Overview
Earlier this year I joined a community called In Women’s Health, which provides education and community for those seeking a career in Women’s Health. As part of that, Jodi Neuhauser organizes a monthly session with relevant founders:
Join In Women’s Health for our members-only monthly “Meet the Founder” series where we talk to some of the industry’s most sought-after founders.
We will dive into their career journey, their leadership philosophy, how they are changing the game in women’s health and yes, their thoughts on how they are growing their team.
Join us for a short conversation and then we’ll leave plenty of time for Q&A so bring all of your questions for the industry’s best and brightest.
I was fortunate to participate in my first such session on Friday, and I wanted to share my take-aways with you. Please note that I am a fast note-taker, but this is NOT a complete transcription.
Interview
Jodi – Please share with the group who you are, your family and experience, and how your own journey in women’s health led you down the path to start Electra.
Alessandra – She is based in New York, and she has a background in innovation and early-stage start-ups. She started her career as employee #6 at ArtSave. It was quite a transition from art to into the menopause space! However, she learned a lot from being part of a company at Seed stage. She was focused on go-to-market, but she learned a lot about product, brand, and culture by doing the work, and the messiness of early-stage start-ups.
Alessandra then went to MIT for her MBA, where she focused on the broader start-up ecosystem. Upon completion, she moved back to New York, she was part of Human Ventures with the goal of bring MIT incubations to the New York venture community.
She had always assumed she would be an operator in the background, but (like many of us wanting to make our way into Women’s Health), her own personal health journey was the impetus for founding Elektra. Five or six years ago she was quite sick, wrestling with integrative medicine and IVF. She felt there were huge disparities and lack of awareness about her experiences. For example, her eyesight became blurry during hormone treatment, and it was brushed off as normal – but we know now that it’s in the long tail of symptoms and should not be dismissed as happens to so many women when seeking answers.
That experience led her down a rabbit hole of estrogen and hormonal health, which eventually led her to found Elektra in 2019. Maven was starting to surface, but on the whole menopause was an underserved area. Elektra is an evidence-based care clinic where Alessandra spent five and a half years at CEO. She recently stepped into an Advisor and Board member role, and her co-founder has now stepped into the CEO role.
Jodi – Before we continue with the Elektra story, what is a start-up studio, and how do they work?
Alessandra – A start-up studio is typically a small team identifying new opportunities. The team may be a mix of researchers, investors, and sometimes product designers. The studio is typically focused on identifying opportunities in an industry or a specific segment. Sometimes they provide a bit of funding, and they are also looking for founders to take their idea and run with it. Women’s Health is a buzzword in this space at the moment.
Jodi – If you have your own idea, there are studios who are looking for entrepreneurs. Others like to incubate their own ideas and then bring in a CEO to run it. There are a bunch of these now, starting to show an interest in women’s health. Jodi has taken a to-do to build out a resource list for the IWH community, since nothing exists at the moment.
Jodi – Menopause has taken center stage. What are the differences between Elektra, Geneve, Midi? What is the ecosystem landscape, who is out there?
Alessandra – The market has evolved a lot, there are so many entrants now. It’s a massive market, so many companies will be successful in this space. Elektra is a telemedicine clinic for synchronous, fee-for-service, evidence-based care. They started out-of-network, and are gradually moving in-network with Medicare, Medicaid, and other insurers.
In addition to telemedicine, Elektra provides a community to support patients beyond the doctors visit. This includes 100 hours of programming and learning content. There are 34 symptoms of menopause, and multiple ways to treat each of them. The majority of women are confused and don’t understand their options, so the community provides support beyond the doctor’s visit. Like Noom or Omada weight loss program, there is a digital resource in addition to care delivery.
Elektra started in D2C and gradually evolved into B2B, working directly with employers and health plans to expand support for their menopause population. This has enabled them to build their use case(s) and improve their clinical model. Now Elektra serves both.
In terms of the menopause landscape, there are lots of players, but Alessandra thinks of them in three major categories:
- Products and Services. Over-the-counter goods such as supplements and wearable devices. These aren’t directly competitive to Elektra, but their marketing efforts help to educate women. These are seeing the greatest growth, including celebrity endorsements. Elektra consider these as potential partnerships.
