ForbesWomen Editor, Maggie McGrath, sits down with Joanna Strober, a seasoned entrepreneur and healthcare pioneer, who has dedicated her career to addressing gaps in healthcare.
After successfully scaling her previous company focused on childhood obesity prevention, Strober pivoted her attention to what she saw as an even bigger challenge she herself lived firsthand: the lack of specialized care for women in midlife.
Under her leadership, Midi Health has grown to serve over 12,000 women per week with their menopause journey, via a network of 250 specialized clinicians. Having closed a $63M Series B round in September, the companies mission is ambitiously moving the dial towards making tailored midlife care accessible to women via insurance coverage and telehealth services.
Subscribe to FORBES: https://www.youtube.com/user/Forbes?sub_confirmation=1
Fuel your success with Forbes. Gain unlimited access to premium journalism, including breaking news, groundbreaking in-depth reported stories, daily digests and more. Plus, members get a front-row seat at members-only events with leading thinkers and doers, access to premium video that can help you get ahead, an ad-light experience, early access to select products including NFT drops and more:
https://account.forbes.com/membership/?utm_source=youtube&utm_medium=display&utm_campaign=growth_non-sub_paid_subscribe_ytdescript
Stay Connected
Forbes newsletters: https://newsletters.editorial.forbes.com
Forbes on Facebook: http://fb.com/forbes
Forbes Video on Twitter: http://www.twitter.com/forbes
Forbes Video on Instagram: http://instagram.com/forbes
More From Forbes: http://forbes.com
Forbes covers the intersection of entrepreneurship, wealth, technology, business and lifestyle with a focus on people and success.
After successfully scaling her previous company focused on childhood obesity prevention, Strober pivoted her attention to what she saw as an even bigger challenge she herself lived firsthand: the lack of specialized care for women in midlife.
Under her leadership, Midi Health has grown to serve over 12,000 women per week with their menopause journey, via a network of 250 specialized clinicians. Having closed a $63M Series B round in September, the companies mission is ambitiously moving the dial towards making tailored midlife care accessible to women via insurance coverage and telehealth services.
Subscribe to FORBES: https://www.youtube.com/user/Forbes?sub_confirmation=1
Fuel your success with Forbes. Gain unlimited access to premium journalism, including breaking news, groundbreaking in-depth reported stories, daily digests and more. Plus, members get a front-row seat at members-only events with leading thinkers and doers, access to premium video that can help you get ahead, an ad-light experience, early access to select products including NFT drops and more:
https://account.forbes.com/membership/?utm_source=youtube&utm_medium=display&utm_campaign=growth_non-sub_paid_subscribe_ytdescript
Stay Connected
Forbes newsletters: https://newsletters.editorial.forbes.com
Forbes on Facebook: http://fb.com/forbes
Forbes Video on Twitter: http://www.twitter.com/forbes
Forbes Video on Instagram: http://instagram.com/forbes
More From Forbes: http://forbes.com
Forbes covers the intersection of entrepreneurship, wealth, technology, business and lifestyle with a focus on people and success.
Category
🛠️
LifestyleTranscript
00:00Hi, everyone. I'm Maggie McGrath, editor of Forbes Women. Menopause has become one
00:08of the most interesting areas of women health startups. Investors are awakening to the financial
00:14opportunity as women are demanding more from their doctors and their care. Within this
00:19space is Joanna Strober. She is the founder and CEO of MidiHealth, a women's health company
00:25that she started in 2021 and now sits on the Forbes list of the next billion dollar startups.
