:29 Speaker 01 I'll do around single dose to a double dose, depending on the day and all that. I find that performance across mental clarity is definitely better with it. I just feel better when I take it, I think. It's hard because creatine is not one of those where you take a scoop of it and you're like, oh, I'm fucking wired right now and I'm jittery.
54:46 Auren Hoffman? Yeah, it's a longer term. You need a couple of months or a month or so before you start to see the benefit.
54:51 Speaker 01 And it's a very passive benefit. It's like, oh, I'm looking a little bit more fuller after working out or I'm feeling better. My cognition's better. I think it's cheap and it's very accessible.
55:01 Auren Hoffman? Good point. I travel a lot. When I travel, I don't bring my creatine with me usually. Do you bring all your needles with you and all your stuff with you when you travel?
55:11 Speaker 01 We're about to find out in a month when I do my next trip, what I decide. The last time I traveled, I alternated my dosing schedule to account for the fact that I would be out for a few days. And I will bring creatine and pre-workout and stuff, or if I'm gone for a long enough period of time, I'll buy it when I get somewhere.
55:29 Auren Hoffman? Yep.
55:30 Speaker 01 But honestly, I've been trying to travel as little as possible and, you know, the peptide's going to be refrigerated. And frankly, it's okay. Testosterone's probably the one. You don't want to miss doses, but I guess HCG now that it offsets. Anyway, we'll find out, but most of my trips are two, three days long anyway. So I can stagger things around.
55:49 Auren Hoffman? It's not that big of a deal. Yeah.
55:50 Speaker 01 And if I am going away for a month, I will refrigerate and bring and do all that stuff.
55:54 Auren Hoffman? Okay. Yeah, that's less common though.
55:56 Speaker 01 Yeah. I mean, with little kids, I'm in Austin, the team's in Austin. I also, I was at a same dinner last night. I was talking to someone and they're like, oh, do you travel a lot for work? And I'm like, no, I don't want to go to conferences anymore. I'm online.
56:07 Auren Hoffman? Yeah, yeah.
56:08 Speaker 01 I want to hang out with my kids on the weekends and I want to go talk to a bunch of people, get drunk in Vegas, send someone on the team to go do that.
56:14 Auren Hoffman? Yeah. This is awesome. Thank you, Alex Cohen, for joining us on World of DAS. I follow you again at Another Cohen on X. I definitely encourage our listeners to engage you there. This has been a ton of fun and really great.
56:26 Speaker 01 Yeah. Thank you for sending the invite. I'm glad we made the time and I'll see you online.
56:34 Auren Hoffman? Thanks for listening. If you haven't already done so, please subscribe to World of DAS wherever you consume your podcasts, YouTube, Apple, Spotify and more. And please help us get discovered by leaving a review. And check out worldofdaas.com. That's worldofdaas.com. And of course, connect with me on Twitter, at Auren. That's A U R E N. Would absolutely love to hear from you.
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