My hot take on the Amazon news today…there’s no big integrated genius strategy. They purchased ONEM and it’s going to continue operating as is, just like their Whole Foods purchase, but with essentially no marketing costs to drive new ONEM subscribers because of Prime. Those clinics will continue to be in the same neighborhoods as Whole Foods and Apple Stores and Shake Shacks. I bet 99% of ONEM subscribers are also Prime subscribers. The opportunity is doubling, tripling new ONEM subscribers via Prime at no real marketing cost to Amazon.

If you’re a med student and you haven’t found a specialty…that’s 100% fine. You’ll figure it out. Most likely, your life will take an untraditional path, and trust me, while that’s uncomfortable as you’re going through it, in the end, it’s more than worth it. Here’s my story: Throughout med school I knew I loved working with kids more than the older folks, so all my electives were in peds and peds subspecialties. I am a visual person so I was naturally drawn to peds radiology. So I interviewed at 12 radiology programs during my 4th year.

If 5% of people consume 50% of a population’s health spend, 95% of people consume 50%. Yet, I bet 95% of all VC investments are targeting that 5%. Here’s what’s crazy about that: In that 5% of high spenders, there are 3 cohorts. 1: Ppl with 1 or more chronic conditions that could be improved or controlled; 2: Ppl who suffer a one time catastrophic event; 3: Ppl with severe chronic conditions who can’t be returned to good health.

If the 10 min video transaction b/w strangers can manage only ~30 simple issues (pink eye), the trend in telehealth is to double down on managing one or 2 even simpler things and make a few billion at it. Think Ro, Hims, etc and create a cookie cutter brand for each simple thing. Which means that telehealth is both a marketing problem (it’s hard to communicate a thing for 30 issues and you’re gonna waste your money for the other 2,000 everyday health issues) and a biz model problem (figure out how to go DTC for vanity problems).

I spoke this morning at Stony Brook University at a telehealth conference. My first slide: “I’m really disappointed in telehealth.” Here’s why: 16 years in, the industry leader did 1.1M video visits in the last 4 quarters. There are 1.1B doctor visits per year in America. A recent study also showed that out of 20M people, 0.51% of people filed a telehealth claim.