00:32Joanna, thanks so much for being here. Thank you. So take us back to the early days of Midi. You
00:38have prior healthcare experience in your business life, but why start a company that in the earliest
00:43days was really focused on menopause? So it really was a personal experience for me. I was in my late
00:4940s and experiencing a lot of issues of perimenopause, and I had a really hard time getting
00:56care. Essentially, I was having all the symptoms, the hot flashes, the anxiety, the mood swings,
01:02painful sex. But because I was still menstruating, I kept on being told I was not in menopause and
01:08none of these things were treatable. And so eventually I found a private doctor that I had
01:15to pay $1,500 to and drive an hour. And in, you know, in one hour, she gave me all the right
01:22medications. And within two weeks, I was back to my old self. And it just became really clear to me
01:28that all women deserved access to this type of care, and it shouldn't just be something from
01:32concierge doctors. And at the same time, I was working at a digital health company, and I had learned
01:39that the laws were changing because of COVID. So we could now make all women have access to this
01:45type of care covered by insurance. So that was really the basis of it, is understanding there
01:49was this huge opportunity to fill this gap of care and to create an expert care company that would be
01:55actually covered by insurance. What's so interesting to me about menopause is you can look at other areas
01:59of women's health, and there are certain things that affect some of us, but not everyone. Not
02:03everyone has allergies. Not everyone will have heart disease. Not everyone will choose to have
02:07children. But if you live long enough and you have female body parts, you will go through
02:12menopause. Right. And yet there's a gap in doctor knowledge. Can you talk about the training? I mean,
02:18it sounds like it really took a lot to find one doctor who was trained in this area to give you
02:23the care that you needed. How many doctors are menopause certified? Yeah, less than a thousand in
02:29the United States. So this all stems back to this 2021, sorry, 2001 Women's Healthcare Initiative,
02:37which looked as though the study initially demonstrated that it looked as though hormones
02:46caused breast cancer. The whole world panicked. Like when you talk to doctors, they actually remember
02:52reading this study. And the study was wrong. The outcome now 20 years later, they've actually learned
02:58that the women who were taking estrogen only were actually having a 30% reduction in breast cancer.
03:04So we have a study out there that is 100% wrong, that has convinced women nationwide that taking
03:13hormones is dangerous and will give them breast cancer, even though that's not true. And you had
03:19doctors in medical school for the past 25 years learning that. So we had this huge misinformation
03:24gap. And many people think this is one of the worst abuses of, you know, women's health in the last,
03:31you know, 50 years is the fact that this study got so wrong. So basically, we just have a lack of
03:36education because people got scared for something that was misconstrued.
03:41I was going to ask about the change in the landscape, because since you founded Midi, it's kind of
03:46corresponded with this burst of public attention on menopause. You have celebrities shouting the words
03:54from the steps of the US Capitol. I get served ads on Instagram or influencers on Instagram who are
04:00talking about it. And I do not think that was the case even 2016, 2015. So is that because of
04:08a reassessment of that study? Or what else is at play here?
04:13So I think there are a few things at play. First of all, younger women are getting to experience
04:17perimenopause symptoms and getting pretty angry about it, right? They're realizing that these symptoms
04:22are derailing them both at their home and at work. And they're really frustrated that they're not
04:28getting taken care of. So that is also correlating to the fact that also we have this study is really
04:34getting looked at again after 20 years. And people are realizing how wrong the initial interpretation
04:41was. And they're looking at this data and saying, wow, actually, estrogen is actually breast
04:48protective. Women can take estrogen even if they have a family history of breast cancer. Women,
04:55even if they have a higher risk of breast cancer, they can take estrogen. All this data is now being
05:01looked at all these 20 years later. And we're realizing how wrong it was. But it is that confluence
05:07of women wanting better care and looking at the study.
05:09We're used to so much information on other things. And as you age, you get to this life stage where it's
05:14like, wait a second, why don't we have answers here? Which is, again, it goes back to the early
05:18days of your company. So talk to us about building it. You have that light bulb moment. You realize
05:24there's a business idea there. What was the hardest part about getting Mitty from that idea to where
05:29we sit right now, which is on the next billion-dollar startups list?
05:32Yay!
05:33So here's what we did. It's actually really fun. We started with two doctors and 150 patients.
05:38And we recruited these women from around California, because we were only licensed in
05:43California. And we said, we're going to give you three months of care. And we're going to monitor
05:47every interaction that we have with you and our doctors. And we're going to give you medications.
05:52And we're going to give you supplements. And we're going to give you lifestyle advice.
