Hello Patient CEO Alex Cohen

Auren Hoffman (00:00.352) go. 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 DaaS.

Alex C (00:23.077) Thank you for having me. I'm excited to always chat things Twitter related or whatever, wherever we get into today.

Auren Hoffman (00:29.378) Super excited. So you read a lot about like, sass and sass sprawl and stuff. What are some of the worst examples you've seen of sass sprawl?

Alex C (00:39.638) Yeah, you know, 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 Spend Doso while I was at Garden Health. was kind of our nights and weekends thing to basically go and build a, 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, but you know, yeah. Yeah, there's, there's a, many of companies doing it. and that was actually the impetus for doing it was we just at carbon, we were going through a big exercise of cutting costs and I'm out. talk about sort of the SaaS sprawler, but, all these companies wanted enterprise contracts to cut your enterprise contracts. And I was like, I don't.

Auren Hoffman (01:11.65) It's a great idea. kind of wish you like built that as a real company. It's like so, so awesome.

Alex C (01:35.978) understand why we're going to pay more money to cut money. Like what, are we doing here? And so we ended up doing the entire exercise ourselves internally. And that's what kind of led to the idea of 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 they're spending on SaaS tools. But it's pretty amazing to me when you, you know, my, the biggest, most like memorable.

SAS sprawl experience from at least onboarding customers 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. so what we were able to see was

Auren Hoffman (02:18.21) And is the best way just like mining email and stuff like that or.

Alex C (02:22.51) We mined the Google OAuth logs and the Octa logs. so, yeah. Emails are actually probably more accurate, but then you have to know what emails you're looking for. But yeah, we saw 700 unique apps connected to their Google accounts across all their employees. And the funniest thing was

Auren Hoffman (02:25.44) Yeah. I thought she had, okay. That, maybe is the best way. Got it. Okay.

Auren Hoffman (02:33.794) Yeah, good point. It's a lot harder.

Auren Hoffman (02:41.206) Wow, it's crazy.

Alex C (02:47.34) We had to let one of the companies know, cause we were still figuring out at the time, like what we were going to build. apparently people on their team had been logging into Grindr using their work accounts. so they were like, they were like, don't. Yeah. And so they were like, yeah, we don't want that. because that's another piece of this, right? Is you, if you have employees signing up for every tool under the sun, what are those tools of access to in terms of like company data? so.

Auren Hoffman (02:56.07) shi- That seems a little weird. Okay, yeah.

Auren Hoffman (03:12.246) Yep. Yeah, exactly. Yeah.

Alex C (03:14.35) 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, this is pretty crazy and insane. Also fun to see that like our tool was actually finding all of that for them, but, um, it's very easy if you're a company to just let it get out of control very quick.

Auren Hoffman (03:34.656) Yeah, 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 whatever it might be that's out there. How do we get more competency about that side of the world?

Alex C (04:16.662) Everything is here.

Action!

Alex C (04:24.59) It's a really interesting point actually. Like no one knows how to evaluate vendors and vendors don't make it easy to evaluate them for the most part. I think as part of the issue too, is if I want to go sign up for a new HR workplace tool, I don't know how I'm going to go, like Workday is not going to go give me a trial. And so you're just going to end up talking to the sales team for.

Auren Hoffman (04:45.91) Yeah.

Alex C (04:49.588) for two months before you ultimately commit your life savings away to go sign up for them. so I think it comes down to having, it's really hard. Like even when I was at Carbon and we were evaluating vendors, we didn't have a process for it. Like 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 a five nine and talk desk and Genesis and UJET and AWS and all these. And I made up my own thing. Like I made up my own spreadsheet to say like, what are we looking at?

Auren Hoffman (05:30.412) Yeah.

Alex C (05:34.936) 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 like what I think they're good at. yeah, I think, you know, it's like trying to stiff arm vendors into letting you do trials or, know, in the contractual period, the ability to get out and trying to do as light of a lift as possible with a vendor, think is probably what.

What, what it comes down to. then when you have every self-service tool under the sun, think you just have to have really, really good monitoring and info sec 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. so, yeah, it's, it's, it's hard. And like the average company has hundreds of tools that they use because no one is that good at one.

particular thing and then I guess we'll get into my band apps list.

Auren Hoffman (06:35.074) And also for, you know, whatever, a couple hundred bucks a month, like, why not? If this is going to help you in some sort of way, be marginally better, like, why not? You know, kind of go,

Alex C (06:45.55) Yeah. And this is the, and this is the dilemma that companies get into. Like ClickUp is on my banned apps list and they have tried to do everything. Like 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. And so you kind of need specialized apps. 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're not that good at being, uh, you know, this like team.

Auren Hoffman (06:59.53) Yep. You're the six best at each thing or something.

Alex C (07:13.004) Like you don't, you don't have real spreadsheets inside of your app. You don't have file management. So what am I using for like pretty notes basically. And so that ends up, you know, when you have these everything apps, that's my frustration is I actually want the specialized tools.

Auren Hoffman (07:15.403) Yeah.

Auren Hoffman (07:19.66) Yeah.

Auren Hoffman (07:26.602) Interesting. What else? I love your list of banned apps that you won't use. What are some of the other cardinal sins there?

Alex C (07:34.094) I think, you know, Carta is on that list now and, you know, hopefully they're not a sponsor of the podcast, but they, know, everything around their managing of customer information and like client information and doing all their, like, all the things that got leaked about them doing marketing campaigns to folks to try to get them to sell secondary.

Auren Hoffman (07:56.61) So like, do you, what do you, does Hello Patient use for their cap table management? Angeles got it. Okay. Yep. Okay. Yeah.

Alex C (08:01.088) Angelist equity. Yeah. Yeah. And they've been great. I mean, like, I can't say good enough things about them, but it was, mean, like, hard has reached out. I'm like, never. Like I just after seeing

Auren Hoffman (08:10.398) wow. Okay. You don't want to say that because now you need to say you'll consider Cardiff so can keep your Angelus bill, Yeah, if you listen to this podcast. Yeah.

Alex C (08:15.598) That's true. That's true. yeah. Yeah. Dan and Angeles knows that I'll tweet meanly about them if they try to get me into a higher tier. But yeah, mean, look, like that's one of the cardinal sins is don't do shady practices that make me think that you're going to go, you know, if I own stock in a company and you now are telling people that and you're leaking confidential information, even if I

Auren Hoffman (08:25.858) Got it. Okay. Got it. Okay, cool

Auren Hoffman (08:34.785) Yeah.

Alex C (08:45.382) agreed to it in some deep terms of service that you hit it in. That to me fits into the cardinal sin.

Auren Hoffman (08:50.784) Yep. Okay. Interesting. What about like, just like some of these UIs are so bad that they, they just, they don't care about the user clearly. Like Salesforce is just, it's just clearly doesn't care about the users. They might care about their ultimate customer who's like 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 that's there. Like they, they just.

Alex C (09:06.125) No.

Alex C (09:10.349) Yeah.

Auren Hoffman (09:18.124) They make it so hard, they make everything so slow. What about those types of things?

Alex C (09:24.052) you know, 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. I think when you have something like so, yeah, no.

Auren Hoffman (09:31.232) Yeah, okay. Yeah. Workday also is just terrible. Like they just, clearly don't care about anybody at Workday. By the way, like this is why we don't have any sponsors on World of Dats. Like nobody would sponsor this podcast because we're like shitting on everybody.

Alex C (09:41.058) Hahaha.

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?

Auren Hoffman (09:56.202) Yeah, yes, yeah.

Auren Hoffman (10:01.014) Yeah. I mean, it is literally the, it's probably the worst product I've ever seen. Like, it like, hasn't changed at all. I don't think since 2004, 2005, like maybe 2006, they made a major upgrade or something. I don't know. Not sure. So it's like 20 years old.

Alex C (10:07.982) Yeah.

Yeah, concur.

