Rob Sebastian - Forward Health - Massive Disruptions In Global Healthcare

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[00:02:14] me directly. That's podcastcollective.io. Alright, we are live. Rob Sebastian, welcome to

[00:02:24] the future of fitness my friend. Thanks a lot for having me, Eric. Yeah, I've been, as I was

[00:02:28] telling you, I wasn't kidding. I've been very excited for this interview for months now since

[00:02:33] it's kind of popped up on my calendar and you know, having your co-founder Adrian on the show back

[00:02:38] in November of 2022, which just it's not that long ago but it feels like a lot of time. Yeah,

[00:02:44] it's a more perspective as well. A lot's been happening. Yeah, yeah for you especially,

[00:02:49] but you're the co-founder of Ford Health. I've been excited to get an update on it and I can

[00:02:54] just tell by our conversation and the pre-interview here that it's going to be really really good. So

[00:02:58] let's just dive into it man. Let's start with maybe Rob, if you give us your background and then

[00:03:04] we'll kind of get into the problem that Ford is solving and then we'll take it from there. So,

[00:03:09] yeah, tell us about you Rob. Okay, cool. Yeah, imagining myself on a therapy couch, let's do this.

[00:03:16] Yeah, let me let me kind of just give the teaser of what Ford is so that people have an idea

[00:03:20] where I'm going with this and then happy to answer your question on my background and how I got here.

[00:03:23] So for those who aren't familiar, Ford is our mission is to build the world's best health care

[00:03:30] for billions of people for free. And so that's what we're working on. And then some of what I'm

[00:03:35] sure you and I will spend time on today is we recently launched a product called the Carapod,

[00:03:39] the world's first AI doctor's office, which is a really exciting step towards that mission. So

[00:03:44] that's kind of what I'm working on, which might help contextualize a bit of like where I've been

[00:03:48] before this and why. Basically, I want to spend my life trying to build beautiful things that help

[00:03:54] people on the problems that matter. And so with that in mind, like I can give a longer version,

[00:03:59] but let's kind of at least start with Google right before this. So right before this, I was

[00:04:04] working with Adrian, my co-founder who you've chatted with before at Google, working for Larry

[00:04:08] Paige, starting Google companies. And as you can imagine, that was a very fun job. And there was

[00:04:14] an interesting day where a one-point Adrian came to me and he's like, hey, between you and me and

[00:04:18] Larry, we are not going to run out of ideas here. Like, there's tons of things we could imagine

[00:04:22] doing. Like, what should we focus on? And I said to him, I was like, well, I've, for better or

[00:04:27] worse, agonized my entire life over this question. Like, what is even the point of a job? And what

[00:04:32] I've come to and what I think we should focus on is I only care about three things. First,

[00:04:37] is this problem massive? Like, no offense, but I'm not really interested in a problem that only

[00:04:42] affects like Rob and Eric and lucky people in like the US. I want to know there's a chance we'll

[00:04:47] serve the entire world before I even start. Cool. The second criteria is if it's massive,

[00:04:51] is it meaningful? Like, there's some huge companies, they serve billions of people,

[00:04:55] but they do it on things that may not be the most important in the grand scheme of humanity,

[00:04:59] you know? And so it's like, I don't want to build a photo sharing app personally. Like,

[00:05:02] I want to work on the things that are foundational to like our human existence,

[00:05:06] whether that's education, whether that's employment, whether that's like health,

[00:05:09] whether that's climate change. Like, there's some things that I think are very foundational

[00:05:13] and problems worth solving. And then finally, if it's massive, and if it's meaningful, that's a

[00:05:17] problem worth solving. The last question I ask is like, can humanity even solve this? And

[00:05:22] the reason I care about that is because I'm not particularly interested in working on making

[00:05:26] something 10% better. If it's a huge problem, and if it really bugs me how it works today,

[00:05:31] I'm not trying to make it incrementally better. I want to make the thing 10 times better. And

[00:05:34] the only way I've ever seen humans do that in all of human history is by applying technology

[00:05:40] to some deeply technical problem and leveraging the world. And this sounds like kind of a San

[00:05:44] Francisco thing to say like, I'm not from here. I'm from Philly. I'm from New Zealand. I didn't

[00:05:48] grow up like taking computer science classes. I taught myself computer science because I realized

[00:05:52] this point. If you read a history book, like the chapters are called the Stone Age, the Iron Age,

[00:05:59] and the Bronze Age for a reason, like humans were the same the whole time, genetically and

[00:06:03] physiologically we were the same. But what we're saying with those history book titles is if you

[00:06:07] don't know the tools of that human era, you have no idea how they live. That's kind of crazy.