05:55And we're going to just communicate with you a lot. And we'll give this all to you for free for
05:59three months. And then we're going to see how you do. And we got feedback the whole route.
06:03And then we said, okay, it's over. Now we're going to go evaluate. And they panicked. And they
06:10literally, I mean, of the 150, like 140 of them emailed and said, no, you can't go away,
06:16because I don't have any place else to go to get this care. And that's really when we knew we had
06:21something, is being able to offer something that people were literally panicking if we were going
06:25to take it away from them. So now we're taking care of 12,000 women a week. And we have nationwide
06:33coverage of insurance. We are hiring a lot of an army, essentially, of nurse practitioners to
06:41provide this care. We've also extended a lot of the different types of care that we provide.
06:45We very much started as a hormone company doing menopause. That was our basis. And now
06:51we're expanding much more than that, because what we're finding is women will come to us because
06:56they're not sleeping. And then they come back because they want to talk about painful sex.
07:00And then they want to come back because actually, they also have prediabetes. And they want us to
07:04get those blood tests for them. So essentially, what we find is that there's such an enormous care
07:10gap in this country, that once someone comes to us, and they trust us, then they want to come back
07:14to us to get all of their care. And so that's really part of how we're expanding is that people come
07:18back, realizing, oh, you can take care of my thyroid problem, or oh, you can take care of my
07:23migraine. And we are expanding the different types of care concerns that we attempt to take care of.
07:28So you're starting to take a more holistic approach. I think that makes sense, because
07:32the body is integrated. And yes, there are specialists, but there are some times when I
07:37wish my own doctors were talking to each other. You go to the dermatologist because you have some
07:41eczema. Can we tell it's spring? I'm going to reference allergies again, right? And then you go to the
07:44allergist. And is the derm talking to the allergist? But does MIDI bring all of those
07:49pieces together? Yeah. So the way we do that is we essentially create these care protocols. So we
07:54went out to experts around the world and created care protocols for everything. And we could basically
08:01take from five different doctors for any one type of symptom, right? Take thyroid, for example,
08:08or take lack of sleep, for example. We got all the different protocols that include
08:12medications, supplements, lifestyle for every one of them. And then when people come to us for new
08:19types of care, we create more protocols. So essentially, we keep on creating our protocols
08:24and honestly iterating our protocols. We keep on scouring the world for what are the new things
08:29that are coming out? Is there a new drug? Is there a new supplement that can take care of these
08:33issues? And then we add that to the protocol. That's interesting. You say supplements, and that can
08:38be the wild, wild west of medicine. How do you assess what supplements MIDI is offering?
08:44So there is actually very good evidence for some supplements. There really is. Like magnesium is
08:48something that absolutely can help women sleep. We have a cortisol manager that we recommend,
08:53which is a combination of ashwagandha and L-theanine. And it works. There is really good evidence behind
08:59it. There's actually evidence that lavender can be a very good substitute for anxiety medications.
09:05So we look at the research and we pay really close attention to the research. We're not recommending
09:11things that are not with some efficacy. And then we make sure that we recommend brands that have
09:17high quality. You mentioned nationwide. And at the Forbes Women's Summit in September, you talked about
09:2350 states. There can be 50 different insurance rules within those states. So how hard has it been
09:29to get to nationwide? And what was the trick to getting insurers on board? Many of our efforts go to
09:34getting insurance contracts. And we have to do that state by state. There's only three national
09:39insurance companies, so everything else is local. So you have to basically go state by state and get
09:44insurance contracts in each state. And that just is a very long, arduous process that we have become
09:51good at maneuvering within.
09:54Has there been a key argument that you've used in conversations with these insurers or maybe a data
09:59point that they did not realize that, as you have said, then they've said, oh, yes, we get it now?
10:04So the average woman goes to six of the wrong types of visits before she gets the right care.