Yeah. SAP Concur is the same way. It's like, I, God. Yeah. I mean, I, I mean, we had it at Carbon. Someone decided that Concur was going to be our expense management tool. swore they, yeah, they switched to Brex. They switched to Brex and fire them.

Auren Hoffman (10:19.008) Yeah, luckily I've never used concur. So I don't have no idea how it is. I've never worked for government or something.

What? You, you, you did that. my God. Whoever did that, like please, please tweet and please. Yeah. Please let me know that name of that person so I can make sure that none of the companies I've worked with ever hire that guy. That's just clear bad. That's a, that's like just clearly a bad employee. Like, yeah.

Alex C (10:40.524) Yeah, I don't know who...

Alex C (10:45.408) I know. mean, and then, you know, you look at these tools and in my case, I had a company Brex card for like the, 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. it's your problem. Like not my problem now. If it were, and 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 click up or concur or notion someone.

Auren Hoffman (10:59.688) Yeah, totally.

Auren Hoffman (11:04.943) yeah.

Alex C (11:12.91) Either like the CEO or an exec reaches out like, Oh, can we, you know, I'm sorry to hear that. Can we brainstorm and pick your brain and like learn how we can do better? And I'm just like, no, it's going to be a waste of both of our time. Like there's, you are not changing your product strategy because like one shit poster told you that your app doesn't work for them. So no. Yeah.

Auren Hoffman (11:29.654) Yeah, yeah. Plus it's like, it's not easy to change your product strategy. Like that is a super hard thing to go do. Now you are a big fan of like a linear or something, right?

Alex C (11:40.3) Yeah, purpose built fast eye for design and works. I generally like I like tools that work. use granola. Granola is sort of a new tool everyone's talking about and yeah.

Auren Hoffman (11:42.08) Yeah.

Auren Hoffman (11:49.628) Love it. They're amazing. I love it. I use it too. Yeah. Yeah. Yeah. It's simple. They do a good job. Yeah.

Alex C (11:53.294) Yeah, it just works. It's in the background and, and yeah, I don't have to worry. Yeah. Um, I wish they had some more stuff like, you know, maybe team notes or you could tie it to projects and stuff so you could, but they'll get there. Yeah. Yeah. I mean, we use, you know, like figma, another great tool. don't, I'm not a designer, but I make memes in figma occasionally and like the tool works. so, um, I like it when.

Auren Hoffman (12:04.618) Yeah, of course, the more features you add, then it will eventually just like you'll have the sprawl or something, right?

Auren Hoffman (12:13.964) Great tool. Yeah.

Auren Hoffman (12:18.326) Yep.

Alex C (12:22.326) You know, apps, it's really funny too. I, I used to never pay for apps or like never wanted to on a personal preference. And then as someone who built consumer apps, my entire mentality shifted. 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?

Auren Hoffman (12:44.192) Yeah.

Alex C (12:47.278) And she says yes, I'm like, spend the $10 a month, like who gives a shit, spend the $10 and like support the developers. And like, I have so many subscriptions now.

Auren Hoffman (12:50.306) Correct. Yeah, exactly. Yeah.

Auren Hoffman (12:56.374) Yeah, yeah, so do I. Now, if you actually look at the... If I could see all of the applications that your company uses, it is kind of like a DNA. Like 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 somewhere, you have this kind of prevalence to disease.

Alex C (13:10.445) Yeah.

Auren Hoffman (13:26.4) You like that. You can learn quite a lot about if I, if you, all I saw was a company's vendors. I can tell you, I can probably tell you almost the year they started. I could probably tell you, all these others that can tell you roughly the number of employees they have in the company. I could tell you how international they are. I could tell you, I could, I could probably even benchmark the revenue from that.

Alex C (13:32.408) Yeah.

Alex C (13:37.506) Mmm.

Alex C (13:46.762) Interesting.

Auren Hoffman (13:51.875) Right. I could tell you so many things and then, you know, there's probably, I could tell if I want to invest in that company or not. Um, and, uh, like today, if you're, if you're not using like one of these, um, you know, AI enabled IDEs, if you're, if you're a software developer, okay, well, it's probably, you're probably not a company I'd want to invest in. Right. Uh, so, uh, you know, it's just like, it's, got like, how do you think about like, can we just kind of like somehow get that information and then just like decide how we want to invest in companies based on it or.

Alex C (13:57.443) Yeah.

Alex C (14:11.618) Yeah.

Alex C (14:16.717) Ugh.

Alex C (14:22.03) That's so interesting. Yeah, like one of the due diligence pieces is send us your tech, like send us your SaaS stack so we can evaluate and.

Auren Hoffman (14:27.488) Yeah. Yeah. Yeah. We'll, or just send us your off. Same thing. You know, we'll use, we'll use another service to go do that. And based on that, well, we'll, we'll change your valuation.

Alex C (14:32.517) Yeah. Maybe I need to repurpose Spendosa now for like underwriting, no, it's interesting. It's like, get investor updates from companies and they're in Notion. I'm like, oh, you fucking use Notion. And I lose some level of like confidence in the company because I'm like, you're managing your whole company on Notion. Like, yeah, I know.

Auren Hoffman (14:38.838) Totally.

Auren Hoffman (14:52.482) Interesting. Now, one of the best companies I'm an investor in does do that. They send investor updates in Notion. So I don't know if it's perfectly, there's a correlation or anything.

Alex C (15:02.68) But if you're like a three person company using Teams, like maybe I reevaluate your judgment on like what tools you're going to go, like what you use.

Auren Hoffman (15:08.522) Yeah, that's true. That's true. And by the way, I've never seen that. I've literally never seen a three person company using Teams. But you're right. If I did see that, I probably would have reevaluated really quickly. It's like imagine if somebody had, they're emailing you from like, know, aol.com email or something, you're probably not going to invest in them. Yeah.

Alex C (15:11.81) Yeah.

Yeah, yeah, it's a

Alex C (15:27.358) Yeah, no, no. like, they're still using like a Yahoo email. Like I'd question their security practices and judgment. So.

Auren Hoffman (15:33.634) Yeah. Yeah. Everyone's like, got a resume and it's like at Comcast.net. You're like, uh, seriously? Like you want me to hire you to tech company? I don't know. don't know. Can you see some more discrimination? I'm not sure. So I'll probably get like eight lawsuits coming in after this podcast.

Alex C (15:39.726) man.

Alex C (15:49.26) That's funny. I know the tools definitely make up our DNA though, as a company, it's like pretty interesting. You know, we use Google Mead and G Suite for everything. And I don't know, maybe that shows that we're like capital efficient because we won't pay for tools that we don't need or like, you know, you meet a yeah. So I'm looking at like my doc right now I've got superhuman slack, Spotify, granola. I don't even know what app that is. Figma, like outline.

Auren Hoffman (16:01.228) Yep.

Yeah, exactly.

Auren Hoffman (16:14.498) You

What's the outline? I've never heard of that one.

Alex C (16:19.648) It's like internal Wiki software. we use it to basically like. Creator super fast Wiki for all of our internal customers that the QA team when they're reviewing conversations can go like look up information about that company.

Auren Hoffman (16:30.646) Hmm. That's your antithesis or something. Yeah. Yeah. Yeah.

Alex C (16:35.072) Yeah, it's like, I mean, guess Notion would have solved this for us, but Outline was like 10 bucks a month for like up to, it was like some absurdly cheap amount. And, it just works. All I wanted was like, give me a Wiki with like markdown editing and super fast search and outline did that. So anyway, yeah, it's, it's super, you know, and like,

Auren Hoffman (16:43.967) Okay.

Alex C (16:58.574) It is really interesting the stock that you set up when you first start a company and like there's a whole checklist now of what to go through. Like who do I need for incorporation and for filing and for business banking and for security and all that stuff. And yeah.

Auren Hoffman (17:05.888) Yeah.