- Digital Pharmacies. Companies like Ally and EverNow are in this space. While also these are also telemedicine providers, the business model is focused on selling prescriptions and medicines – the scope for offering care is limited.
- Care Providers. Companies like Midi, Geneve, and some other start-ups are seeking to provide care via 15-30 minutes of a face-to-face appointment with a doctor. This is the most like a traditional care model, but typically offered at a lower cost.
Jodi – The products and services category are pushing the bulldozer, paving the way for care providers. Companies like Stripes did a big campaign around National Hot Flash Day. There can be some snake oil products, but a key part of these mission-drive companies is consumer education. As a patient, if you don’t have the vocabulary, you don’t know what to ask for. This is why celebrity involvement is so important.
Jodi – How do you think about talent at Elektra and other companies where you’ve worked? What about people and the role they play in organizations?
Alessandra – Over the course of building Elektra, in general, on the business side they are looking for doers, people who can roll up their sleeves – because there are always too many things to do. People have to pick up the mantle on things that will deliver the greatest impact. At this early stage it’s rarely about expertise, but about people who can work cross-functionally. It’s helpful to have start-up experience but it’s not critical. If possible, try to show a project outside of work – show innovation, or an entrepreneurial path in a larger organization. Especially for the early hires in a startup.
Further along, role descriptions are more narrow. If you are offering clinical services then you have clinicians, doctors, and those building the product to learn, test, and grow. We found that empathy was a critical skill, bringing the business and clinical side together.
Jodi – It matters less about school or credentials. She always looked for people who have taken the initiative to do something entrepreneurial, where they demonstrated leadership and took the reins to solve problems. She encourages people to find opportunities to do that – do a project for a founder for free. Founders don’t have the time to figure out what they need, so find their gaps and offer to solve them for free.
What else to think about for career pivots, coming from a larger organization?
Alessandra – She is a LinkedIn junkie, which is a great way to be active and make connections. Founders and hiring managers may be too swamped to take an intro call. But if you are consistently responding to comments and posting on LinkedIn, it does get noticed – name and pattern recognition. Consistency and following a company and their leaders can be helpful.
Another area to consider it that the definition of Women’s Health and where it’s showing up has evolved:
- There are market maps of key companies in this space. [You can see once such example on the Silicon Valley Bank website.]
- There are also companies that work primarily with the female population, but which may not be categorized as femtech. For example, Omada and Noom are weight loss solutions. They don’t call themselves women’s health companies, but they serve a primarily female audience. Issues of gut health and inflammation predominantly affect women. So you can significantly expand the list of companies working and growing in this space if you look at their patient populations.
- Finally, there are traditional healthcare companies starting to launch women’s health lines of business or small departments to focus on this space. Aetna/CVS has a great women’s health team, for example. Companies need to have dedicated talent and resources. This is more nascent than maternity start-ups, for example.
Jodi – Oura just recently hired a whole women’s health team. Now that they have a solid baseline product, they are targeting women’s health as part of their growth strategy. [You can read more about their expansion here.]
Building your LinkedIn content to train the algorithm is key. [Please see Jodi’s webinar on YouTube to learn more]. If you want to get a job in this space, you have to demonstrate that you are building expertise, and put out your own content.
Alessandra – If you haven’t signed up for the Women’s Health MBA, you should. It’s not just about getting the interview – you have to have an understanding of the space and the dynamics. What will move the needle for these businesses?
Jodi – She is making some changes to the mini-MBA format for next time. There will be 30 minutes of video for the nuts-and-bolts, like the vocabulary around fee-for-service, reimbursement, etc. You have to be able to speak that language, and then understand the nuances in the women’s health space. Understanding providers and how care is delivered – for example, with the large number of religious hospitals, what does that mean for care? The new format will also have six guest speakers.
Q&A from the Audience
Q – What about consolidation, partnerships, acquisition?
A [Alessandra] – She is a big believer in partnerships, because we don’t want to fracture the care journey for women. There are some interesting partnerships in this space. For example, Progeny works in maternity and fertility support, but they are partnering with Geneve and Midi to expand into menopause care. That makes it easier for women, and also for employers / buyers who are assessing who to work with in an increasingly crowded ecosystem.
