Because today, we have someone who we’ve been talking about quite a while. Her husband, Nick, has been on the show a couple of times, and an investor in her company, Amit, was just recently on the show. So today I’m really excited to invite Renee Dua, the Co-Founder and Chief Strategy Officer of Together by Renee, which is kind of cool because it’s your name and everything, but welcome to the show.
Renee Dua: Thanks so much. Thanks for having me.
A.J. Lawrence: You have this wonderful background in medicine. Before we get into like where you see yourself as an entrepreneur, can you maybe talk a little bit about how you got onto the entrepreneurial pathway? Because Chief of Medical, Chief of Medicine. As the grandchild of a doctor who went through pre-med and then realized I liked coding better, you have pretty much an amazing medical background.
How did you get pulled into this slightly crazy world of entrepreneurism?
Renee Dua: Yeah. I’m the daughter of the original gangsters of entrepreneurialship, right? My parents are both immigrants, came here, my father from a very, very poor upbringing and repeated their training. They’re both again, physicians started their own businesses.
My parents to this day will come into their office. They’ve worked together all these years. They’ve been married 50 years. They will come into the office. They will still see their longterm patients. They did all of that in a new country with no cell phones, no wifi, no internet. When I think about what my parents have done, which can never be done again in all fairness, I’m pretty proud of what they’ve done, but I’m less proud of what I’ve done because they gave me everything to do it.
They gave me enormous privilege and they helped me get educated and they gave me the guts and the courage. I remember at one point, my father, when I was running for that Chief of Medicine role that you’re describing, I was the first woman that ever won the position. You have to be nominated and voted in.
And my father said, this could really hurt your business, right? People don’t like the Chief of Medicine. That person runs the show, runs the department. It might affect your consult rate. And I said, look dad, I want to do it. And he said, that’s my girl. You’re fearless. Right? And I got that 100% from my dad, right?
For my parents, there was no plan B. Nick and I talk about that all the time. I have plan B, C, D, and E, but it’s from my parents.
A.J. Lawrence: Maybe in a little bit I would like to come back to that because I think there is a common thing around the relationships we have as entrepreneurs, but that you had a framework of watching your parents work together in a way that probably did help, not to go into your relationship with Nick, but just your ability to have that framework together.
Where do you see yourself as an entrepreneur? Because Together by Renee as an app I’ve been playing with, it’s really pretty cool, very smooth, very elegant, and the potential is so amazing. You’ve had other companies, you’ve exited Heal, you’ve been with Chief of Medicine, you’ve done all these things.
Now Together by Rene has been a pivot within itself already. Where do you see yourself as an entrepreneur?
Renee Dua: I definitely would call myself an entrepreneur. I agree with the terminology, right? I started my own private practice, again, 20 years ago. Nowadays, people don’t do these sorts of things. They go and they work for somebody.
When I started my own practice, once again, I was the only woman in the entire San Fernando Valley that was actually practicing kidney medicine, which is sad when you think about it. I happen to be fluent in Spanish and my practice, therefore kidney disease affects people of less privilege, and therefore I got very busy very quickly taking care of a minority population.
And that was my first real shake in entrepreneurialship, where I learned how to run a business. In medical school, we are not taught how to hire, fire, right? I didn’t understand why did people need an office manual? Don’t you just know what to do when you get here? Right? I had to write these things. I had to figure out how to work quickbooks and buy health insurance for my employees.
I had to create a schedule. And when I first started, there was no EMR. So I was, in fact, the first doctor in my neighborhood that meaningfully used an electronic medical records system. I got the whole thing paid for because I used it according to the tenets of how you can meaningfully deliver results to patients.
So, I would consider myself absolutely an entrepreneur, maybe not in the way the Silicon Valley world does, right? I wasn’t a venture funded operation. I was making mistakes left and right. I was taking care of people who honestly had no one to take care of them. They had largely been ignored because nobody spoke Spanish, right.