Auren Hoffman (17:09.26) That's right. Yeah. Yeah. I mean, just the UI of like a Mercury as opposed to an SVB is like nine day or something like that. Right. So.

Alex C (17:16.15) Yeah. God. Yeah. We use citizens right now and I love citizens because like there comes a point where you say, fuck my bank account. I need someone who can give me a load when the time comes. so we use citizens and they're amazing from a relationship perspective, but it is painful sending wires and like doing anything inside their tool.

Auren Hoffman (17:26.164) Yeah, yeah, yeah.

Auren Hoffman (17:33.6) Why do you need a loan? What's the like, why does like, this more capital efficient to do that or something?

Alex C (17:38.464) No, it's like they'll give me a mortgage as a founder versus like, 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. Like you bank with us. So.

Auren Hoffman (17:41.058) Uhhhh

Okay. I got it. I see. I see. But you got to bring your business stuff over or something like that. Okay.

Alex C (17:53.622) Yeah, exactly. So we do all of our business banking with them. They have whole startup program and Mercury was great, but Mercury doesn't do mortgages.

Auren Hoffman (18:02.42) Yeah, of course. Yeah, it makes sense. Okay. Yeah. Yeah. It's a new product they've got to add on or something. And then, yeah, how do think about these all these new like coding tools, dev tools, know, there's these like cursor bolt.new, there's all these like, there's like new things that come, you know, they're coming up every single day.

Alex C (18:20.974) Yeah, it's interesting. think everyone tries to equate these tools to sort of a coworker. Like I have this coworker AI assistant or I have this like coworker finance assistant and generally, you know, someone who is building the coworker for patient engagement, if you were to use that same analogy and

Auren Hoffman (18:29.249) Yeah.

Auren Hoffman (18:38.016) Yep.

Alex C (18:42.688) it's, it's sexy marketing, whether that's like the real thing, I'm not entirely convinced yet. You just have to treat these things like interns, frankly, like if you don't discreetly define the work that you want the agent to do and sort of this like scoped way of the output that you're expecting, I think you ended 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, it's like, they're great if you're like,

Auren Hoffman (19:03.103) Yep.

Alex C (19:12.064) I need this thing. It has to look like this. Use this stack, go do this thing. And you've given enough instructions that it's operating within the constraints of like what you want. If you were to build an app from scratch, I'm sure one of the tools could do it. Like, is it going to be the right way to build? Like probably not. And so you just have to treat it like it's a junior level employee that just takes tasks that you're like, you're micromanaging your tools basically.

Auren Hoffman (19:18.529) Yes.

Alex C (19:40.329) And, you know, and I do this like for writing, yeah.

Auren Hoffman (19:41.314) The nice thing is like, that every, every over time you can like make quick modifications and all the future ones will use that. So your, your, your prompts are going to get better and better over time at looking at, don't do this or take this thing out or whatever as well. 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. You might, it may not be necessarily written down.

Alex C (19:52.558) Thank you.

Auren Hoffman (20:08.918) But, then over time, they're just getting it better and better. It's kind of like the same kind of thing except, except, 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 can probably move to three other tools. If that one's not working as well, the stress game or expensive or something.

Alex C (20:09.165) I see.

Alex C (20:12.994) You hope.

Alex C (20:17.773) Right.

Alex C (20:25.486) Yeah, yeah, that's totally, that's a fair point for sure. think, um, you just have to go in with the expectation that like to be more productive, I have to tell it what to do. And that's totally fine. Like I write SQL queries using Chad GPT and I just like 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 like write the entire query and the last 20 % I'm happy to do, which is refining it in the way that I need it. Um, and that's generally true, think for most.

Auren Hoffman (20:39.02) Yep.

Alex C (20:54.378) AI assistant so far, like these AI SDR tools have incredibly high churn because they can't do the last 20 % that well. They're like fine at the first 80%. but even with what we're seeing at Hello Patient, like we're learning every single day, something new with the, with the conversations that are happening with real patients. And then we are refining the prompts and those apply, we call them global prompts, but like across all the different practices. And now.

Auren Hoffman (21:00.983) Yep.

Alex C (21:23.084) You are able to like, you know, there's, there's two parts of this one is like, good are you at prompting? The other is how smart is the model? Both of those things will get better over time. And hopefully eventually like, you don't even have to think about good prompting. It's just the model is so smart, but I don't know. I think we're kind of far from that.

Auren Hoffman (21:37.782) Yeah, I agree. I've had, in results where if things where I'm doing many times, you can get good at it. The problem is if you're only do a lot of times, you're using these things for things you're doing, you need right now. It's a new thing. You've 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 the, that at least right now, maybe you're not, at least for me, I'm not super well trained that it's just a lot easier either to tell someone else or do it myself.

Alex C (22:07.394) Thank you.

Auren Hoffman (22:07.648) 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. Like 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 the only in that case, it makes sense if like I can do it over and over and over again on that.

Alex C (22:26.299) For sure. Yeah, 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. so, 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, like the...

The world in which we're going into is like the people who are really good at writing and communicating will probably win because you're going to like that is the way that you interact with your with your LLF.

Auren Hoffman (22:56.737) Yeah.

Auren Hoffman (23:02.862) 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. Like, like what advice would you have for someone who wants to be a better at this?

Alex C (23:15.274) Hahaha

Alex C (23:20.238) Oh, that's interesting. I'm actually, uh, I've been writing a document for myself, uh, and to share, we'll see, I'll share it to you when I'm done with it, if you want to read it, but it's like, it's like, what do I actually, let me, I forgot what I like officially have it called, but I think it's something along the lines of like how to become a Twitter shit poster. And, I'm not planning on sharing it broadly and widely. I, uh, it's mostly for like,

Auren Hoffman (23:30.914) 100 % I wanna read this.

Auren Hoffman (23:43.626) Yeah, okay.

Auren Hoffman (23:49.74) Just share it with your friend's name or in place. Yeah. Yeah, yeah. Okay, perfect.

Alex C (23:51.182) Yeah. Anyone whose name starts with an A, we'll get it. But I've been thinking about this a lot, like 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 cringy replies. I was a reply guy for a while and I deleted most of those tweets, I think.

I really used it as like a, I started in this like niche circle. And so I think ultimately what it all comes down to is relevancy. It's, it's, you how do we stay relevant on the internet? Cause that's the most important thing. The next time you want to go sign a deal or go meet someone, they like remember you. And so, they've seen you online. So there's this like aura of relevancy and it is a lot easier to stay relevant within a niche than it is to be like a mass market. You have to be like a celebrity.

Auren Hoffman (24:37.761) Yeah.

Auren Hoffman (24:45.57) Got it. So if you're just about all you care about is basketball and then 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 going to talk to the environment. I'm going to talk about science. I'm going to talk about, oh, by the way, I'm going to spring on some venture capital things.

Alex C (25:00.718) Correct. Yeah. And eventually you get to a point where you are sort of like 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. Like 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

Auren Hoffman (25:07.263) Everything, yeah, okay.

Auren Hoffman (25:13.378) Yeah.

Alex C (25:25.58) 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. And so 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 like, yeah. I know.

Auren Hoffman (25:34.816) Yep.

Auren Hoffman (25:41.024) Well, that's a problem though. That's the hard part. Like I'm hoping for the easy things like making like original thoughts that are, you know, super interesting and relevant. Like, wow, that's like that not that's not an easy thing to do.

Alex C (25:49.976) Yeah.

Yeah, I mean, I just, I was at a dinner last night and someone asked similarly, like, 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 just, literally don't know it's ever. My brain is functioning that day. There's no rhyme or reason to it for me. It's been an outlet. Like I don't write blogs online or anything. just tweet. so.

Auren Hoffman (26:01.525) Uh-huh.

Auren Hoffman (26:16.16) Yeah.