10:11So if you look at that, if we can avoid all of those unnecessary visits and stir with the right care,
10:16we can reduce costs immediately. And then the other thing is, like, the average primary care doctor
10:21refers 35% of their patients to a specialist because they don't have all of the expertise and
10:28they don't have access to this huge number of protocols, right? So now with our patients,
10:33we only refer 4% of them to specialists because we're able to take care of a really much larger
10:39group of symptoms. And then what we're doing is we're connecting with health care systems around
10:45the country so that if someone needs in-person care, we can get them efficiently into that health
10:51system. So, for example, in New York City, we're partnering with Mount Sinai. We have a relationship
10:57with them. So if you are a MIDI patient and you need in-person care, we can get you in faster.
11:02So getting the insurance companies on board is one lever to growth for you and for MIDI.
11:07The other big one is investors. Can you talk about the conversations you've had with Silicon Valley
11:11and perhaps how the tenor of those conversations have changed from 2021?
11:14Yes. So when we first started, convincing investors that menopause was a hot topic was not easy,
11:22honestly. It was a complicated discussion. Like, why aren't women just getting this from their
11:28primary care doctors? Why aren't they getting it from OBGYNs? Is there really a market opportunity
11:32for this? So the first funding was hard, and I'm incredibly grateful to those early investors who
11:40took a bet on us when we really had nothing more than a PowerPoint and this pilot that showed that
11:46women really wanted this care. Now the fundraising has changed because we're able to show so much
11:52traction. So we're just on a very fast growth trajectory. We're probably the fastest growing
11:58telehealth company ever, quite honestly. We are showing extensive repeat patients so that it's not a
12:06one-off. They come back to us over and over again, and we're showing they're actually staying with us
12:10for years. So people, we really are taking a part of their healthcare spend and becoming an integral
12:15part of their healthcare lives. So the fundraising has been much easier now that we're able to show
12:21that it's not about women's health. It's just about being a good business.
12:24In September or in the fall, you announced a special purpose vehicle that had some celebrities
12:30on the cap table. And you and I have talked about the difference between physician advocacy
12:36versus celebrity advocacy. How did that SPV in particular help MIDI? The press loves writing about
12:44celebrities. The truth is that celebrities have a unique way of breaking through the noise
12:49that most other people cannot do. So there are online celebrities, influencers that are very
12:57powerful. There are different women who are high profile who are able to break through, but that
13:07ability to break through is hard in today's world. And celebrities have a unique way of doing that.
13:12And so we're really grateful to those who are willing to give us their money, but also their name
13:17and their support, and honestly also become our patients. So Amy Schumer put out a video a few
13:25weeks ago on being our patient and how grateful she was to MIDI about the care that we are providing
13:31to her. And that was very valuable to us. So not, and she said, I'm an investor in this company and I
13:38invested because I believe in it and because I'm a patient. And, you know, the news picks that up and
13:43they love writing about celebrities. And so it is a good way of breaking through the noise.
13:47What's interesting to hear you talk about MIDI is you use the term healthcare company, holistic
13:53health, more than you use just even women's health or menopause health. Can you talk about
13:58how you see MIDI potentially as a play on longevity medicine?
14:03So it's funny, you know, longevity medicine is actually preventive care and it is a much better
14:10branding than preventive care. But what is longevity? Longevity is taking care of your bones,
14:16taking care of your brain, taking care of your heart, making sure that you're eating
14:20appropriately, making sure that you're getting the right screenings. Are you getting your cancer
14:24screenings? Are you getting your mammogram? Are you getting your colonoscopies? That is actually
14:29women's longevity. So what we have found is that for many women in their 40s, for example, they don't
14:37know if they are in perimenopause. They do know they want to be healthy grandmothers and they know that
14:44they would like to take care of their bodies so they can see their children grow up and have
14:48children. And so what we have learned is that there is a very tight confluence of perimenopause,
14:54longevity, which is essentially primary care, and then menopause, which is for women who are a bit
15:00older. It's actually really important that you start the preventative measures before menopause.