[00:06:12] So basically, that's what I'm looking for. It's super simple. I want massive,

[00:06:15] meaningful problems that could be 10 times better. And so with that in mind,

[00:06:19] you can probably start to get a sense of why I get excited about something like healthcare.

[00:06:22] And so I'll pause there. I mean, I'm happy to obviously get into healthcare specifically,

[00:06:26] but you asked to build it up my background. I can go in many different directions with that. But

[00:06:30] this is sort of like my motivating goal in life is to work on building beautiful things that help

[00:06:35] people on the problems that matter. And that's how I try to find them.

[00:06:38] Yeah. Right on, man. It's inspiring. It's interesting to me when people like yourself,

[00:06:44] I had a relatively young age, kind of figure out how you want to approach your life. Most

[00:06:49] people are, I don't know, I just want to make some money and have a good time on the weekend.

[00:06:53] But you've taken it much broader. Where does that come from? Is that something that's

[00:06:57] influenced by your upbringing, your family, mentors, something you read at early age?

[00:07:06] Like, where does that scale of thought come from? Yeah. Now, definitely on the therapy couch.

[00:07:11] Yeah. Welcome to my office, Rob.

[00:07:13] Look, I'm incredibly, I'm incredibly lucky is, I think, one of the origins of it. I think about

[00:07:19] the family that I was born to and the amazing parents that I have, I think about my amazing,

[00:07:23] like family and siblings. I think about where I was born. I think about when I was born.

[00:07:27] I think about the gifts that I was endowed with. And I just feel incredibly lucky. And I know that

[00:07:31] there's a lot that was happenstance that resulted in that. There's also a lot of hard work. And I've

[00:07:35] really spent a lot of my life trying to make the most of that and do good on it. But that's kind of

[00:07:40] some of it is I feel very fortunate to be where I am, when I am, and doing what I do to kind of

[00:07:45] explore a bit of like, okay, but how did you get here? Like, if you think about, like, whatever,

[00:07:50] I think about what I was doing as a kid, like, I, I loved reading about people in art and science

[00:07:56] and math. Like, I had a bunch of different interests. And so I loved reading about Michelangelo and

[00:08:00] Da Vinci and Einstein and Newton. And what I always found super interesting was like this little

[00:08:05] abstract idea. Like, imagine there was a little curve and it showed human progress. And like,

[00:08:10] you're zoomed way back. Like, you're literally like coming out of caves and then all the way

[00:08:13] through to today's era. Like, what's that curve? And what was always really fun was like, you could

[00:08:17] almost imagine the kink in that curve or the change in its trajectory based on one of these

[00:08:22] heroes of mine, right? Like, you can imagine after Einstein's 1905, like humanity was on a slightly

[00:08:28] different trajectory. And frankly, like, when I look at the Sistine Chapel and I am so moved to see

[00:08:32] that, I imagine that humanity had some small change in its trajectory by virtue of that beautiful

[00:08:37] work. And so I grew up with this idea of like, look, I'm not any one of those people, but it'd be

[00:08:42] really cool if I could try to help bend the arc of humanity in some good way and be part of this

[00:08:46] greater collective that is humanity. And so that was sort of where I started. And as I alluded to,

[00:08:50] my first couple of jobs, I honestly, I didn't find that meaningful. Like, I'd come up with this

[00:08:56] very altruistic notion of trying to help the world. And then my first jobs were kind of what you said,

[00:09:00] frankly, it was like, make some money, have fun on the weekends, you know? And it's like, okay,

[00:09:04] so I worked one was in banking and one was in consulting, both ostensibly very good jobs.