Alex C (26:16.846) Twitter became my personal blog and 60 second dopamine hits and I'm fine with that. I think people who try to plan their content and write these very elaborate, strategized posts with just the intention of gaining followers, it's like, just go to LinkedIn. What are you doing on Twitter? That's my approach to Twitter is find a niche that you love and that you're good at, write content, shoot from the hip, engage with other people who you find interesting.

Auren Hoffman (26:35.541) Yeah.

Alex C (26:45.324) And don't really focus on the outcome, like focus on great inputs into your Twittering or Xing, whatever, whatever we call it these days.

Auren Hoffman (26:52.002) No, 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 will blow up and I'll have like two, you for me, 200,000 views, which is for me, a lot of views. I don't usually get that many. And I'll get like three new followers from it or something. Like it just doesn't seem like they convert at all to new followers at all.

Alex C (26:58.018) Thank

Alex C (27:04.174) That's great.

Alex C (27:08.674) Mmm.

Alex C (27:14.23) I don't know. It took me a long time to get to 200,000. I was stuck at like one night, like 150 forever. I, again, I don't know what actually converts people to following. wish, Elon, if you're listening to this, like make it easier or more like make people, yeah. it would be nice. mean, I don't know how many views I get in a particular, I'm sure I could look real quick and see like how many views I get in a particular month or year for.

Auren Hoffman (27:29.836) To understand, yeah, exactly, yeah.

Alex C (27:43.15) on Twitter, but it's, it doesn't really convert either to a ton of followers. It's just a lot of the laying off tweets do for whatever reason, whenever I joke about getting fired for some reason, people like that, here in the last, four weeks we've had.

Auren Hoffman (27:58.807) Yeah.

Alex C (28:07.854) 22 million impressions with a 4 % engagement rate. 236,000 people visited my profile and I probably gained like a couple thousand followers.

It's like not super high conversion. I don't know what slaps for people. In the last year I've done...

Auren Hoffman (28:24.896) Not a lot, right? Yeah.

Alex C (28:33.454) 330 million impressions in the last year. think that that's low.

Auren Hoffman (28:41.538) They don't even do a good job of like, Twitter doesn't even do good job of like helping you find where your stats are.

Alex C (28:47.342) No, I had to like go find this in a setting buried somewhere, but...

Auren Hoffman (28:50.984) Right, right. Exactly. It's in some like really buried setting. It's like they don't really want you to know about it or something like I don't even know. Like, isn't that something people would want to find out about?

Alex C (29:01.422) Oh, interesting. can now see who my most common. So 80 % of my followers are male, 20 % female. No 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 seeing this. Anyway.

Auren Hoffman (29:08.662) That's not a surprise, right?

Auren Hoffman (29:14.708) Okay.

Auren Hoffman (29:24.158) Okay. Yeah. Yeah. Yeah. Okay. Right. So you're just looking, you're looking at your four week stats, right?

Alex C (29:31.746) I looked at four weeks and, you know, or even the last year. It says I've had a million and a half people visit my profile in the last year.

Auren Hoffman (29:35.37) Yeah. Right. And they don't even tell you how many, how many, from there, they don't even tell you how many followers you got from that. Right. Which also is weird. You would think that's like an obvious thing that they would be able to tell you from.

Alex C (29:44.194) Not that I can tell.

Alex C (29:49.398) Yeah, they tell you what which of your tweets have the most impressions, which is pretty interesting. So, yeah.

Auren Hoffman (29:55.808) Yep.

Alex C (30:01.688) That's Twitter though. So again, I don't have the answer to like what actually converts people. I just recommend firing from the hip and seeing what lands and continuing to like double down on content that you're good at.

Auren Hoffman (30:14.934) Now, if you saw someone who's starting to have like a ton of engagement on Twitter, do you think this person, like, 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?

Alex C (30:29.934) That's a great question. I think at some point they become a bit of a brand risk for sure if you have someone who is very popular. We just saw this with the, there's some payroll company, I think they're called Warp. And one of the people who work for Warp went on this super racist whatever

tyrant or rant online are on Twitter and then the CEO got called out and then all the stuff started to leak in their Slack messages. And that's just like, there's only doubt. There's only downside to that. I think you can definitely hire great people who have Twitter personas.

Auren Hoffman (31:08.14) wow. Yeah.

Alex C (31:18.732) I haven't yet, so I don't know.

Auren Hoffman (31:19.862) Yeah, okay. Got it. Got it. But you were, I mean, obviously now you're an entrepreneur, but you were working for companies before you clearly already had a Twitter persona when they hired you. But like, would they, would you just, would you, or you really make a better founder than an employee or like?

Alex C (31:37.934) I think that there is definitely this element of, you you want to build your public brand. They might go one and the same, right? 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 kind of have a bit of free for all. It is risky. Like we've seen founders get canceled and everything, you know, tarnished because of their personal brand. so

Auren Hoffman (31:48.417) Yep.

Alex C (32:05.142) 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 and they can actually go and like, unlocks the sort of superpower that they have. I don't really think anyone falls in the middle. I think you're on one side of the equation.

Auren Hoffman (32:29.026) I do know 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 maybe I'm not doing enough because I'm on Twitter or something.

Alex C (32:34.667) Mm-hmm.

Alex C (32:43.565) Yeah.

Alex C (32:49.166) I think Twitter has only been a net positive for the work that we're doing. Now, our audience, like our ICP is not really on Twitter as much. They're more on LinkedIn. And so probably have to go flex the LinkedIn muscle a bit more. you know, I've, if you go look at my tweets while I was an employee, I was tweeting a lot more than the last nine months since starting a company. Cause you just lose the time and you lose the focus, you lose the motivation.

Auren Hoffman (33:14.56) Yeah.

Alex C (33:17.038) For me, it's never been about like follower accounts or you know, ex pays like shit. So it's not about money. It's not about like, you know, no one really it's not like YouTube where you become a celebrity off of Twitter, but I I just enjoy the love of posting so and I enjoy it's like my writing outlet. I don't really like write anywhere else. So yeah, yeah

Auren Hoffman (33:30.945) Yeah.

It's creative. Yeah. It's interesting because, you know, 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 you first, even before you did the company. And, know, and the main thing I got to know you for is like, well, you make me smile, right? I laugh and I can smile. And like you say interesting things and stuff like that. But I mean, I do think like it must be good for business. I got a certain point, especially at your level, and you're not at the

Alex C (33:47.693) Yeah.

Alex C (33:53.358) Hahaha

Auren Hoffman (34:03.958) Elon Musk level of course, but at the 200,000 follower level, like it must be a good thing for business.

Alex C (34:09.661) Yeah, it's basically what I would say is 99 % of the people that I want to get in touch with like will respond to me now because of Twitter. if I need to go, if I, yeah, yeah. Like Elon won't write me back. I've tried DMing him, but like the majority of people will engage back. And I've met so many people I would never have met.

Auren Hoffman (34:19.031) wow, that's huge. Okay, that's massive.

Auren Hoffman (34:25.087) Uh-huh.

Alex C (34:33.048) had it not been for Twitter. so like, for example, the CEO of ZoomInfo gave us like a year of access to the product because he just like follows me on Twitter. And I didn't even know he followed me. It's like random things like that where all of a sudden it's kind of goes back to the relevancy point. It's just, it's, actually very beneficial staying relevant on the internet. If you can do it in a way where you just like continue to not piss people off or, you know, alienate them. so,

Auren Hoffman (34:41.952) Okay, yeah.

Alex C (35:00.334) And so that piece has been amazing. It's like we have direct access to the majority of people that we would need access to so long as they use Twitter primarily. It's funnier though, do you want to know where I first became familiar with your content? Can you guess where you, yes.

Auren Hoffman (35:13.246) Okay, tell me. Yeah. Quora? Quora maybe? Okay, yeah, I used to back in the day I was big. I was big on Quora. Yeah, yeah.