15:07So we don't want to wait until we're 65, for example, to take care of our bones. If you wait
15:13until 65 to get a DEXA scan and you find out that you have osteoporosis, it is too late to do
15:20something. In your 40s, you can start getting some scans. You can start seeing how your bones are doing
15:26and you can start taking medication, if appropriate, to keep your bones strong or lifting weights to keep
15:30your bones strong. So what we have learned is that you can't really tie these things apart. It really is
15:36about prevention and making sure you're doing the things that can keep you healthy and not just
15:42treating the symptoms when you're not feeling well. That's interesting. Now, in September, you talked to
15:47us about a piece of legislation in Washington, D.C. around telehealth. And you mentioned that in the
15:53earliest days of MIDI, telehealth regulations because of COVID really helped you grow. So what is the status
15:59of that legislation in general, telehealth access in the United States right now?
16:04So it's a bit precarious. There are a lot of questions about exactly what government will
16:09continue supporting in terms of insurance-covered telehealth. I do believe that will continue.
16:16The bill that I was lobbying for, that I spent a lot of time lobbying for, was regarding the DEA
16:22and enabling controlled substance to be prescribed online rather than having to go in person to have
16:30controlled substances. And the controlled substances include ADHD medication. They include sleep
16:36medications. They include testosterone, which is an essential part of women's hormone treatment,
16:42particularly for low libido. And I was and actually remained concerned that if you require people to go
16:49online, excuse me, if you require people to go in person to get this care, they won't get the appropriate
16:54care. So the extension happened for a year in December. And so it'll come up again this December.
17:00So I've been talking to a lot of senators and congressmen about this. The good news is this is
17:06not a partisan issue per se, because there are many people who represent rural healthcare areas,
17:12for example, who do understand that you don't want to take online prescribing away because it really
17:19is taking access of care, you know, access to care away from people. So I'm cautiously optimistic that
17:26the law will stay as it is right now and not go backwards. But, you know, there's a lot of open
17:32issues that need to be managed.
17:34Bipartisan is probably the magic word these days. How much of your time as CEO, as founder,
17:40are you spending or do you need to spend on the lobbying front versus talking to investors versus
17:44talking to patients? Is it like a third, a third, a third? Or does it depend on the week?
17:49I would say it depends on the week. I was, I went through a very intensive lobbying time in the fall
17:55when I realized there was a chance that we would no longer be able to prescribe these essential
18:00medications. I went on a tear to DC and spent a lot of time trying to talk to people in the government
18:07about this. And then the extension got passed. So we have a little bit of a calm before we'll have to
18:12start doing this again. And then investors, honestly, it's the same thing. You go from
18:17fundraising round and then you kind of get a break until, and then you get to go back and
18:22focus on the company and your patients. What else has changed since we spoke in September?
18:27What are the new offerings? I know you mentioned 12,000 patients a week, but what are the other
18:30big developments since you've read the Forbes Women's Summit and also since the next billion dollar
18:34startup list came out? So, I mean, I think since the last billion dollar startup list came out,
18:39we've actually doubled in size. So, yes, we are growing really fast. It is exciting to watch
18:49how fast we are growing and to realize how many people need this care and how many people are
18:55interested in getting the type of care that we're offering. We are developing actually our own line
19:00of some skincare products that are exciting. So, we found, for example, that there's a need for
19:07estriol face cream. So, estrogen, we know, is a really good, it's because as you age, your skin
19:16gets thinner in part because of a lack of estrogen. And so, if actually there's an estriol
19:21stress cream that we actually created for your face that helps thicken the epidermis and makes it
19:27less likely to get wrinkles. So, we created that. We actually created a vaginal cream that is
19:32particularly attractive to women. And then we're creating additional products as well. So, we're
19:37basically, we're understanding what the women's needs are and we're creating products in order to
19:42solve those needs. Creating them in-house with your own formulas versus licensing others or
19:47prescribing out, I guess. That's right. We're using compounding pharmacies to actually make the products
19:51that we realize are appropriate. Is that your big focus for 2025 or what else do you have going on
19:58right now? So, first and foremost, we're always going to be a service company, right? The products
20:02are always going to be second. The most important thing I do is provide really high quality care to
20:07women. So, we are creating more care protocols. And essentially, we're creating care protocols in
20:12response to the reasons why women are coming to us. We're seeing more women coming to us with mental
20:16health issues. And so, we've been expanding our mental health issues and adapting more screening,
20:23for example, for depression and anxiety on the onboarding so that we're able to refer women to the
20:28right place if they have needs that are in excess of what we are able to offer them. We are, you know,
20:35expanding more of our understanding of GLP-1s and making sure that whether it's compounded or whether
20:40it's not compounded, that's not the issue for us. Making sure that you get access to the right GLP-1
20:45that's appropriate for you if you want to lose weight. We're also exploring, honestly, GLP-1s
20:50microdosing for longevity. I think that as the longevity work comes in, we are seeing that
20:57combination of hormones and GLP-1s are the two components for women for longevity. And so,
21:04we are going to be looking carefully at prescribing hormones and GLP-1s, not just for symptom treatment,
21:11but for your brain and your bones and your heart. What are the impediments to growth that you see
21:16right now? It's an uncertain economic environment. It's uncertain political environment. That's kind
21:21of broad. What specifically in Mid-East world could be a limiting factor?