[00:09:08] Everyone said, congratulations, that's so cool. You got that job, that's so excellent. And yet,

[00:09:13] at my core, I was like, why did these even exist? Like, why do we do this? It doesn't seem to matter

[00:09:18] in the grand scheme of humanity. So I went down kind of a long exploration where I was like, look,

[00:09:23] a job is made up like a job is an invented human construct. How did like the world's apex predator

[00:09:29] decide that they were going to spend all of their time from nine a.m. until five p.m. working

[00:09:33] a job, it's invented. And if you think about it, a job is invented inside of a company. Well,

[00:09:38] companies invented to, and if you think about it, even a company is often trying to make like money,

[00:09:43] money is made up. The first money was like cowry shells in Africa. And if you think about it,

[00:09:47] money is the currency of capitalism. Well, I've got to have like surprise for you,

[00:09:50] capitalism is made up to. I'm not saying that they're not useful. I actually think you need

[00:09:54] these sort of shared lies that we all agree in and actually say are important to have a sort of

[00:09:58] common ground for from which to operate. But there's no law of physics that says I should have a job.

[00:10:03] I didn't have any money. So that was a separate problem I'd have to figure out. But like,

[00:10:06] there's no law of physics that says you should have a job. And so I questioned that and I said,

[00:10:09] what is the point of a job? And this comes back a little bit to what I said earlier.

[00:10:13] Like, I started realizing like, I want to create things. I want to build beautiful things that

[00:10:17] help people and the problems that matter. And if I want to do that, I could imagine being like

[00:10:21] Michelangelo, not that I was ever that good. But like, I could imagine being Michelangelo

[00:10:25] flying on my back, painting the Sistine Chapel ceiling, dripping paint in my eyes.

[00:10:29] But I'd kind of like to do with some other people. I kind of like to have it like affect a lot of

[00:10:33] people. And that starts to sound like maybe a job inside of a company with some other people

[00:10:37] working together. Okay, fine. I'm willing to grant the idea that a job might be part of my life.

[00:10:42] But I want to do it on my terms, working on the problems that I think are truly worthy.

[00:10:47] So you'd asked a little bit of like, how did I get there? How did I have this perspective on what

[00:10:50] am I life to be? I feel very lucky for having been blessed with what I have. But I also have been

[00:10:55] very intentional and quite self critical at times of like, is what I'm doing right now really what

[00:11:00] I'm meant to be doing? And I think, you know, through the trial and sort of error of it all,

[00:11:04] have gotten to something that feels like a really meaningful manifestation of my life.

[00:11:07] Yeah, right now on my own. It's, it's funny. I think, you know, there's something in there that

[00:11:11] maybe a lot of people don't think about. And I don't know if you've read about Como Sapiens,

[00:11:15] but he talks about essentially this evolution, like that we live off this world that's like this

[00:11:20] collective, like, we all agree that these fictional things exist, right? Many corporations,

[00:11:26] like all that stuff. And it drives everything, but it's just our collective imagination and

[00:11:31] how fragile that is. And it's kind of all those things like, if you start thinking about it,

[00:11:36] it's a rabbit hole. It's going to mess you up a little bit because it'll kind of shake your,

[00:11:40] your foundation of what our society is actually built on. So it's just a really,

[00:11:45] it's a fascinating thought to just sit on a rock and ponder for a while.

[00:11:48] Yeah. And I think that those, those shared lies or shared stories are what made us the apex predator.

[00:11:54] It's not our athleticism. It's not our, like, vicious fangs. These things can barely do anything,

[00:11:58] you know? It's not our superhuman strength. We're not particularly superhuman. In fact,

[00:12:01] it's by definition not. So it's like, that was the power that made us what we are as a species.

[00:12:06] I'm not sort of saying that that's not important. It's crucial. But you've got to pick and choose

[00:12:11] your battles. Like some of these things, you can just kind of live your life and say, you know what,

[00:12:14] I'm willing to just accept that dogma and just move on. Because I don't want to spend my time

[00:12:18] reinventing the wheel and everything. But when it comes to something so important as, how do I

[00:12:22] spend the majority of my waking hours? It did seem worth actually questioning the premise pretty

[00:12:27] hard and asking, what is it all for? And you know, you'll see a similar pattern as we get into

[00:12:31] healthcare. It's like, on a problem as important and as broken as healthcare, I'm not willing to

[00:12:36] accept the dogma. You've got to actually dig deeper and ask, you know, with no constraints,

[00:12:40] what would I have built in the same way that I asked, what's the point of a job? I actually,

[00:12:43] in that case, happened to conclude it was a thing I wanted. But I did it actually through a lot

[00:12:47] of like reasoning about why does it exist and what does it mean to me personally.