Alex C (35:22.156) Yeah, you were like a prolific Quora poster, if I recall. So.

Auren Hoffman (35:24.256) Yeah. Yeah. I love, I wish they were still popular. I just stopped posting because like no one, no one, no one's there anymore, but I would have, I would have kept, kept doing it. And then like, and then I only got people in India, like, like no one in America, America was there and then no one in India was there anymore. I was like, I'm not even getting people in India anymore.

Alex C (35:27.95) sorry.

I know, it's sad.

Alex C (35:42.008) That's amazing. But yeah, it's funny. life comes full circle. Cause when I was, think even in college, like I was, I would use Quora to like look up answers. And I remember your, and again, that kind of goes back to like your profile photo, the black and white one is like stuck and ingrained in my memory from Quora, from all the questions that I read that you had an answer. mean, every, mean, cause you used to write about all the venture capital and fundraising and stuff and like, yeah. Yeah.

Auren Hoffman (35:49.696) Yeah, so good.

Auren Hoffman (35:59.586) It's hilarious.

Auren Hoffman (36:03.522) Right, that's what I wrote, right? I kind of followed your strategy, that niche-y thing, right? Yeah, yeah.

Alex C (36:08.162) Yeah, exactly. And then you become relevant and people are like, who do I go race from? do I go ask questions to it? It's like, I got to go talk to Orin. I got to go ping him. And it's, like, again, that whole relevant, it's so easy. It's easier to stay relevant within that like niche or several niches because that's the content that you know, and that you live in and people love that stuff. And so, you know, RIP Quora, but

Auren Hoffman (36:15.67) Yep.

Auren Hoffman (36:27.042) And by the way, know, I, cop, the reason I did that is I copied Jason Lemkin. He was on Quora. And I was like, I like, I like his content. I'm just going to copy him. And so I went on there myself, you know, and I just had an exit. So it's like, okay, well, I don't have any boss now as I can just go do my thing and stuff.

Alex C (36:30.966) Yeah.

Alex C (36:37.452) Yeah.

Alex C (36:43.554) Yeah. And he has great content, even on Twitter still. He's the person who I point to. I'm like, you have questions about hiring sales staff? Go read one of Jason's posts. 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. so think going back again, bringing this theme back to how do you get better at posting online.

Auren Hoffman (36:46.368) Yeah, he's amazing. Yeah.

Alex C (37:10.646) It's just easier to come up with a, and you might not know that your content is original. Like in your head, it's very simple. Like it's the thing that, know, it's not that creative. Everyone knows about this, but most people like really don't know about those topics.

Auren Hoffman (37:15.777) Yeah.

Auren Hoffman (37:22.368) It's interesting because there are some people that you 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. Like I think that they're famous because I really value their content. They're writing something maybe very initial I care about, but maybe not enough people care about or just they're just not yet. They're not discovered yet, maybe. But sometimes I'll see who else is following them.

Alex C (37:37.942) Yeah.

Auren Hoffman (37:51.936) And it's like, it's like, they'll have like eight billionaires that follow them. only have like 2000 followers or something. Right. And you're like, my gosh. Like, so they are influencing people in a very interesting way.

Alex C (37:52.321) Mmm.

Alex C (37:58.126) of

Alex C (38:03.764) Mm hmm. Yeah, yeah, you don't need hundreds of thousands of followers to really have influence online. 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 like dumb tech content, tech adjacent content. I try to avoid politics and religion and all the other thing. I mean, like it's just. I think like the memes, but memes, I'm not like posting, I don't want to like.

Auren Hoffman (38:20.353) Yeah.

Auren Hoffman (38:25.878) So you've got a decent number of politics ones too, right? I see you here and there. Yeah.

Alex C (38:33.752) I'm not trying to share my conspiracy theories or like what side of the spectrum I'm on. And then, none of it matters. It's all, there's some stuff where it's only downside. you know, I'm, you could think about a number of folks recently have gone very deep into the political content posting and like, I'm sure it's working great for them, but in the group chats, it's like, this person needs to just like, it's getting annoying after a while. It's like what is sort of the theme that you start hearing. And, you know, even like,

Auren Hoffman (38:36.163) yeah, yeah, yep.

Yeah.

Auren Hoffman (38:49.493) Yep.

Auren Hoffman (38:57.761) Yep.

Alex C (39:03.47) October 7th, I got a lot of backlash for posting. It's like the one thing I've posted is like support for Israel and then the amount of backlash you get in the comments. like, I'm not making a difference generally. So like, why am I posting about this stuff? It's only downside.

Auren Hoffman (39:10.955) Yeah.

Auren Hoffman (39:18.218) Yeah, yeah, yeah, yeah. Yeah, yeah, yeah. It's a it's a good it's a good point. Now we talked about vendors. One of the more I would say hated vendors in health care is Epic Systems. I would say like when you poll people in health care, they're probably the number one hated vendor, I presume. I'm not sure. OK, Cerner. Yeah, good point. Yeah, there's a few there's a few up there, but they're

Alex C (39:40.47) Maybe Cerner. Cerner might be above them.

Yeah.

Auren Hoffman (39:46.944) you know, incredibly successful, incredibly successful company. How do you, how do you dis-immigrate this, this kind of like hated yet still super successful kind of thing?

Alex C (39:59.404) Yeah, I secretly love Epic as a company, think. So my brother-in-law works for them actually in Wisconsin, I just like, know, Julie, their founder and CEO is just like a legend in healthcare. I and you think about everything that they've built. There's not another.

Auren Hoffman (40:02.792) Okay, great, okay.

Auren Hoffman (40:17.559) Yeah.

Alex C (40:21.512) EHR that does like there's a reason why every hospital system in America uses Epic. There's a reason why every intensive specialty uses Epic. Like the amount of ingrained deep integrations across hardware and devices and like just the hospital network and operations that they have, you just can't switch for them. And that's why they're hated and they're loved because like 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.

Auren Hoffman (40:50.6) Yeah. And they don't, yeah, they won't, they won't integrate with other apps and stuff like that. So it's like, it's very, it's like hard to sort of innovate on top of it.

Alex C (40:59.81) Yeah, and they don't buy companies either. It's in their mantra or values or whatever. It's just like, don't acquire, we only build. And so it's a really fascinating company. They've never taken outside capital. It's just so...

Auren Hoffman (41:08.791) wow, okay. I know that.

Yeah, which is, I mean, look, it's an amazing, like, it's amazing company,

Alex C (41:18.501) Yeah. Yeah. And I, and I think everyone is like, we're going to go build a better Epic. I'm like, no, you're not like you just, can't it's, uh, you got to go back to like 1990, go integrate with all the random MRI devices inside the hospital and all the different, you know, all these like, there was like one person at Epic who's maintaining device integrations from the year 1995. It's just, you are never going to replicate that. And the only way that you're going to go, that you will be able to.

I think go up against Epic is you have to own the hospital. Like you're basically saying I'm Ascension seeded and I'm building like, or I'm building new hospitals and like, and, there's, yeah, yeah. But there's really like, is that their core competency? No. They're good at charging people for hospital stays. Like they're not great at building software. So, and, we like to sit kind of agnostic downstream of all these vendors. It's like, use whatever EHR you want, use whatever patient management system.

Auren Hoffman (41:51.029) Yep.

Auren Hoffman (41:55.933) HCA. Yeah.

Auren Hoffman (42:00.972) Probably not, no.

Auren Hoffman (42:14.369) Yeah.

Alex C (42:17.728) 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.

Auren Hoffman (42:25.608) And I mean, you're kind of in this interesting position to see how like 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 and almost every single stack is very different. Even one's doing like 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 is it like involved in such like a different parallel path?

Alex C (42:39.779) Yeah.

Auren Hoffman (42:56.362) Is it the regulation? it the buyer is so different? it?

Alex C (43:01.942) Yeah, think it's 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

Auren Hoffman (43:14.581) Yeah.