It was a wild time. And then, as you mentioned, some of those interesting things I did like running the medicine department or creating peer review departments, things like this that I did that hadn’t been done or certainly hadn’t been done by a woman ever.
I think that those things definitely define me as an entrepreneur. It wasn’t until I met Nick though, I think, and I really always, whenever I get invited to do a podcast, I always want to give credit to Nick because Nick is a serial entrepreneur. I mean, he’s been doing this for 30 years and he is the one that saw in me, even maybe more than my own parents, he saw in me that you can fly, right?
You are a doctor who’s compassionate. You care. You can make things better in the world of medicine. And he’s the one that, again, took a chance on me to join him in the journey we had at HEAL. And he is really the person that showed me, wow, I can learn how to operate a business, how to manage compliance, how to deal with hiring hundreds of doctors and providers and expanding through States.
It was really Neil, I’m sorry, Nick, that gave me that confidence.
A.J. Lawrence: I think a lot of times when you are doing something so amazing, and you were, you’ll have someone else come and kind of see where it could be used in a different environment. That is a really powerful moment because I know in having spoken with your husband, he has talked about how amazing your ability, his opinion of your ability to kind of bring passion and bring intelligence to create these solutions.
So I think finding someone who can help support your dreams. Between Heal and now the iterations of Renee, how have you kind of seen what you believe is possible as an entrepreneur kind of evolve?
Renee Dua: Yeah. So, fundamentally in health tech, I think there’s a very serious problem. And the very serious problem is that billions of dollars go to insurance companies, go to hospital systems, whose incentive to help patients is not actually aligned with the patient and what the patient needs, right? As doctors, and I’m going to speak very generally about us, we are altruistic people. We spent a fortune to become doctors, we have lost our youth, we’ve given up, we have sacrificed so much to become physicians, right? I don’t think anybody can challenge that sentiment.
And when we get to see a patient and we’re pushed to do things in 10 minutes, and we’re doing a half ass job and you know, we’re being blamed for this, or patients aren’t willing to wear a mask or get vaccinated, like when you’re pushing us to deal with all of that, we’re not able to align with doing what’s right for a patient.
And when you flood the health tech market with billions of dollars paying for coaches and this and that one point solution that manages this small little aspect of a sick person’s life, you’re not actually solving anything. And one of the greater shocks to me, and I’m speaking very candidly to you about the VC community, one of the greater shocks to me is the focus on exits and how much money I got. Ten times my return. Yeah, but did you help anybody? Right?
You can sell something for billions of dollars and it’s shelved, literally shelved. And so, I find that kind of heartbreaking and discouraging. So if you were to ask me iterations on Renee and what I’m trying to do with Heal, the first and most important thing I’m trying to do and hope to succeed at, what I would call a success is that millions of people are using the software that I’m envisioning that directly helps them unincentivized by somebody else making a buck for the wrong reason, right?
Directly on their phone, they were able to use an app that got them a house call, got them a health assistant, and they got what they needed. They controlled their information, they shared their information and they felt better or something in their medical life got better because of some product idea that I had that Nick helped me roll out, right? That would be how I would consider the iterations of what we’re doing will be a success.
A.J. Lawrence: The complexity of the health care system, I mean, yes, health care in just the concept is a complex thing, but it does feel, especially having now lived abroad, we’re adding extra and you know what I mean in socialism, whatever you want to call it. Living in Spain, yes, sometimes it was slow to get an appointment and bureaucracy is insanity, but it’s never the kind of the negative experience of trying to find or trying to justify a coverage when your own doctor is the one saying you need a coverage.
It is really that instance of here in the States does make it extra. That does allow an ability to have a better kind of interface to the system, which I think is so interesting about together by Renee. But even then going, as you’ve said, the VC community, there has to be a profit because there are things that cost. But the value where that level goes from sustainable to overly, I think, is that question.
These are some things that you are now kind of facing from some success. This is an amazing app. You have raised funds. I’ve talked to some investors who don’t quite think you walk and order, but very close.
