Episode Summary
Executive Summary: Andrew Dudum, founder of Atomic and Hims & Hers, explains how a startup studio approach led to consumer health brands built around telemedicine, standardized digital workflows, and direct-to-consumer pricing. The discussion covers Hims & Hers’ rapid growth, SPAC-driven IPO, recurring-revenue economics, remote clinical care, and how the pandemic accelerated acceptance of online healthcare.
Main Topics: Atomic startup studio and Hims & Hers origins: Dudum recounts his path from dropping out of Wharton, moving to San Francisco, founding an early Sequoia-backed company, and then launching Atomic with Jack Abraham. He explains the studio model of running many tests, selecting promising ideas, and spinning out companies, with Hims/Hers emerging from that process. Hims & Hers product-market fit in consumer healthcare: The company was built on the insight that consumers expect on-demand, transparent, mobile access in healthcare just like in food, transportation, and shopping. Dudum frames the brand as bringing control, convenience, and affordability to treatments like ED, hair loss, acne, birth control, and mental health. Telemedicine workflow and clinical standardization: Dudum emphasizes that patients are still speaking to real doctors, but through a standardized digital interface that improves access, consistency, and tracking. He argues this format can reduce errors, improve compliance, and make specialist care available nationwide, including rural areas. Economic model, pricing, and recurring revenue: The business relies on cheap generics, high gross margins, and subscription-like recurring revenue rather than insurance. Dudum highlights how direct-to-consumer pricing makes care accessible and creates a predictable, efficient public-company story. SPAC, public-company transition, and investor story: He describes choosing a SPAC with Oak Tree Acquisition and Howard Marks after considering a traditional IPO. The reasoning centered on efficiency, lower cost, and the ability to go public while still early in the company’s growth curve. COVID as a forcing function for remote healthcare: The pandemic accelerated mainstream acceptance of telehealth, validating Hims & Hers’ model and forcing providers and hospital systems to rethink in-person-only care. Dudum believes remote medicine is now structurally embedded in the future of healthcare. Future expansion and industry disruption: Dudum outlines potential expansion into chronic care, lab kits, weight loss, diabetes, hypertension, and more geographies, while noting that pharmacies, hospital systems, and insurers will need to adapt as digital-first care takes share.
Key Arguments: Startup studios can improve hit rates by combining investor pattern recognition with operator pattern recognition and by testing many ideas before scaling. Healthcare lagged behind other consumer categories in on-demand access, despite consumers already expecting speed, transparency, and mobile convenience. Telemedicine can improve quality because it standardizes intake, preserves records, and enables specialists to review patients with more consistency than many in-person workflows. Hims & Hers makes care cheaper by using generics, direct-to-consumer fulfillment, and subscription pricing, often eliminating the need for insurance. The company’s model is attractive for public markets because it combines strong margins, recurring revenue, and high growth with a long-term category expansion story. The pandemic normalized remote healthcare, and both doctors and hospital systems are now structurally rethinking how they operate. Physical clinics may still exist for some patients, but the dominant experience for routine care will increasingly move online. Universal-healthcare countries still have long waits and poor everyday access, creating an opening for Hims & Hers internationally.
Data Points: Atomic fund size: $100 million - First Atomic fund launched in 2013 with Peter Thiel and Marc Andreessen as core LPs Startup tests run annually: 20-30 tests per year - Atomic tested ideas via landing pages, go-to-market tests, and fake-sales calls before spinning out companies Time from founding to IPO: 36 months - Dudum says Hims & Hers went from founding to IPO in about three years Revenue before IPO planning: Approaching $100 million - Company reached this level after about 1.5-2 years, prompting public-market consideration Projected annual revenue: About $140 million - Company’s first year as a public company / projected revenue guidance Gross margin: 76% - Reported gross margin in Q3 last year Gross margin range: 70%+ - Describing current expected economics of the business Recurring revenue: 90%+ - Dudum says most of the business is recurring Doctors on platform: 300-400 doctors - Specialists across dermatology, primary care, internal medicine, and ER medicine Medical visits completed: Almost 3 million - Total visits completed on the Hims/Hers platform over the prior couple of years Doctor pay: $100-$150 per hour - Hourly pay for doctors on the platform, matched to local geography Viagra cash price: $65 per pill - Used to illustrate how expensive branded drugs were before generics Generic Viagra price: A couple of dollars per pill - Approximate cost comparison versus branded Viagra High-deductible plan cost to see a doctor: $40-$50 per visit - Used to show why many consumers choose direct-pay telehealth Average annual deductible: About $2,000 - Describing common insurance cost burdens in the U.S. Monthly Hims/Hers price: $20-$30 per month - Includes doctor visit, medication, personalized treatment, delivery, and unlimited access Fake online Viagra share: 80% fraudulent - Claim about the prevalence of counterfeit medication online UK wait times: 3-4 weeks - Wait time for appointments in London’s system as contrasted with digital care Team size: 200 people - Current company size when discussing remote operations Office count: 0 offices - Dudum says the company has no physical headquarters and is fully remote Countries with hiring/operations: Nigeria, UK, Mexico, Argentina, Canada - Examples of where the company has hired people while remaining remote
Pivotal Quotes: "“If you could combine that type of venture capital pattern recognition with operator pattern recognition, we felt like you'd have a much higher hit rate at building companies.”" — Andrew Dudum: Explaining the thesis behind Atomic’s startup studio model "“Why was it that I could get a car, I could get food, I could get clothes, but I couldn't get a doctor on demand?”" — Andrew Dudum: Describing the consumer insight that led to Hims and Hers "“There are 300, 400 doctors on the platform at this point.”" — Andrew Dudum: Answering concerns about whether users are actually speaking with real clinicians
Implications: The conversation suggests telehealth is becoming the default for routine care, with big implications for pharmacies, insurers, hospitals, and digital health startups. Consumers, doctors, and investors may increasingly favor standardized, low-cost, remote care models.
About This Week in Startups
Jason Calacanis covers startups, tech, markets, media, and all the hottest topics in business and technology. He also interviews the world’s greatest founders, operators, investors, and innovators.