Alex C (43:29.154) bespoke things for the specialty that they landed in. And they've just, you know, like they've, they've adopted, almost became sort of like half consulting shop or like half dev shop, half SaaS company. And so you just ended up with this fragmentation of like all of these different tools that do a whole bunch of different things to try to adapt to a whole bunch of different processes that the, 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 like, we need to build that feature for them. are 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 like, here's what it is. there's very few companies in healthcare that actually like do a, do a standardized model, like simple practices. 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.

Auren Hoffman (44:03.041) Yeah.

Alex C (44:28.854) are scheduling, you make it work for us versus us making it work for you. And they've been quite successful with that approach because they work with the sort of like independent, smaller SMB providers. Yeah. And on the other hand, you have like Athena who is in the middle where like 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, you know,

Auren Hoffman (44:32.535) Uh-huh.

Auren Hoffman (44:38.338) They're like the Zoho for doctors or something? Okay.

Alex C (44:56.928) an ecology chain is using them. it's just a completely different, 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. But even Epic, 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.

Auren Hoffman (45:12.662) Interesting.

Auren Hoffman (45:23.35) Yet. then how do think about like, there's all these consumer health apps, obviously devices, et cetera. and then you've got the data that flows to them. Sometimes it's not, not clear how you evaluate the data or how you can like access the data. Or could you bring the data into some other types of things? Like, how do think that evolves?

Alex C (45:43.308) Yeah, I think that there's a couple different pieces of categories of data that are important. There is your medical health records that you went to your doctor, they charted, they have soap notes, you want access to those. You want to have this historical log of what happened based on what a physician.

Auren Hoffman (45:52.097) Yep.

Auren Hoffman (45:58.122) Yeah, ideally I want to, I want to be able to log in somewhere and have my own copy and be able to manipulate it and see right now I'm getting, I have like PDFs on like a Google drive or something. Yeah.

Alex C (46:05.026) Yeah.

Alex C (46:09.398) Yeah. Healthcare data has been like inherently non-interoperable for a long time. Like 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 of like the aura 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 sort of like

Auren Hoffman (46:16.331) Yeah.

Auren Hoffman (46:22.145) Yep.

Alex C (46:38.988) 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 like what that team has built. There's a lot, I mean, I think like frankly, Apple health will win the battle here. If we're talking about like who's going to win long-term of I want access to like one single point of longitudinal data, like healthcare data and seeing all the different

Auren Hoffman (46:39.873) Yeah.

Alex C (46:59.648) markers and metrics and all these things related to my care. Like Apple is probably the company that wins there. Frankly, like 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 the sort of like middleware of this and say, we like 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 the 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.

Auren Hoffman (47:16.864) Yeah.

Alex C (47:29.506) software interpretation layer. They want a provider to interpret the data.

Auren Hoffman (47:33.41) Yep. Yeah. Interesting. Yeah. It's a super, it's super cool. Do you think it will like evolve in any like, or do you think in the next five years it will change dramatically or do you think it be just kind of like more incremental?

Alex C (47:46.803) I think we're going to move to a world where like you have a concierge doctor, like a private, you know, you, have someone who's a health coach or a doctor somewhat medically trained and they are the ones have access to all your data within the platform. You do see things, but you're not interpreting them. You know, you can get Chad GPT or Claude to interpret your medical data in a way that. Yeah. Yeah.

Auren Hoffman (47:55.35) Yep.

Auren Hoffman (48:07.296) Yeah, I've done it multiple times. I've uploaded. What does this mean? Or, you know, I've had friends who've had issues and uploaded. What does that mean? And it's actually pretty good.

Alex C (48:14.594) Yeah. Yeah. 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 like, everyone has access to a concierge longevity style doctor that they pay a thousand bucks a year for something like that. In that system, you have this style of like, here's your AI.

Auren Hoffman (48:21.27) That's right.

Auren Hoffman (48:25.515) Yep.

Alex C (48:39.778) companion to ask questions to it's based on all this data. 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, you know, here, get access to all your vitals in a cool chart.

Auren Hoffman (48:53.697) Yep.

Auren Hoffman (48:57.354) Yeah, I mean, like some of you, have a currency years doctor, is significantly higher price than a thousand dollars a year. And, and so, and I love that I can benefit from that, but it would be great if like, if we could push that down to a large number of people who could also benefit from that kind of same, maybe, maybe it's not super white glove, but still quite good kind of service.

Alex C (49:04.494) Yeah.

Alex C (49:17.635) Yeah.

Alex C (49:23.98) Yeah, I think we'll unlock.

Auren Hoffman (49:25.622) And a router too, to help you, you got to 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. Like you got to go get this test or you got to go do this thing or whatever. Let's do the full body MRI. Now know you don't want to do it, but it's like, whatever it is, like whatever, whatever the nag is that you didn't want to go do, you have VO2 max, whatever it is, like just someone to, okay, well that's great. I think that's awesome.

Alex C (49:30.136) Uh-huh.

Alex C (49:36.312) Yeah.

Alex C (49:47.448) Yeah.

Well, that's what we do now.

Auren Hoffman (49:54.838) Because you people need they just need they need annoying person to remind them to guilt them into doing it and sometimes as a spouse who's like guilting you in or it's a sibling or it's a parent or a child or good friend who might guilt you into it But you know, 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 guilts me into doing is like he's like you got to lift more weights

Alex C (49:54.84) Yeah.

Alex C (50:18.712) Yeah.

Alex C (50:23.374) Mmm.

Auren Hoffman (50:23.566) he's like, that's really important. You gotta go and he'll just get on me and he'll just be start like, you you're not, you're, know, that, you know, that's important. I'm like, I know I just hate doing it, but like, yes, I know. Yes, you're right. And I got to go do it. And then, and then at least for like the two weeks after talking to him, I do a good job of it.

Alex C (50:39.822) Yeah, I mean, and I think, you know, maybe we figure out there's a class of workers who we train and 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, or they can tell you to do things without giving you medical advice. And, 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.

Auren Hoffman (50:52.853) Yeah.

Auren Hoffman (51:08.342) That's right. And by the way, like for, for most people, it's pretty obvious cause they haven't done most things. Right. So it's pretty obvious. Okay. Here's like the 20 things you need to do, or you need to do better at, right? It's like, let's just start with those first before we do the long tail of stuff. It's like, okay. how are you sleeping? you're getting a five hours of sleep. Okay. Let's try to get six. Okay. It's like, yeah, it's kind of obvious. Yeah. Yeah.

Alex C (51:09.534) And AI, yeah.

Alex C (51:18.914) Yeah.

Alex C (51:25.23) For sure.

Yeah

Alex C (51:31.66) Yeah, there is a baseline. Yeah, there's, there is a baseline. Like there's just things that you need to do. I think, you know, one company that might own or become big if they, you know, depending on the route they go down and it's like function health. If you've seen them, I mean, they're, they're, what is it like $500.

Auren Hoffman (51:45.794) No, I haven't yet.

Alex C (51:51.31) twice a year, get access to like 80 biomarkers or something. And they do like all the testing, they visualize it all. So they have like 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, and into like the coaching, the membership, the subscription, the hardware, the wearables, the upsells, whatever it is. labs are just, unless you own the lab itself, it's just not that.

Auren Hoffman (51:55.819) wow.

Auren Hoffman (51:59.681) Yep.

Auren Hoffman (52:07.818) Other types, yeah.

Mmm.

Alex C (52:19.544) profitable of the business. 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? So 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...

Auren Hoffman (52:31.136) Yeah, yeah, yeah.

Yeah, absolutely.

Auren Hoffman (52:39.339) Yeah, yeah.

Alex C (52:44.608) nighttime boners and then like all the consumer apps like we'll get into a really interesting world in the next five or 10 years where everyone cares about this stuff.