What are some of the difficulties you think, some of the transition points in going along your own entrepreneurial journey, what are some of the ones that you’ve had to face and how did you deal with kind of coming into those transition points?
Renee Dua: Whether I’ve dealt with or am dealing with, I think is the million dollar question. I think I’m dealing with these issues, but the biggest one that comes to mind is there is a competition, right. Who’s smarter? The doctor that sees the patients and sits and sees how they’re not able to solve basic problems to get health and wellness or the VC who read about it. Right? And what that VC wants to fund.
That’s the tension. I was at a VC get together yesterday and I was talking to a VC and we were talking about, again, I’m a kidney doctor so we were talking about health tech in the kidney space. And there is a massive amount of work that needs to be done in kidney care because millions of Americans walk around with kidney disease and they have no idea, which is an utter failure of our American health system.
I said that one of the fundamental issues with what I see in kidney startups at the moment is they are hugely focused on human resources to get kidney patients what they need. And unfortunately, there’s not going to be enough of those human resources. We have to integrate AI and software to bridge these gaps and scale these ideas.
And he said, I disagree with you. And who knows who’s right, right? I go to the dialysis units. I see whether or not the social worker or the nutritionist shows up, whether or not those patients are adhering to their medications. Once you’ve made it to dialysis, it’s a literal success story. Most people die before they get to dialysis.
It shouldn’t be the case at all that you need dialysis. So are there enough nutritionists and social workers and case managers and primary care doctors that are making these diagnoses early? Dialysis itself is a whole racket of terrible ethical issues, right? So who’s right in that scenario? The guy with the gold, the VC, or the doctor on the other end, that’s actually sitting next to that patient in a dialysis chair or making that diagnosis in someone who doesn’t even speak English?
This is a reality of our specialty. So I think I’m dealing with that dilemma. I would call it a dilemma. It’s my job if I want to be an entrepreneur in the tech community to convince a VC that I might know more than that VC does. But I don’t always win. In fact, most of the time I lose, right? That’s the business of fundraising. Most of the time, the answer is no.
I still find that strange when your experience is not as hands on, certainly in health tech. I don’t tell anybody how to run a bank or get airplanes off the ground, right?
I mind my business and I stay in my lane. But I find that dilemma, that tension, sort of odd. I advise a lot of companies actually in the health tech space and I go with a CEO and I help that CEO pitch. It’s so important to have a clinical understanding of what you are saying and what you are doing and the relevance, but interestingly, it may not always matter.
And then I find that that software, who’s it going to help? What’s it going to do? And maybe the goal is just to have the multi-billion dollar exit and shelve the product, like I’m saying. Maybe that’s part of the rigmarole, right?
A.J. Lawrence: I was speaking with a VC who does look into the health, and in a sense, what he says is because of the complexity in the state of the US, what they try and do is they have an expectation that they’re going to do good. But the first expectation is the ability to, in a sense, simplify and bypass a lot of the structure of the American healthcare system.
So it’s just the ability to get prescriptions better, to get an appointment easier. But at the same time, your product from what I’ve been using, just the straight value right off the bat versus, Oh, here, we’ll give you a concierge, we’ll give you this and a pill.
I had another VC in women health, she just said, if it can’t be done with a pill or a service, we don’t get fundraising. But how are you trying to handle this situation and use this to kind of create something for the longer term?
Renee Dua: So the idea behind Together, well, let me just tell you. Nick named the company Renee, right? And the reason he named the company Renee is because I’m a health assistant for our parents, for our children, for my patients. And at one point I was so overwhelmed by the number of responsibilities that I have, including a full time job, that I turned to him and I said, I need to be automated.
I need to automate myself. You do not need a human calling and making appointments, reminding to take meds, refilling, this is silly, right? Like automate me, that’s the next company, what I want to do next. And as we’ve been trying to find product market fit, it was really almost frustrating for the company to be called Renee because at once I’d be listening and be like, are we talking about me? Are we talking about the software? What’s the ask, right? Who are you talking to?
