23andMe's Anne Wojcicki: Embrace the gatekeepers

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Hey folks, Jeff Berman here. I am thrilled to share some of the new names who will be joining us at this year's Masters of Scale summit. This may be our biggest stage yet. Reed Hastings, Meredith Whitaker, Van Jones, Amjad Masad, and more. Will be there with us October 20th through 22nd in San Francisco. If you're building something great, or you want to build something great, We want you there with us too.

Join us at masters of scale dot com slash apply twenty six. That's mastersofscom slash apply. Twenty six. Welcome. to the Masters of Scale movie club.

It's accepted knowledge. The nineteen ninety-four Cohen Brothers classic. Hudsucker Proxy. It's one of the best movies of all time. Especially for entrepreneurs.

Set in the Utopian Heyday The late nineteen fifties corporate boom, the Hudsucker proxy. Offers up a witty. Wonky, take on ambition, luck. and cutthroat competition.

that every founder can relate to. But there are many other nuggets of gold. Throughout the history of cinema. Sometimes

You'd the least suspect. Today I want to look at three scenes in particular. They all come. From very different movies.

But each of them. Can tell us something. about what we'll be examining on today's show. Something every startup. Can expect to face

Gate keepers. comes from Indiana Jones and the Raiders of the Lost Ark. Indy is racing through a busy Cairo market. Suddenly.

Proud parts. Revealing. A sword wheeling ruffian. Clearly intent. on cutting our hero to pieces.

and he makes his intention clear with an elaborate display of sword swing. Unperturbed. And he nonchalantly pulls out his gun. And shoots the guy. The lesson here.

Sometimes Your best option is to cut through any gatekeepers that bar your way or Without hesitation. Our second movie. is another Spielberg masterpiece.

Jurassic Park. The scene is set. In an industrial size kitchen. With aisles. of chrome work services.

A velociraptor has cornered two children. They scurry around the reflective counters. trying to skirt around the dinosaur to freedom. The predator spots one of the children huddled in an alcove and leaps to attack.

But rather than being rewarded. With a tasty human morsel. A dinosaur slams into core metal. It was the little girl's reflection. Having outsmarted the dinosaur, she flees the safety.

For many entrepreneurs, this is their natural approach to dealing with gatekeepers. Find a smart hack. or ingenious ruse to get around the obstacle and keep up momentum. Our third scene. Comes from Monty Python.

And the holy grail. The knights have near the end of their journey. All that stands between them and their destination. Castle of Ar. Is the bridge of death.

And it's Guardian. The Bridge Keeper. The knights must answer. Five questions. It's three questions, sir. Three questions from the bridge keeper to pass. Lancelot answers first.

And honestly. and is allowed to pass. You have to know these things when you are king, you know? But Robin. and Galahad overthink their responses. No, and are flung from the bridge.

The learning here is that sometimes dealing directly and honestly with gatekeepers Is the most prudent Course of action. Of course.

Sometimes The red tape. is so thick that dealing directly with gatekeepers Like regulators. Vested interest.

Or other parties in control. can seem like far too much of a drag when you want to move fast and capture your market. Your instinct. is to be more of an Indiana Jones. than a landslide.

But sometimes. It is actually beneficial to To slow down. and deal with all the red tape. Especially if

In doing so, the You'll be charting New territory. Because on the other side. You may find

Unfettered opportunity. I believe gatekeepers aren't an impediment that you should outwit. But an opportunity. That you should Embrace.

You gotta have incredible talent at every position. Like this huge push. There are fires burning when you're going out. Can you believe it? And then you go back to this is totally gonna be amazing. There are so many easy ways. So I have no idea what to do. Sorry, we made a mistake. But you have to time it right. Oops. Working out of a three bedroom apartment. We haven't made it. Just how you do it. This Is masters of scale.

I'm Reed Hoffman. Co founder of LinkedIn. Partner at Greylock. And your host. And I believe

Gate keepers. aren't an impediment that you should outwit. But an opportunity. That you should embrace. Gatekeepers come in many forms.