21:26You know, that is a really interesting question because we do think about it all the time.
21:30The nice thing right now for us is that we are only taking commercial insurance,
21:34so we don't have to worry about Medicaid or Medicare changes. If I had to worry about that,
21:40it would be much more complicated. I don't believe that insurance is going to stop paying for our care.
21:45So, for us, it's actually operations, quite honestly. It's hiring the right number of NPs,
21:50training them, making sure they're really talented, making sure their quality of care does not go down
21:57as we scale. That's probably what I think most about. We have a 95% CSAT right now. I want to
22:03continue that and make sure that as we have thousands of providers taking care of women,
22:07that we are offering the same quality care that we are offering now. And then, honestly,
22:13using AI to figure out how to scale better. There's a lot that we can do with technology
22:18to ensure high quality, whether that's using the AI to review the charts, whether we use it to
22:25do the trainings. We're never going to have AI do the care, per se, but there are a lot of very
22:29exciting opportunities to use AI to make sure that our care is higher quality, and so we're spending a
22:35lot of time looking at that. Well, I wonder if there's a discovery factor there because I feel like
22:38there was just a big story from a Forbes competitor about how AI was used to diagnose a rare disease.
22:45So if you have patients coming to you with confounding symptoms, could AI, potentially,
22:51I don't know what type you're using, could it connect the dots and say,
22:54this is this person's disease or issue, and these are the treatments?
23:01So what I'm hoping in the next year is you're going to see a MIDI AI, and we're calling it MIDI Pal.
23:08And basically, I think I mentioned we have protocols. They're like this, right? We have
23:12massive amounts of protocols. We will basically put all of that into our own AI, and then the NP will
23:20be able to type in a question and see where someone would come out. And then we don't have
23:27to worry about hallucinating, right? Because the biggest problem with AI right now is the
23:30hallucinations. And so you can't trust the AI because of those hallucinations where it makes
23:36things up. But if we make it just on our protocols, then the NP will be able to quickly go in and type,
23:41you know, this person has a high risk of cancer. Her mother had cancer. She has a risk factor for
23:48BRCA, but she's interested in hormones. And it will immediately tell them what the possibilities are.
23:54You have a lot on the horizon. Is there anything we missed in your final 30 seconds here? Anything
23:59else you would share with the Forbes audience about what you have on your plate?
24:02No, it's really exciting. I'm actually incredibly excited that women can get access to this type of
24:06care. And I think that everyone does deserve access. So I think eventually we have to offer this
24:12for men. We have a lot of men calling and saying, I want access. Once in a while, you know,
24:17my wife says that I should come to you as well. So I do think that eventually we will offer a MIDI for
24:23men and, you know, not just give women access to our high quality care.
24:29Comprehensive health care. Joanna Strober, thank you so much for sitting down with Forbes. We so
24:32appreciate it. Thank you.