And it was almost metaversing, which I still sort of love that you can talk to Renee on your smartphone and Renee can do things for you. I still have this vision of your smartphone becoming your health assistant.
We iterated and got to Together, we’re in this together. Right? Where, again, your smartphone via app becomes your health assistant. And our goal is to create an app that millions of Americans can turn to for a health assistant. We know that Americans are aging. We know that we are going to have fewer and fewer caregivers. We know that people in healthcare are leaving in droves. In droves.
I mean, it’s crazy how many doctors have left in the last two years and will continue to leave. How many nurses are leaving. You’re seeing the strikes left and right. There is a serious, again, misalignment of values in health care, right?
And when you and I get older, it’d be nice if our kids took care of us. We don’t necessarily want that for them. And so we’re going to depend on the one thing we’re all going to have, which is our phone. And I envision a world where I’m literally talking to my smartphone and saying, Hey Renee, I took my medicine. What are my vitals? And look at the phone and check my blood pressure.
I’m imagining that just like millions of people use Instacart and Netflix, they will use this software as a health assistant. That’s my vision for the company. That’s the idea to patch the holes that are most definitely coming to affect me and you in particular.
A.J. Lawrence: Yeah, I can see that very, very much. And I have teenagers, one who just started university and I’m still dealing with that, like, wait, he’s not here. And one is going away and then the youngest two has a few more years, even though they’re ready to leave now. They don’t want to be an only child. But yeah, the joy of technology is when it sort of just becomes part of our life and enhances it.
The fear of technology is when it disrupts our life. And changes everything we’re familiar with. I really feel that Together has that more of an enhancement. But I like that kind of thought that you have put into that. Like, all right, this is a way of dealing with this and kind of coming through. You talked about the framework of watching your parents create these lives here as entrepreneurs, as doctors, what do you think helped you with these transitions that people can kind of learn from?
Renee Dua: Yeah, well, most definitely being a caregiver for my parents. Everything you see in the app. My father has an iPhone and he was trying to do the data entry on Apple health to enter his medications. And he wasn’t able to hold the phone and type the medicine. And my father’s a physician, but he was having a hard time spelling these complicated names. My father’s also a complicated patient, right?
Watching that experience, I thought I’m never going to make someone enter data. I’m going to scan the pill bottle and all the data is going to be entered, right? Being proactive as a physician, right? Every few weeks, I still get to see my patients. And when I see them, I break down a task list of four things invariably I want them to do. These are my complex kidney patients. And I promise you, even after knowing me for 20 years, more than half of them will only be able to complete two of the tasks.
Some authorization didn’t come through, some refill wasn’t ready. Some nonsense happens that prevents them from getting what they need. I couldn’t sit on hold to make an appointment, right? I got hung up on five times at CVS. Everybody has this story.
And so hearing my patients, having the privilege of being able to still see patients, and then having our parents and me being their caregiver, that has been so instrumental in every aspect of what you see.
Another really interesting thing, or two interesting things in Together, we incorporated your vitals. There is no point in taking medications left and right if they’re not working. There’s just no point.
So if you’re taking blood pressure medicines, you can hold a literal smartphone up to your face for less than 60 seconds and get your blood pressure and you know. Okay, it’s working. And in some ways this is far better than going to a doctor’s office fuddling with a blood pressure cuff. No batteries, it squeezes, it hurts.
You’re doing it yourself, which is complicated and in and of itself. So this is nice. And then for me, and I say this in every single podcast that I’m given an opportunity to say it in, there is no health without mental health. Anybody who’s treating the body and is not treating the mind is not doing anything.
There is something like over 60% of diabetics are depressed. And we, again, have the ability within Together to listen to the sound of your voice and determine, do you have symptoms of anxiety or depression?
In a future iteration, we’ll be able to look at your insurance card, read it and say, here’s an in network therapist. Let’s make you an appointment. We are routinely seeing that you’re anxious and your blood pressures are elevated. Again, we’re using modeling language models to put together a very reasonable case that someone is anxious, their blood pressure’s going up, they need mental health help, right?