But there is one thing they all have in common. They bar the way ahead. And anything that prevents you from making constant accelerating forward motion. particularly in the early stages of scale, is something you must avoid. There are many different approaches to tackling gatekeepers.

You may op for sheer force. Battering your way. through that gate, and consequences be damned. Or you may prefer the more subtle approach.

Biding your time until you see an opportunity. The slip through. And of course. There is the method that appeals most to the entrepreneur in you. Finding an out of the box route.

That takes you over, under. round or through the gatekeeper. In an audacious manner. But there are times when you will come up against the gatekeeper. That is the immovable object.

Your unstoppable force. I wanted to talk to 23andMe Founder. Anne Wajiski. Because your company is carving out exciting new opportunities. in the sphere of genetic testing and health.

But to get to this point. And faced a number of gatekeepers. She managed to work around these, but Until she came up against one that was unavoidable. The FDA.

She realized she had to put her scale ambitions on the On hold to work with them. In doing so. She has helped build a bridge. Toward an entire new growth industry.

It is the combination. of Anne's charisma, her belief in her mission, and her pragmatism that has let her take twenty three and me, So far against the odds. Her journey has also taken

Grit. Something Anne learned as a child had On an outdoor ice rink. In Palo Alto. I don't know what it was about ice skating, it was in that sense of like it was outdoors and you could be group where it was solitary. But I always found it like beautiful. You have the steam that kind of rises off in the mornings. Like I loved it.

My parents did not. Like it was expensive. There was a lot of sort of this pageantry of like your makeup, your hair, like which was obviously just not a woodiski trait. One thing. That is very much.

A Wojisky trait. is perseverance. Although her parents Weren't keen on her passion for the rink. She kept going.

I was really determined, like, I don't really care that you don't like ice skating, like I'm gonna keep skating. Her parents We're so against it. They refuse to buy her skates. But that

Didn't make Anne. Her passion. On ice. So I had to win the skatathon every year to get my skates. And so I'd walk around the neighborhood and collect money from my neighbors and there'd be like a day long skateathon, how manps do you do? But that's how I win my skates every year. Like I didn't have a choice. It was like I have to win it. I had a really great skating teacher who was a single mom and I would

babysit for her in exchange for Skating lessons. It was a perseverance. That was admirable. But also

Pushed against limits. I was kind of also known at the rank, like I often snuck in. And I remember them saying at some point, like Anne, at some point you need to pay for admissions. This is the kind of behavior. A cute kid.

and a thick winter coat and skates can get away with. And has continued to be able to push limits. While maintaining her charm. into adulthood. When you next hear her speak

She's still talking about ice skating as a child. But she could just as easily be talking about her later experience with twenty three and me. I loved it. It was one of the first areas where I really expressed I'm gonna do this whether you like it or not. And I just always figured out ways to keep doing it. True to a word. And stuck with escapes.

She took them with her when she enrolled at Yale to study biology. As well as skate competitively and play on the ice hockey team. After she graduated in nineteen ninety six, she started a career in healthcare investment. It combined her scientific training with With another childhood obsession.

I was always fascinated by investing and I didn't know that you could get paid for it. In fourth grade, I remember calling up Fidelity and saying, like, who picks your stocks? And I think the sales rep on the other side was like kind of confused. But I was like so interested in this process of oh, someone like is just analyzing companies all day. So Once I graduate college I discovered you could get paid to do this, which was amazing to me. So I spent 10 years investing in healthcare companies. I always loved hospitals. Like I'm one of those people where I walk into a hospital and I take a deep sniff and I'm like, I love it. Like I just love I love everything about hospitals.

But it's often the things you love the most. That you can see the most flaws in. I loved investing in healthcare and like getting to know all the aspects of it and how these things work and the in-depth machinery. And as I Got to know the space, I became more and more disillusioned.

that like wow, this is like a really awful system. And that in some ways this system really takes advantage of Sick people. Anne's professional career had been devoted to promoting this health care system.