Auren Hoffman (52:52.738) It's interesting, I remember Brian on this podcast, Brian's a long time friend of mine. And when I ask him advice on stuff, he's just like, okay, like the simple thing is like, there's just like, for the 90 % solution, he's like, you don't have to get to me, which is like the 99.9999. It's like the 90 % solution is just stop doing these four things and start doing these two things. And it's all basic.

stuff and like, so he's like, just do that first. He's like, you know, before I did this, I just had to stop eating pizza at 2am. He's like, okay. I'm like, okay. Yeah. Stop eating like bags and bags of Doritos. Like when I met him, when I was back in the day, we were friends and he was, he was like overweight guy. Uh, yeah. So it looks amazing. Yeah.

Alex C (53:29.099) yeah.

Alex C (53:33.602) Yeah, he looks great now. mean, I know he gets a lot 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 like I would have.

Auren Hoffman (53:43.923) I think he's a hero for our society because like even if he gets most of it wrong, we learn so much from him. Like he is, he's putting himself out there. I love the fact that I wish more people did that rather than go like buy a winery or yacht or something like do something like actually meaningful for society.

Alex C (53:50.338) Yeah.

Alex C (53:58.126) .

Yeah. Well, I'll tell you this, like if Hello Patient has a big outcome one day and I become rich enough to go do all the, just spend all my time on longevity experiments, I will absolutely go do that. I would love nothing more. so, yeah.

Auren Hoffman (54:12.226) I would be that would be so awesome to have more of those. think that's great. All right. We have two questions to all of our guests. One of them is what is the conspiracy theory that you believe?

Alex C (54:23.374) Okay, this is the I was actually just talking about this last night with someone I It's I guess it's a little spicy like I genuinely believe that we that there is big food Which is controlling our food supply and putting all the toxins and everything into our food That and they know that it causes cancer because they have a relationship with the big pharma companies who then sell the kids

Auren Hoffman (54:28.477) okay, good.

Auren Hoffman (54:43.991) Yep.

Auren Hoffman (54:50.079) Uh-huh.

Alex C (54:52.152) Pharma companies don't make money if people are not getting sick and needing their drugs. And so I believe that there is a, God, someone's gonna come to my house and like shake me down after this. But yeah, that's true. Yeah, I just think like, you know, lot of pharma incentives are misaligned, especially when we've identified, I think we know that food is the source of our issues. Like we should not be eating corn syrup. We should not have.

Auren Hoffman (54:56.578) Yep.

Auren Hoffman (55:03.404) They're gonna come to Bobby Kennedy's house first or something, right? Cause he's probably talking about this stuff too.

Alex C (55:18.36) I learned last night from someone that there's this process that food companies can go through to get labeled as like, we think that this is generally safe and then they're allowed to put it in their food and it only needs like one study and it can be like closed off. Like you don't have to make those records public for the study. And then that food ends up in our, like we're just eating that all day. And I believe that food's like probably.

the main factor why people are getting sicker and getting cancer younger. And then I believe that like big pharma doesn't want that to stop. So that's my current conspiracy theory.

Auren Hoffman (55:51.874) It's interesting in the Peter Tia, like he's kind of recently changed his mind where he kind of said, he's, recently, he used to talk a lot about diet and now he's moved to much more like, you know, yeah, diet's great or whatever, but, it's, it's way less important than exercise. So he's really kind of changed his tune on that. Like, how do you, how do you think about that?

Alex C (56:12.229) Yeah.

Alex C (56:15.97) I, I listened to his like 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, but yeah. And to some extent, our food supply is out of our control versus like the amount that you exercise is in your control. And so.

Auren Hoffman (56:25.364) Yep. And people change their mind about it every year. It's like new data comes in and...

Auren Hoffman (56:38.838) That's right. Right. Like the amount of like, I'm not going to read every label of it's just too hard. Maybe, maybe, maybe with an AI will help me in the future, but

Alex C (56:43.296) No.

Yeah, yeah. mean, you literally have to go to like specialty grocery stores and only get grass grown, know, fed meat and like to avoid plastic. And at this point, I'm like, just, don't care. Like I can't, yeah. I think exercise is, I mean, I don't know. I'm not a doctor. 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 like general.

Auren Hoffman (56:56.258) Right. And who knows if it's even true, you know, it's like, you know, it's like.

Auren Hoffman (57:13.62) Interesting. Yeah.

Alex C (57:15.15) if I had a bet on one of the two things being true, more true.

Auren Hoffman (57:18.56) And how big a factor you think will these like GLPs, cause you know, in some ways like there's a lot of it's just like people have too high BMI or something like that, right?

Alex C (57:28.77) Yeah, think GLPs are amazing. I think we're all going to have custom formulated peptides for us long term that we inject to, you know, to regulate our hormones and other markers. And I think

Auren Hoffman (57:40.104) really? So you think there's going to be a common thing we'll all have, which are based on our own genetics slash age slash, you know, other types of body characteristics.

Alex C (57:47.596) Yeah.

Alex C (57:51.426) Yeah, I know nothing about the science, but my current like future thesis is that the drug companies are going to invent a, they already have a pill version of a lot of these drugs for like the GLP ones. They're going to invent a custom formulated peptide vitamin or pill or whatever that you take once a day for that is specifically formulated. Yeah. For all of your, yeah, for your gene makeup and, and for everything. so like I.

Auren Hoffman (58:01.269) Mm-hmm. Yep.

Auren Hoffman (58:13.9) for you. Wow.

Alex C (58:18.222) I'm doing some supplements due to like, I'm in like the mid range of testosterone. We're trying to boost it to the higher, you know, top 5 % range of testosterone.

Auren Hoffman (58:26.914) Yeah. What do you and do you do you take out orally or do you cream or you inject or what do do? Okay. That's annoying. Right? Yeah.

Alex C (58:32.992) inject at the moment. like, yeah, it's, it's fine. Like you get over it. I'm doing, I do per week about 10 different injections right now. So I'm 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.

Auren Hoffman (58:44.745) wow, so not just testosterone.

Auren Hoffman (58:56.124) What what I don't know that much about HCG what can you let us know what that is and why do do it?

Alex C (59:00.718) In the crudest form, it can be used to like get your body to naturally produce more testosterone. It like tells the balls to produce more. But when you take it with testosterone, 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 like an external testosterone, basically.

Auren Hoffman (59:24.355) got it. So if you're in like, I'm still having kids kind of face of your life, HCG would be okay.

Alex C (59:28.416) Yeah, yeah. Or if you don't want your balls to shrink, because that's what they do on testosterone is like they just get tiny because they're like, I don't need to go make testosterone anymore. It's coming from an external source.

Auren Hoffman (59:36.418) And what's the downside of shrinking balls or something? Like then you're just more reliant on this drug going forward.

Alex C (59:43.374) It's mostly

Yeah, you end up like reliant on testosterone for life. most guys probably should be on it, frankly, like with the way testosterone trends have come down over time. The range never used to go to, it's like 200 to a thousand is like normal range or something. It used to be like 500 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. But yeah, and then the downside to some of the drugs is like,

Auren Hoffman (01:00:07.127) Mmm.

Alex C (01:00:17.206) If you're not really working with a doctor, not getting your markers done, like higher HCG can lead to your estrogen levels getting higher. And then you have to like take a estrogen blocker. Like there's just things you have to do to regulate all the stuff you're taking. So.

Auren Hoffman (01:00:30.537) God, it becomes like a whole thing where you have to like figure all this out.

Alex C (01:00:34.158) Yeah, so I'm working with a doctor to do all of that and I don't have to think about like, Hey, chat GPT, like how much should I be taking today? But yeah, like most

Auren Hoffman (01:00:42.762) Right. And your doctor will kind of change things over time based on, and so you have to, so I assume you have to do a lot of blood work as well.

Alex C (01:00:51.776) I did a lot of blood work to start and I'll do blood work like every three months or so.