Seems so practical, so easy, so commonsensical, and yet in the reality of medicine, people aren’t getting mental health help. I don’t care how many startups there are, there’s no good outcome data that they’re getting the help they need, right? But they don’t even know. No one has even stopped to give them an Inkling of an idea that this is going on with you, right?
So what I’m describing to you is in medical terms, it’s called care coordination. And what we’re doing is we’re saying, don’t wait for the doctor, care coordinate for yourself. Let’s give you some suggestions. Let’s guide you through what is happening to you and let’s let you take charge, take action. Don’t wait.
That’s really, again, a very important vision. But I think to fundamentally answer your question, that’s what I see my patients and my parents failing to do and how I think this software can help them to do.
A.J. Lawrence: In describing that, I agree with you completely. I think that coordination is so amazing because as in very many aspects of life, there’s so much noise. You should do X.
In business marketing, and I’m always telling clients never listen to people out there. Figure out first your foundation, do the things that need to get done first before you try 20, 000 things .And that’s just to move people from one part of the web to the other.
You’re talking about how people live their lives. It’s a little bit more important and yet I almost feel the amount of noise around what you should be doing, how you should do this, do that, all that, just having a simple coordination. How do you bring that kind of do the right things for the right reason approach into the app?
Renee Dua: Well, so I’ll answer that question personally and then professionally. Personally, I’m again, altruistic doctor. Not interested in doing half the job, not interested in doing the wrong job, not interested in doing a piece of the job. I’m interested in a very big vision, which I was also a Heal, right.
It was an enormous, way ahead of its time company when we started Heal. So I think that’s just who I am as a person. It’s not interesting if I’m not solving a giant problem. But professionally, again, because I’m able to maintain my boards and study and see patients and put my money where my mouth is, I know what should be happening for good patient care.
And then I build a team of product people and engineers, some of whom have been with me in my first company and have known me for years. And they want to work with me because they like learning. Oh, that’s what happens when you see a doctor, right? That’s what should happen. Or that’s what she’s doing behind her computer screen. Or that’s what she means when she says, go refill this medication. Here’s what it’s for. Or why she gets these labs.
So it’s about me teaching medicine to my team, my team of engineers and product people and frankly, any other CEO or strategist that wants to work with me from a clinical perspective. And I think slowly and surely there are more and more doctors in tech. Not enough, but more.
And I think, especially when we actively see patients and actively care for people, I think this is the value we bring. We can train models intelligently to solve circular problems, right? We talk a lot about generative AI and all the security issues and the mistakes it’s making. Who’s teachIng it? That’s the million dollar problem.
And I’d like to think I’m intelligent enough with the team I have to teach some basic steps on this care coordination that can be very valuable and really sensible.
A.J. Lawrence: Yeah. No, I think that is the interesting because generative AI is so cool, but if you’re not, and especially in the case of Together, if you’re not adding that care to it, if you’re not enhancing your own large language models to do so, there could be some issues.
So the fact that you are is pretty impressive. As you look forward, and I know Together by Renee is still early, still moving, how are you looking at what success is going to be for yourself, not for Together with Renee, but yourself as an entrepreneur, as someone who is on this mission to kind of make a living, yes, but really kind of solve these issues for people. What’s that’s going to look like?
Renee Dua: Yeah, I think for me, it’s what I said that people like you reach out, you find what I’m doing interesting, interesting enough to try the app and use it and tinker with it, right? Make it a part of your life and to see more and more of that – millions of people using this software and making it a part of their daily routine. Because as you use it and it gets smarter, you can share it. When you can share your data with people and they can use it and they can share their data with you.
And as such, we’re controlling our health information. We’re not letting an EMR control it. We’re not logging into a portal. And when we have control of our own health information, and when we know what we need to do next, we are controlling the paradigm of how we’re going to receive care. And we’re demanding that I don’t have to get a prior auth, right?