But as more cracks began to show Her priorities. Started to change. You start to realize the human component of margin expansion or a pricing scenario. I became more and more disturbed by how the healthcare system was. And at some point

I didn't feel like I could morally reconcile. that I was investing in an industry that I didn't think was in the best interest for consumers. And took inspiration from grassroots efforts to put health. in the hands of the people. I did get to know the HIV community really well in the late nineties, and I was impressed with

how they advocated for themselves. And this is a community that didn't just say, I'm gonna sit around and wait. They were a community that was very proactive. The health care system. Was a monolithic fortress manned by multiple Powerful gatekeepers.

Getting it to change though was tough. and began thinking how advocate groups Could amplify their voices. and their ability. to go up against those gatekeepers.

By using the internet. She found inspiration and In her sister Susan's garage. It was at this time. Ann met her former husband.

Sergey Brenn. who was working on small startup. With his partner Larry Page. Its name. was Google.

I happen to see Google starting in my sister's garage. And then I met people like Katerina Fake, who like sat me down. I was like, this is the future of the web. People are gonna connect, web two point zero. And put together All these ideas and influences. And I kept thinking, I was like healthcare's actually about all of us.

And we should have this system where you can get your genetic information which suddenly was accessible. And you can connect with each other the way all these other social networks are starting to happen. And we're gonna be able like, why do I need the rest of the healthcare industry? Like why do I need the hospitals? Why do I need the academics? We like we the people Can actually stand up and self report and we can crowdsource research.

This was a problem and was passionate. About solving. And so. When she thought she had a solution, she went all in. In two thousand six

and founded twenty three and me with Linda Avey and Paul Cusenza. Its aim. was to give people direct access to their genetic information and then use it to make decisions about their health. And so twenty three me really came out of this idea of social activism, like based on the HIV community, that patients actually really want to come together. The social networking that was happening on the internet. And then um last the fact that there was actually a technology where you could affordly get access to your genetic information.

23andMe would help patients get around the gatekeepers that barred the way. Yeah. the consumer should actually have more control. They should have control of their medical records. They should have more, like why do I have to go to a doctor every time I want a blood test? Like I should just have more control.

within limits, but largely we should have a better attitude about how we represent the consumer. That was the big picture. Like I wanna change that. And I wanna have that trickle down effect in all kinds of other aspects of healthcare. Now patients would be able to identify diseases and conditions that they might be susceptible to and then take measures to mitigate these risks. They would be able to look at an entire body of personalized knowledge.

And seek out Precisely the right experts. To help them. It would transform the current health care system. That had first enthralled

And then repelled. And Twenty three and me would provide easy to use genetic test kits. To its customers. People just need to provide a sample of saliva and return it.

This would then be tested. and the results would flag any potential health issues that had been discovered. It was an unprecedented Level of access to the very building blocks of life. Surely

Everyone would leap at the chance. Well If getting traction for ideas that promote the greater good are Were this simple. We'd already be living in a world without war.

Famine. Or hate. Anne had fallen into this common trap. Her training experience had put her in the ideal place to see what was wrong and how to fix it. However, this same training experience

Meant it was Too obvious. For her. Her potential customers weren't even aware of the lock gates that twenty three and me was offering them the keys to.

We did no market research. Like in some ways it's like really cute how we launched this company. One of the things I also realized, like a lot of great scientists are just really awful. business people. I would talk to scientists and they're like, wow, if you could launch a company like that, you would make so much money. You know, the thing that we realized in those early days Is that Most people have no idea why they'd ever want their genetic information.

The term Market research. probably conjures up images of carefully selected focus groups. Picking apart your product. As you watch horrified.

From behind a two way mirror. It's no wonder. That many founders Сіє з абстал. in their path.

to bringing their great idea. Into the world. But this Is a narrow view. Because market research is about far more than letting a cross section of your target audience

prod and poke at your prototype. I like to call it. Viability research. Because it will tell you how much of an uphill struggle. you will face in getting people to latch onto your product or service.

and all of its possibilities. Most ideas are iterative. They will improve upon a known product. You may need to educate your customers on small things, Like Which buttons to press. But the overall point of your product? Well

That's obvious. Other developments can be far more transformative. Think of the internet. Іву трансфорсі і умаджал вез. However

It was still iterative. in its development. You didn't need to understand all of the ramifications of instantaneous worldwide communication. in order to send an email. However

Something like twenty three in me doesn't fit in either of these categories. People may have an understanding of genetics. But they had no idea. How to use that information. No inkling of how having access to it could transform their entire way of thinking about health.