Auren Hoffman (01:00:56.256) Yep. Okay. That's another, and that's another super annoying thing too, right? Is to have some phlebotomists come in and...

Alex C (01:01:00.652) Yeah. Yeah, they miss. Although I got to say the last few have been surprisingly painless. it's maybe I'm just less sensitive to needles now after injecting, you know, almost every night, but the needles are like the insulin needles are so small that you don't really feel them. You just have to like, I feel like I'm a drug addict in the fridge. I like take out the vial and I like pull it and I flick it and then I got a, but I don't know. That's the,

Auren Hoffman (01:01:13.036) Yeah.

Auren Hoffman (01:01:22.72) Yeah.

Alex C (01:01:28.482) That's the cost of wanting to like experiment with biohacking your hormones.

Auren Hoffman (01:01:33.13) 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?

Alex C (01:01:41.038) Mmm.

I probably should have thought about this one before I joined,

Alex C (01:01:56.878) I might need a second to look up some conventional advice and see what I disagree with.

Auren Hoffman (01:02:03.093) Hahaha

Auren Hoffman (01:02:08.822) I mean, you know, you, you definitely have something where I heard you say, like, there's some, some advice where people say like, everyone should start a company and you often say, well, this is terrible advice or, yeah, I've heard you say that before.

Alex C (01:02:20.142) Oh yeah. Yeah. I mean, I think, you know, I definitely don't, you know, I look back to, and I'm an N of one. So I always try to like preface anytime I give advice with like, it's just me. Like I'm your only sample size. Uh, I don't have any data to support this, but like, I think my career path would have been different had I not started a company right out of college and joined a company to learn. like missed that learning experience and learning on your own is a lot harder, I think than had I joined.

Auren Hoffman (01:02:31.798) Yeah.

Alex C (01:02:47.394) you hopefully like any company that was growing pretty quickly at the time. So yeah, I don't think being a founder is for everyone for sure. think, you know, there there's a lot of like, I guess, conventional things that disagree with, like, I do believe that you should be, you know, that you're like,

physical performance absolutely impacts your mental performance. for the most part, like executives should be in shape. Like people should, I feel like it translates to all parts of your life. so, and you know, obviously there's reasons why some people aren't, and I'm not talking about the medical related things, but generally it's like, I think people should be working out and lifting a lot harder than they do. They should be like really focused on optimizing. Cause it's, it all goes, I think.

Auren Hoffman (01:03:17.367) Yep.

Alex C (01:03:34.326) Just like we optimize other parts of our life, like you should be optimizing your markers. You should be trying to optimize for mental clarity. should be like your brain is another muscle. Like, why are we not trying to do the things that get us like the highest level of clarity and focus and all that. so, and some people just like, they're like, I don't need to focus on it. you know, or like our food impacts it. think, you know, more people should probably take. Long. I mean, I guess this goes back to longevity care, but like longevity care a lot more.

Seriously.

Auren Hoffman (01:04:04.62) Do you do any like, you know, you do a lot of things to stimulate your body. Maybe some these also stimulate your brain, but they're obviously there's like caffeine that stimulates brain or nicotine. Yeah. Nicotine might be a brain stimulant or these other types of things that are out there. like, have you thought about that more and like, okay, I want to increase my cognitive performance. Or do you think just like, okay, I'm increasing my physical performance, which will also have some benefits to my cognitive.

Alex C (01:04:14.263) I drank a lot of caffeine.

Alex C (01:04:32.67) no, I definitely think about like what supplements I can take to help increase cognitive performance. think working out and like creatine is probably the biggest supplement that everyone, think maybe that's it. Like every single person should be on creatine. I don't care.

Auren Hoffman (01:04:45.6) Okay, no, why? Okay, I'm on creatine. So I've drunk I'm drinking the creatine Kool-Aid. And I think it's interesting. was like, my wife thinks I look better because I'm on it. So because it like, you know, make your muscles look a little better and stuff. I'm not. Yeah, yeah, I'm not I'm not clear. It's not clear to me that I'm that it has been but I'm drinking the I'm on it. I'm on it. Like, how do you convince people are a little bit more skeptical of it?

Alex C (01:04:56.162) Hmm, interesting.

Yeah, you puff up a little bit.

Alex C (01:05:14.594) I just don't think there's any downside to taking it. It's like, 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 like vendors that you should buy. you, if one's making you sick, try a different one or whatever. But, there's studies where like after a traumatic brain injury, you should basically have that person take like an excessive drink, an excessive amount of creatine and it reduces the inflammation in the brain immediately following. so.

Auren Hoffman (01:05:28.961) Yep.

Auren Hoffman (01:05:41.376) wow. Now, do you take more than like, I just take like the scoop, the one scoop a day from the thing. Are you like triple scooping it or something or?

Alex C (01:05:49.198) No, I mean, I'll do like around a single dose to a double dose depending on like the day and all that. find that like performance across like, yeah, mental clarity is definitely better with it. Just general, I could just feel better when I take it, I think. It's hard because creatine is not one of those where you like you take a scoop of it and you're like, I'm fucking wired right now and I'm jittery.

Auren Hoffman (01:05:56.865) Yep.

Auren Hoffman (01:06:05.303) Yeah.

Auren Hoffman (01:06:12.49) Yeah, yeah, it's a longer term over. You need a couple of months or a month or so before you start to see the benefits.

Alex C (01:06:19.18) Yeah. And it's a very passive benefit. It's like, I'm looking a little bit more like fuller after working out or like I'm feeling, you know, better, like my cognition's better. think it's just one of those it's cheap and it's very accessible.

Auren Hoffman (01:06:24.311) Yeah.

Auren Hoffman (01:06:30.902) Yeah, it's cheap. Good point. Now, do you like, so do you, mean, I travel a lot when I travel, like all my things, like I don't bring my creative team with me usually. Like, you, do you like bring all your needles with you and all your stuff with you as you're, when you travel and things?

Alex C (01:06:46.798) We're about to find out in like a month when I do my next trip, like what I decide. The last time I traveled, I alternated my like dosing schedule to account for the fact that I would be out for like a few days. And so I will bring like 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. But honestly, I've been trying to travel as little as possible. But yeah, like, you know, the...

Auren Hoffman (01:06:50.572) Okay.

Auren Hoffman (01:07:07.532) Yep.

Auren Hoffman (01:07:12.522) Okay.

Alex C (01:07:14.658) the peptides need to be refrigerated and like it's frankly it's okay testosterone is probably the one where like you don't want to go you know you don't want to miss doses but and I guess HCG now that it offsets anyway we'll find out but most of my trips are like two three days long anyway so can kind of stagger things around them too yeah yeah and if I am going away for like a month I will refrigerate and bring and do all that stuff so

Auren Hoffman (01:07:26.848) Yep.

Auren Hoffman (01:07:32.034) So it's not that big of a deal. Okay.

Auren Hoffman (01:07:37.886) Okay, yeah, yeah, yeah, that's less common though. Those are less common.

Alex C (01:07:41.038) Yeah. Yeah. I mean, with kids now, like little kids, I'm in Austin, the team's in Austin. just not. I also, 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, like I don't want to go to conferences anymore. Like I'm online. I want to hang with my kids on the weekends and I want to go talk to a bunch of people, get drunk in Vegas. Like I'll send someone on the team to go do that.

Auren Hoffman (01:07:44.055) Yeah.

Auren Hoffman (01:07:54.346) Yeah, yeah, yep. Yep.

Auren Hoffman (01:08:01.654) Yep. All right. This is awesome. Thank you, Alex Cohen for joining us on World of DaaS. I follow you again at another Cohen on X. I definitely encourage our listeners to engage you there. This has been total ton of fun and really great.

Alex C (01:08:05.164) Yeah, it's just fun.

Alex C (01:08:15.756) Yeah, thank you for sending the invite. I'm glad we made the time and I'll see you online.