I am diabetic, I am obese, I deserve Ozempic, right? It’s changing people’s lives. Everybody should get it or Farxiga, whatever the medication is that can help. It is going to put power in the hands of the users, the patients, their caregivers, their loved ones. And they’re going to say, like, I need these things. You’re actually withholding care. For what? For a couple bucks?
It’s going to turn, I think, the patients into the empowered people that can control how they expect and should have their health care executed. I think right now American health care is for profit, right? And again, totally misaligned incentives on what is good for the patient.
And so I want to do what’s good for the patient. I want millions of people to agree and use this software to help themselves.
A.J. Lawrence: Yeah. And there is so much research that shows that early preventative care and just evaluation of blood, but just seeing it in other countries that the money spent early saves money for long term. It’s just a lot of the incentive is to a short term money saving process, not for a long term. So I do like that you have created something that allows that push past it. And I’ll have to definitely get some of the things you were talking about. I’m like, ah, I know already I’ve sent some stuff to my doctor and said, Oh, I should be. How? Yeah, yeah. We were going to probably talk about that in your next appointment. I was like, great.
I like what you’re doing. I think it is really cool. Other than downloading, we’ll have a link of course for Together by Renee, what is some way for people to get a better understanding of what you’re doing and where you’re going now on this journey?
Renee Dua: Where we’re going is we are training those language models that you described to be more and more proactive and preventive, right? If we know that you are taking a certain medication, we’re thinking about all the ramifications of taking that medication. What those tests need, what those imaging or lab studies are reminding you to do them, giving you the option to share and communicate them with your doctor, looking at your insurance eligibility so you’re not missing out on tests that somebody forgot to order, but you need.
These are all things that are coming. And I would say how to know more about what certainly I’m working on, what Nick’s working on, we have the privilege of people like you asking us to speak on your podcast or in the press, right?
And I say the same things over and over. I’m always for the patient. I’m always for the people. I’ve been saying that for 10 years on CNBC and Fox News, and now with you.
I think if you really want to know who I am and what I’m trying to achieve, listen to anything I’ve said, because it just simply hasn’t changed in all these years, which I think is in some ways a really great thing on who I say I am. But it’s unbelievable that I have to keep saying the same stuff over and over.
A.J. Lawrence: No, I mean, I appreciate it very much. Very informative. And just looking at how you’ve approached this and the ways that other entrepreneurs, even if they are not dealing with something as amazing and as important, but just in the same thing, just your dedication to care, to living your product, for lack of a better term, and bringing that type of attention to detail to then the creation of this, I think, is really important, especially in the face of what AI can do.
Renee Dua: Absolutely.
A.J. Lawrence: And what it will be doing even faster and faster. That is really something to take out of this.
Thank you so much for coming on the show today, I greatly appreciate it.
Renee Dua: Thank you so much.
A.J. Lawrence: All right, everyone. As I said, we will have Renee’s link to her LinkedIn. But I think today is a great example of why becoming an entrepreneur can be so powerful if you have that strength of vision around creating value, this mission, that drives you to find the people to help you create this board.
We’ve already heard from Nick, her husband Nick, who sat and created a business around her. We’ve heard from Amit with Tau Ventures about investing and the reasons why. There is so much more this mission to kind of create, but the work and the effort in doing so has allowed others to help her create even a more amazing impact.
So just something when you’re looking at the reason why, realize it’s more than just kind of a nice little paragraph that you’d throw up on the site and say, Hey, this is why we did it.
If you live it and you do the work in being there present with it, and I don’t mean go find someone who’s going to bang on a drum for you, but like literally just find a reason why and make it something important through what you do. The impact you can have as an entrepreneur can be so much larger.
So please, if you enjoyed today’s show, sign up for our newsletter. And that way, whenever we have other amazing entrepreneurs like. Dr. Dua on the show, you’ll be the first to know.
All right, everyone. Thank you so much for listening today. I greatly appreciate it and I’ll talk to you soon. Bye-bye.