Twenty and me had huge potential power. But that power could only be realized and a future Where systems. And attitudes. had shifted.

So when twenty three and me launch in two thousand seven. It was met. With a shrug. those early days, like we we launched the company, we sold a thousand kits those first couple days. And then and then we saw it trickle down to like ten.

to twenty kits a day. It was so sad. But Anne didn't lose faith in her mission. This lack of understanding amongst her customers was another obstacle. She was determined to To overcome. I never once doubted that this was a viable business.

But to me it was always that We have to take a different path. The path we approached Uh Just putting out a scientifically really interesting product. And we thought that there was like

Big consumer interest. That there had to be more education. So for me it was like I failed my customers more. because I failed to properly educate them about the potential. So then we had to take a step back to say, like, well, what are we gonna do? One of the things my marketing team will say is like You need to take it from the weird to the wonderful.

Twenty threeandme had enormous potential. But the concept behind it was too weird. Very few people. could see the point of paying to have their genome analyzed.

And needed to educate people. About the benefits and then get them to sign up for twenty three and me. Education. doesn't mean putting together tiresome tutorials or laborious workshops.

Think of it more in line with a filmmaking adage. Show Don't tell. If you can put a product in your customers' hands and

Get it. Immediately. but they can immediately start becoming familiar with it. And then Fall in love with it.

For twenty three and me, the trip from weird to wonderful was achieved by letting people learn about their ancestry. I think one thing that we were really clear about is that no one wants to sit around and talk about their disease all day. You know, if I carry Hashimoto, I have Hashimoto's, I take thyroid, like You would never want to do a podcast like just talking about my Hashimoto's like and all the interesting aspects of it. But if I came in and I was like, guess what? I found out I have ancestors from Thailand and West Africa and this. It's super injuries. And I've like met all these relatives like

Holy cow, we get stories all the time about that. So the ancestry side really opened up massive numbers of stories and explorations, a s sense of identity is like that's changed. This took genome testing from the weird to the wonderful. And also injected an urgency for people to share. Yeah.

Note how helping people explore their genetic ancestry Wasn't directly. Part of Anne's mission. But it was additive to giving people More power.

over their medical histories. People always ask like are you a biotech committee, are you a science company, what are you? And I said we look at genetics holistically. Your genetic is just the digital manifestation of you. And you are really interesting. You sometimes need

to take oblique. Yet complimentary. Approaches to reach your goal. This helps you gain scale rapidly. It prompts you.

To diversify. It can also be a lifeline. If you hit any unexpected And powerful blocks. Like the powerful gatekeeper.

and was about to run into. We'll hear about that. After the break. When you've built substantial wealth through your business, it's often tied up in a single equity position. The upside is real, but so is the risk, and knowing when to act isn't always obvious.

Creative planning works with business owners to build a strategy around concentrated equity. When to diversify, how to manage tax risk, and how to protect what you've spent years building. Creative planning where wealth works together. Learn more at creative planning dot com slash masters of scale. Humans will never be more intelligent than AI. There's gonna be two types of companies.

Those were great at AI and those that went out of business because they weren't. How do we build a future? That is human centered. I'm Rana El Calyubi. On my podcast Pioneers of AI, we answer that question and so many more. As an AI scientist, entrepreneur, and investor, I know what it takes to build AI that works for everyone. Every week, I sit down with the pioneers shaping our future. And we take you behind the scenes of the AI that's transforming our lives.

Find pioneers of AI wherever you tune in. Hey listeners, Bob here. If you listen to Rapid Response on Masters of Scale, you may be missing half the show. Because every Friday we release a second rapid response exclusively in the Rapid Response feed. The guests and topics are just as compelling and timely from Ford CEO to NASA's administrator to the lessons from The Devil Wears Prada. It takes about 10 seconds to find, just search rapid response wherever you listen to podcasts and hit follow to make sure you never miss an episode. I hope to see you there.