Midi just paired with a company for musculoskeletal and pelvic care on topics like heart, bone, and brain health, acne, hair loss, and more. Partners are working together to built out the scope of care services. An idea situation would be to pull these companies together with a partnership for sharing of patient information, provider referrals, etc. – some connective tissue. But then allow these companies to support on the stage where they have the expertise.
She would like to see some private equity firms thinking this way. It’s challenging to support women from 17 to 75. There is no Holy Grail, no Uber or Lyft. But we’ll see how the chips fall, it’s still early innings – the space is only 5-10 years old.
Jodi – we are a little impatient, but she agrees we are in early innings. If you are in marketing in women’s health, you know that companies are not doing patient acquisition handoff very well. We are all paying $200 to acquire the same customer. You can start with something as simple as brand partnership. A customer may leave when they finish their fertility journey, but then pregnancy companies pay another $200 to acquire the customer at the next stage. There are some giveaways and joint content, but no true customer handoff.
Q – As an early player in menopause, was it hard to raise money? Did later rounds get easier? As new companies emerge is there a halo effect, or did that make it harder?
Alessandra – Their pre-seed fund started in 2019. She had a friend, a male angel investor who gave her an intro and the opportunity. His first question was “how do you catch menopause?”. It wasn’t true in every conversation, but it helped her realize how far we have to go in this space.
How can you get it to be a big business opportunity? It has certainly been a slog. There have been more female founders in the past 2-3 years, but the macroeconomic environment has been tough. Each round was hard-won. She received a hundred NOs in the Seed stage. In the last round they had eighty NOs. That isn’t so bad if you talk to other founders.
In the early days compared to now? There is more appetite, more inbound, more recognition that this is an area to make money. However, there is still a lot of bias. She met a VC who was excited about Elektra, but it was hard to get buy-in from other partners. The conversations are more enthusiastic, there is more appetite to invest in menopause. But it is still a hard-won yes to raising money – that is still true. Right now, VCs are using the election as an excuse to delay. We see the fanfare on LinkedIn, but there is an iceberg of effort underneath that.
Her advice for founders is that if you have 30 minutes with a VC and you spend most of your time explaining the market, there is no time to explain the business opportunity. That seems like a simple suggestion, but as she reflects on meetings that didn’t go as she hoped, she spent too long on the founder story and why menopause was a problem, rather than on the business fundamentals.
Jodi – This is also true in the interview process. Don’t spend a lot of time talking about your passion – talk about how to move the business forward. That is sage advice for VC discussions or job interviews.
Alessandra – You’ve seen the pictures of the President before they take office and when they are done. It’s similar for founders. Not to intimidate or focus too much on that, but it is a slog.
Q – How do you address the dilution of the brand with non-medical brands?
Alessandra – Two responses to that. Elektra’s care model and what we recommend to women includes supplements, prescriptions, and in their newsletter, “healthy obsessions” like cooling sheets. They offer a suite of services and products to navigate difficult times. This is oftentimes where women first start spending money – beauty, self-care. So we spend time curating the list of brands and offerings they might be interested in. Their clinical team works hand-in-hand with marketing and the business side on content review for blog posts and articles, so there is always a clinical resource or a tight communication loop – any brands or products must pass muster with the clinical team.
However, they have never monetized that. There are no affiliate links, no referrals, no kick-backs for the products or services they recommend. That was a really important strategic decision for them, so that when they went to hospitals and health plans, they could truly be an independent and trusted resource to secure partnerships and contracts.
Q – What do you recommend for MBA students trying to make their way into this space? There doesn’t seem to be the same pathway as we see in consulting and banking.
Jodi – There are some people working on that. She tries to take one a year. What advice do you have for finding summer internships, Alessandra?
Alessandra – An organization to keep an eye on is Flare Scholars. They are one of her lead investors, and they have an annual program. They create a scholar cohort and place them in the portfolio. There are likely others like that. At Elektra they hired MBA interns during the year or over the summer, but it was usually based on cold outreach. In September they were not planning ahead of summer. Even January is a bit early.
But if you can initiate a cold outreach outlining your experience and what problem you could solve, that goes a long way to opening doors. Every single outreach doesn’t turn into an interview or job, but it shows initiative. She would take a couple of calls like that every month, which helps her understand how you would show up for the company.
