By Chrissie Kremer
When Joanna Strober started having hot flashes and other menopausal symptoms, she couldn’t get the answers she wanted from her primary care doctor. She went in search of answers but wasn’t able to find what she needed. So she started the women’s telehealth care company Midi. I chatted with Joanna about Midi and how any woman in the US can now access excellent women’s health care that is covered by insurance.
How did you and your co-founder decide to launch Midi?
My co-founder Sharon Meers and I were experiencing severe menopause symptoms, trying to evaluate whether to get on hormones, whether they were appropriate for us, how to help ourselves sleep and feel better. Everyone we knew was going through the same thing! And we couldn’t find good solutions. It was incredibly hard to find knowledgeable doctors who really knew what they were talking about. I went to my primary care doctor and was given sleeping pills. They weren’t telling me that these symptoms could be related to my hormones.
So the original idea for Midi came from need. It came from ’let’s get women access to hormone experts to help them understand hormones, understand if hormones are right for them, and have that care covered by insurance.’ Because one thing that felt really unfair to us was that it seemed the only people who were getting access to this care were those using concierge doctors and paying $750 a visit. We wanted to expand that access and give everyone that level of knowledge and care. The change in laws due to Covid also made this possible. During Covid telemedicine health laws changed, and now you could get reimbursement for telehealth. After the laws had changed we saw that it was an opportunity.
How did you start Midi once you had this idea?
Sharon and I recruited some amazing doctors to start. We started with Dr. Mindy Goldman, who runs the UCSF survivorship clinic. And then also Dr. Kathleen Jordan, who is an expert in women’s health, but also an internal medicine specialist. What we really wanted to do was combine the expertise from internal medicine and ob-gyn so that we would be overall women’s health experts. And then we’ve scaled our care around their knowledge. We are staffed with all women, and all of the doctors and nurse practitioners are full-time Midi employees. We officially launched in May 2022.
We did a pilot for about six months where we had 150 patients going through it. We also got in network with insurance companies. So by the time we launched, we were ready to scale the product and we had really good insurance coverage. That was our goal – to make sure that we could, at least in California and now nationally, have really good insurance coverage for our care.
How is it going since the launch?
It’s going really well. We’re expanding incredibly fast. We are taking care of thousands of women per week around the country and it’s super exciting. I’m sure we’re the biggest menopause provider in the country at this point. We’re taking care of a lot of women, who are coming to us from every state.
How are women finding out about Midi?
Social media, PR, friends, and 15% of our business is just from women telling other women about us.
What are patients’ most common concerns?
The big things are hormones, weight, and sex. And that’s what we do.
Doctors often can have an extended wait time to see them. What is your average scheduling wait time?
Our goal is 3 days.
How is tele-medicine working vs visiting a doctor in person?
You don’t need to be seen in person for any of this stuff, except things like pap smears that we will arrange for you. And actually, tele-health is a much better place to have these conversations. It’s actually easier to have these conversations on tele-health. Who wants to sit down at their doctor’s office in the six minutes that you get with them and talk about painful sex or not sleeping or anxiety attacks, or joint pain? And you’re wearing a gown, you’re sitting on the cold table, they’re doing the pap smear and then they’re like, ‘how are you’?
Telehealth is actually a much better place for these conversations. We also have really long visits. Our visits are 30 minutes. So women actually have a chance to talk about their issues. A lot of what people tell us is that they felt heard. They feel we listen and pay attention to them. And that’s a really important thing we hear a lot. Plus, we do not just make them feel heard, but we understand women’s health really well and we take care of these women incredibly well. And that’s something they can’t get anywhere else in the medical system other than concierge care, which very few people can afford.
Plus, we take most insurance, which is huge. And patients can request to get the same provider over and over if they want to have that consistency.
Your target is obviously women, but specifically who?
I would say it’s 35 to 60-year-olds. Most of the women are in their forties and fifties.
How many of the women who go to Midi end up going down a path of hormonal replacement?
We’ve launched weight loss visits too. So I would say about 80% of the people leave with a weight loss medication or a hormone. But not everyone. Some people want supplements and we have supplements. Some people want non-prescription recommendations and we have lifestyle recommendations. Some people want medications that are not hormones. We offer a very broad spectrum of care.
Hormones, sex and sleep are women’s primary concerns. And those are things that historically people don’t always talk about. Do you think that women are talking about these things more these days?
Yes. They’re finally talking about it. I think it’s been this quiet secret for a long time and people are finally talking about it, really paying attention to it, and realizing that the way that they’re feeling does not have to be like this. That you don’t have to feel bad. People are finally really understanding that and getting care. For a long time, if you felt poorly during this time of life, people just thought that was okay. And now they’re realizing it’s not okay and you can feel better.
Do you think this is because men were running the companies before, and they weren’t realizing what women were going through?
A lot of it is that. Plus, I think if you don’t know that you can get treated, you don’t look for care. It’s super scary. So you don’t want to talk about it. If you think that you can’t get treatment, then why would you talk about it? But if you know there are treatments available, it’s much easier to talk about. This is a medical condition and can be fixed. I do believe that a big part of what’s going on is that now we can tell women, that if you’re not feeling great and you’re in this age category, you should go to a women’s health expert who can help you. They will make you feel better.
And if women aren’t talking about it, they think they’re the only ones. So if they have pain during sex they may think ‘Well I must be the only one so I’m not going to tell anybody that.’
That’s exactly right. I joke a lot of times that we’re a marriage saving company. And it’s not just because of sex, it’s because of sleep issues or being crabby or being anxious or depressed. All those things are related to menopause. And women don’t know that, so they don’t get the right treatments. But we can make you feel better.
Are there other companies doing what Midi is doing?
We’re the only ones providing insurance-covered care.
I know you don’t stay up at night because you’ve got the sleeping issue covered now, but figuratively speaking, what keeps you up at night about the company?
My job is just to make sure that we are providing incredibly high-quality care. And I think about that all the time. My mother, my sisters, my closest friends, they’re all patients of Midi. Everywhere I go, people are patients of Midi. I have to make sure that our care is amazing. And that’s my number one thing. Everything else will be fine as long as our care is amazing.
You’ve probably find a lot out about your friends that you didn’t know before!
We spend a lot of time talking about sex!
Where would you like Midi to be 10 years from now?
Because of this Covid law change, you can now basically have a national healthcare company. Before Covid you couldn’t have this. We want to become the trusted brand for women’s health. We want people to know that we provide the highest quality care. And that if they are a woman in this age category, and actually of any age honestly, we want to be there for you. Whatever issues women are going through, we want to be the trusted brand for healthcare in this population.
Do most people who have an OB have choose between their OB or Midi?
You don’t have to change to us entirely. If you have an OB-GYN that you love, keep using her and use us too. We don’t have to replace them. We can be an addition.
If you have a doctor that you love, great. If in between visits you’re having some sleep issues or some other challenges, we can also be there for you. You don’t need to wait to see us just once a year.
If you don’t have a doctor or OB that you love, we can be that provider for you. 50% of the counties in the United States don’t even have an OB-GYN. So it’s not like there’s like a plethora of OB-GYNs. So in the end, we can be there for you if you have one or if you don’t.
Joanna’s FabList of Top 5 Symptoms Midi Sees
- Hot flashes and night sweats
- Sleep
- Brain fog
- Weight gain
- Painful sex/decreased libido
Thank you Joanna!