Before the break. We heard how Anne and her team took twenty three and me from Alien Concept. To must try Marvel. In two thousand eight. Time Magazine named Twenty Three and Me's

Personal genome test kit. Invention of the year. People were excited about exploring their ancestry. And they were being introduced to the concept of of using genome testing to gain more information about their health.

But although consumers were coming around to twenty three and me. There was a group that was proving tough to convince. Doctors. We're direct to consumer. And I think that that is one of the biggest controversies about the company is that we don't go through doctors.

So most your health information today Access is controlled by physicians. But if you look at the history of medicine, things like pregnancy tests, it was seen as highly controversial at the time, whether or not people should get direct access. To their pregnancy results. Doctors have been the established gatekeepers.

It was a setup. That had until now. remained unquestioned. Since the days of Hippocrates. So for physicians

they're used to having the information come first to them and then they're used to deciding whether or not you should have information. So it was sort of shocking that people were walking in And saying, look at all these things I learned about myself. Like what do you think? For me it wasn't shocking because I remember so well when I was investing in Web MD and physicians had a very similar opinion. It was like, wait a minute, I'm the one who would tell you all the different potential diagnoses. There was another problem. 23andMe's focus on encouraging people to take preventative measures.

At one meeting, a doctor stood up and he said, Look, the biggest problem with twenty three and me is you generate non billable questions. This is like where I have the empathy for the physicians because a lot of what we do is we bring up risks. And risks are not something that's usually well covered. In the healthcare system, doctors are really trained to treat the disease.

But thinking about prevention In some ways, like that falls on you. We're playing in a world that's kind of outside of traditional medicine. Twenty three and me. Was facing a systematic and cultural block to their business.

And if doctors wouldn't come aboard. Then consumers. might be turned off. It's an issue that the company is still dealing with. So I recognize like it was more of a transition and we took the direct to consumer approach, frankly, because it's a much more scalable approach. Like is what I've learned in Silicon Valley, like consumers can drive behavior change. I was never gonna be able to afford to have a physician.

education campaign. So we created all kinds of support materials for physicians and we wanted to make sure They understood what we were doing and it was scientifically valid, but the medical community definitely has been slow to adopt genetics. However There was one gatekeeper. Even more challenging.

than the medical community. The Found Administration. 23andMe was offering raw genetic info. ancestry and reports on genetic diseases. The ancestry aspect of

Was the wonderful that was helping people understand. The weird. However In two thousand and ten The FTA told twenty three and me.

That it had classified Genetic tests. as medical devices. This meant Twenty three and me.

Would need federal approval. to market them. The FTA story is always really interesting to people. I do this class every year at Stanford Business School. And they survey the students and they're like, Did twenty three of me get their warning letter because of Silicon Valley arrogance?

Or just like totally ineptitude. And overwhelmingly they vote on Silicon Valley arrogance. And I always I kinda love it. I can't blame them for voting that way. Silicon Valley, unfortunately, has become a byword for arrogance. And I think it's unfortunately justified.

But I also think it's a shame. Because putting up a spirited fight for a product you believe in Isn't arrogant in itself. Disruption. has become a negative term.

But the flip side is that it is disrupting vested interest and gatekeepers. and making the world better for everyone. I want to get back. To that sense of disruption.

It's not that Anne and her team had arrogantly decided to ignore the FDA. In fact. Right from the start. They had been speaking with

Both state. And federal regulators. We got multiple. Different state level warning letters. Like we had a cease and desist from the state of California. We've gotten letters from New York.

Okay. When I said that Anne and her team hadn't arrogantly decided to ignore the regulators. This wasn't exactly true. They'd had multiple run ins with state level regulators.

And each time, they found ingenious workarounds that kept 23andMe's business in full swing. For example collecting saliva to test for DNA. We had this issue where you couldn't legally spit in the state of New York. but you could spit on like the George Washington Bridge.