Jodi – You also need to be clear on what you financially or personally need. Be realistic about how much a women’s health company will pay. Maybe Wharton will have a program that can support you – Darden (her alma mater) does. You have to understand or get around the budgetary piece.
We do not have the brain space to figure out what problems you can help us solve. We haven’t even figured out what to have for lunch today, much less where you could fit in their organization! Explain what you can provide, or why you are interested – do it in eight sentences or less. Do NOT write an essay, I will not read it (nor will any early founder).
If you say “hey, I think you would benefit from a customer study”, or “I am an expert financial modeler”. She was in between fractional CFOs, and she needed exactly that kind of help at the moment it was offered.
Q – Engagement is such a crucial challenge in digital health. I’m curious how you think about measuring and driving consumer engagement at Elektra?
Alessandra – When you take the mini-MBA, you will understand how to secure payer reimbursement. The secret sauce for them was demonstrating that their model wasn’t about one doctor’s visit. Some women were coming back to the content 12-14 times in the first month. They were reading, engaging, figuring out how to take ownership over their health. You have to fight to get paid for these non-traditional care visits and services, but that is the shift of where healthcare is going, that digital companion piece alongside care.
Q- What are your closing thoughts or advice?
Alessandra – She attributes community to her success as a founder, to accelerating Elektra – especially as they chart the next chapter. Create a peer group of people looking for jobs, which can be powerful and helpful. It might be a little cheesey, but organize an in-person breakfast, engage on LinkedIn, or join the In Women’s Health community. Opportunities come from staying connected, understanding where the industry is headed, and where needs might change.
Jodi – Those who are getting jobs are doing it through their network – we are all here to help!
Closing
As you may have gathered from my recent posts, I’m seeking opportunities to deepen my understanding of women’s health and get involved in this fast-moving and emergent space. I found this session beneficial to get me thinking about challenges and opportunities in the women’s health market:
- There are unique challenges because there is so little scientific and clinical data about major physiological transitions in a women’s life. This is in part because of lack of diversity in clinical trials; medications targeting women are tested on male mice to reduce complexity, leading to unanticipated and potentially devasting consequences for female patients.
- Historically, there have been more men (62%) entering the medical profession than women (38%), though it varies by specialty and it’s starting to change. The number of active female physicians has increased by 97% since 2004, paving the way for women treating women, and the possibility of true empathy in the physician / patient relationship.
- As anyone involved in this space knows, women founders are grossly underfunded relative to their male peers (a mere 2% of VC funding for all-female founding teams), which creates mountains to climb for women seeking to build businesses in this space.
I found Alessandra’s taxonomy of offerings (OTC Products & Services, Digital Pharmacies, and Care Providers) instructive, and I appreciated learning more from Jodi and Alessandra about how companies offering over-the-counter products are educating the market for more sophisticated services and business models to come.
I also learned from Jodi’s remarks on the cost of acquiring new patients, and how partnerships could help to defray that cost across the patient journey from first cycle to menopause. Combined with point solution fatigue by patients, providers, and PE firms alike, this seems like a significant opportunity area.
I found Alessandra and Jodi’s mindset inspiring! There was no discussion of competition, but rather a focus on how we can all lift each other up, whether that’s in professional networking or in a new business model:
- While networking, keep in mind that founders are busy. There is always more work than there is time, and fundraising is a grind, with hundreds of NOs before a YES. If you want to help or get involved, you have to be specific about how you can help, and keep communication going over time.
- At the level of the business model, navigating collaboration is more nuanced than simply understanding the motivations of payers and providers and patients. Companies may be serving the same patients at different stages of their lives, and thoughtful partnerships can reduce patient friction and acquisition costs for the companies who succeed.
All-in-all it was an informal but very informative session. If this is a space you’re interested in, I’d recommend you join the In Women’s Health community (link below) to learn more and build your network.
Learn More
AAMC. Women are changing the face of medicine in America.
Deb, Trisha. Male and Female Doctors Statistics 2024 by Disparities, Trajectories and Professions, via AAMC.
Hill, Amelia. Why sex bias in labs means women are the losers in research into ageing. 22 July 2024.
In Women’s Health community, education and networking calls, and newsletter.
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