Um and so I remember like w like that was kind of our work around there. We're kind of clever at coming up with like okay, let's figure out how we can make this work. Though I would say it was more playful. Than arrogant. By the time of our warning letter from the FDA. We were kind of used to

controversy and used to also knowing how to deal with it. In two thousand thirteen, the FDA sent a cease and desist letter to twenty three and me. And was going to treat it. Like all the previous run ins.

With the FDA. So when we got it, my first reaction was like Oh, it's not a big deal. You know, this is manageable, like no one panic. It's fine. However. This time.

It was a big deal. The FDA claimed that because twenty three and me was offering medical advice. There was a health care product. It was a clash. That had been brewing.

Since twenty three and me. had launched. But by Monday morning when the FDA published it And press came out and some of that original team from you know FA advisors had called and they're like, th this is no joke.

It was the first time in my experience where the problem was not solvable. I really had to shift mentality. At first And took the classic approach. of any entrepreneur.

She tried to find the smart workaround that that would let her get back to scaling as quickly as possible. I was like, I don't know what the solution is. I called around, spent weeks in my pajama just like calling people and getting advice.

With her back against the wall. Anne's first instinct was to do what many other impassioned founders have done in the face of gatekeepers. Fight. My first instinct was I represent the consumer and the consumer has a first amendment argument here. It's their information and they're just interpreting their information. But then Anne had a revelation sparked by an encounter with one of the very regulators she was preparing to do battle with.

I had one very wise regulator who Ask me, she's like, Well what do you want to do? Do you want to sell this company in two years? And if you want to do that This is your strategy. But if you really want

to change health care. You just sit down and you work with the FDA and you do the hard work. And it's gonna take you Years. And you gotta be ready at the end of those years, you will have really changed. Society.

but you gotta know that you're committed to doing that. And I said I was like, you know I'm like thirty, whatever, like not going anywhere. Like what else do I have to do? I'm committed. We tend to see gatekeepers as obstacles that we need to circumvent. But a gatekeeper.

Doesn't just block the way. They can also Open it for us. Years. Of working through and around various run-ins with state and federal regulators meant Anne had very good contacts with these various gatekeepers.

Enough. To have kept from being totally stopped. In her tracks until now. But what if she hadn't cultivated those contacts? Knowing who to talk to is important when dealing with gatekeepers.

It's a problem, Spotify founder. Daniel Ack. ran into when he was trying to convince the music industry to get on board. You know, I slept in these like thirty dollar night motels where the wallpaper falls down on you and there's all sorts of things in the bathroom that you don't want to know what it is running around. Uh it wasn't a very nice time. I did sleep outside of the conference room for a few nights, waiting for an executive to turn up at one point.

The reason why that happened was that You know The way the music industry works is there's certain things that the local teams can take a decision on. There's certain things that the European or international team can take decision on. And there's certain things that people at the global headquarters need to take a decision on. This was one of those hairy things where No one really knew where we would fall under. You know, I never worked on trying to sell anything to a large company before. So understanding who's who in the hierarchy and who influences a decision, who the stakeholder is, and it took me a good bunch of time before I realized who I was even talking to in the room.

It was a long process that put the brakes on Spotify's early expansion. but by taking the time to learn the ways of the music industry gatekeepers. Daniel was setting Spotify up to lead the way in music streaming. This is a strategy. And followed.

With the FDA. If you can change regulators and you can help them understand and you can prove out, then you're gonna have a much bigger impact on society. and came around to seeing the run in with the FDA. as an opportunity. But it was a long task.

And I have to say, it was painful. There were some early days that were off, like that were just like really painful. It was a distraction from the mission, the kind of distraction that would raise the hackles of any founder. trying to get a nimble tech system where you're just like constantly used to iterating and calling and like doing all this stuff. To suddenly saying no, you have to do this validation work.

but if they could get through to the other side. They would be first. And they would have a clear Head start. Everyone in this building believes in the potential of the consumer.

and the potential of this direct to consumer pathway. one of my lawyers used to say, She's like, Anne, you're on the right side of history. And it was almost like Law and the beauty of a case and a beautiful position and story. It's a matter of what is the data that I have to put together. That's gonna help us.

Reach that endpoint. But it's gonna take years. and could have gone in. Guns Blazing And fought the FDA.

But instead They decided to pull back. And slow down iteration. Usually. This is the last thing a founder should do.

And I think this is where a lot of the bad vibes around disruption come from. Disruption. Doesn't need to mean. Destruction. Your disruptive wave.

May initially said. All of the boats on a lake. Bobbing up and down frantically. And it could upturn them. But it can also raise the water level higher.

For everyone. But some founders can lose sight of this. Rather than believing in their wider mission, like Anne does, they fall into the trap. Of believing солі

In their narrow products. But in twenty three and me's case. No one else. was going to grab market share. The FDA was a hard ceiling.

That someone would need to break through. Although working with the FDA would be slow. It would build trust. That would allow twenty three and me. And those who followed it.

To grow rapidly. In the long term. The FTAC's a lot. And there's a lot of bad actors out there. And so I have a lot of respect for them. having gotten to know them now better, like they have a tough job. Like it is a tough job. You're constantly dealing with people who are trying to trick you.

And so it is like it's our responsibility to show that what you're doing is safe, that people can understand it. And the more you show it, the more comfortable they get with it. The more we can establish like hey, consumers in all broad swathes of the area of healthcare can understand this information, the easier it will be. By working with the FDA. and has made it easier for other firms entering the field. For the FTA to understand their aims. And for consumers to get on board with twenty three and Ms.

Weird. And Wonderful mission. I think the trust element is one of the biggest, and in part because You know, we are a company that works with really sensitive information.

Like I have your genetic blueprint. And I ask you lots of questions about you. And then I wanna do research, I wouldn't make discoveries like on depression and Allergies and asthma and fun characteristics, but we have a lot of really sensitive information on customers.

And we have to prove that we're like responsible every day. And that we're making good decisions and our customers trust us on this. And so Because we have this research mission. The only way we will ever understand the human genome, and the only way that we will all collectiv from the human genome is if we trust. Trust one.

The floodgates. Are open for wave after wave. Of new possibilities. Once we got to that first million We learnt

That there is a really natural viral component to it. that people want to learn about their ancestry. They want to connect with friends and family. I look back on the decision that we made pre FDA to say get to a million people, it's the most important thing for us to do because you're disruptive. Like I don't know how it will happen, but I know it will catch fire. Because Anne and Twenty Three and Me took the time to work with the FDA,

They help set a roadmap. For the wider industry. Although there are still limitations they face. I have to say, like I'm really proud today. Like we don't have our full product back. and we suffer lots of pain and I can see other companies doing things that I wish we could do.

But fundamentally, I feel like I'm speaking the language of regulators and scientists, and that I'm proving out my position with data. And we're succeeding. They can now focus on all the exciting possibilities ahead. A lot of those things come with scale. Health is one of those things people are still figuring out. How to use this information.

And like what does it mean for me to like step up If I'm higher risk for you know, type two diabetes, like what do I do? And there's not a huge support system yet. And that's one of the things I think Silicon Valley will have more and more of a role to step up in. And so I see the next decade in some ways as like driving. a lot of the viral connections, there's gonna be a different healthcare world than the world that we know today.

In the world we known today that is predicated on physicians and hospitals and in person visits. There's gonna be an entire healthcare world that's predicated on your phone. It's a grand vision.

That will not be easy. to make a reality. But it would have been impossible. If Anne hadn't taken the time.

I'm Reed Hoffman. Thank you for listening. Masters of Scale is a Wait What original. The show is recorded on site in California and produced at the studio inside SY Partners in New York. Our executive producers are June Cohen and Darren Triff.

Our producers are Chris McLeod, Adam Skuse, Jenny Cataldo, Jordan McCloud, and Ben Manilla. Our supervising producer is Jay Punjabi. Origin music. by Allison Leighton Brown. Sound Design Mixing and Mastering by Brian Pew. Special thanks

De Chris Yay, Elisa Schreiber. David Sanford, Saida Sabieva, Christina Gonzalez, and Sarah Sandman. Visit masterstofscale dot com to find the transcript for this episode. be sure to subscribe to our email newsletter.

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