[00:12:50] Yeah, right on. Well, let's take that entry point and get into it. So I think anybody who

[00:12:54] listened to this podcast would agree that healthcare, uh, turn to use my words, give it suboptimal

[00:12:58] at this point, right? Very sure. Yes. Yeah, it's, it's many say it's broken. Many say it's just,

[00:13:04] you know, it's just completely ineffective given where we're at as a moderate civilization. And so

[00:13:11] maybe you can outline from your perspective, Rob, like what exactly are the issues that hold our

[00:13:15] healthcare system back? Like, why is it broken? Yeah, I mean, I certainly, uh, you're choosing

[00:13:21] your words carefully. I think it's fair to say it's broken. And I think like, so I'll kind of

[00:13:26] describe how I came at this when we started, right? So, uh, I think that when we started for it,

[00:13:30] I didn't really know anything about healthcare. I knew that it was a problem worth solving.

[00:13:35] deeply meaningful problem to sort of harken back to the first two criteria. I was pretty

[00:13:39] sure it could be 10 times better, but I really wanted to understand why is it broken in the

[00:13:42] first place before I could really assert that. And if you think about it, the thing I found

[00:13:46] most helpful was I was like, look, all of health care is broken because we accidentally

[00:13:50] invented the doctor before the computer. I get why it happened. I know anthropologically

[00:13:55] why the doctor came first, I totally get it. But in the grand scheme of human history,

[00:13:59] it was a vanishing incident between these two things. But because we invented the doctor

[00:14:02] before the computer, all of health care is wrong. All of health care was built inside

[00:14:06] out. All of health care was built to inherit the flaws, as well as the great aspects of

[00:14:10] human beings as the centerpiece of that system. So just think about it for a second. Like

[00:14:14] the first major issue I have with health care to come back to your question is like the

[00:14:18] quality of health care sucks. And I'll just start you right off the bat. None of this

[00:14:22] is a critique of doctors, doctors are incredible. But the problem, the fact that they're so

[00:14:26] smart and so rare and so expensive is kind of the problem. So okay, think about the quality

[00:14:31] of health care. You live in a world where like, you know, we have the some knowledge of humanity

[00:14:37] at our fingertips every second of our life. Like that's incredible. You live in a world

[00:14:41] depending on where you live, where you have like cars driving themselves around your streets,

[00:14:45] you live in a world where we shoot rockets into space, we flip them around, we land them

[00:14:49] on robot barges in the middle of the ocean, all in service of trying to like go colonize

[00:14:54] Mars. You live in a world where we have artificial intelligence that is so good that we're

[00:14:59] literally starting to ask, what does it mean to be sentient? And in that same world, your

[00:15:03] health care is a doctor listening to your chest with a hollow tube. It's your doctor

[00:15:07] is smacking you on the knee with a hammer and seeing if you react. It's your doctor

[00:15:11] like asking you how your great and zoo died and being like, okay, based on that, here's

[00:15:16] how you might die. I'm like, what are we doing? Like, what are we talking about? And again,

[00:15:19] none of those are the flaws of the doctors, but they have not had the right tools. So

[00:15:24] I look at the health care system of today and I say the quality is actually atrocious compared

[00:15:27] to what it should be. Then on top of that, not only is the quality terrible, it turns

[00:15:32] out that health care is 20% of the American economy, or maybe put more viscerally for

[00:15:37] every dollar you earn 20 cents comes right out of it and goes to health care. So you

[00:15:42] pay some huge amount of your salary for that terrible product. And on top of all of that,

[00:15:47] you and I are lucky enough to be able to debate is health care like good or bad for the money

[00:15:51] in the US? It's a fair question. And as you probably gathered, I don't think it's good.

[00:15:55] But that is still a privileged question because it turns out there's six billion people in

[00:15:58] the world, three quarters of the world that don't have anything. They don't get to ask

[00:16:02] if health care is good or bad or expensive or cheap. They have nothing. And that's how

[00:16:06] the system of today works. So I look at that system and say, man, there are some huge problems.

[00:16:11] In fact, they're so big and so sort of like accepted that they're called the iron triangle

[00:16:15] of health care quality, cost and access will never simultaneously improve. You can try

[00:16:19] to cherry pick one, but you're going to trade off the others. So I look at all that and

[00:16:23] say, yeah, that health care system is incredibly broken. We need to try to break the iron triangle.

[00:16:28] We need to actually reject all three of those things at once. And so while everything that

[00:16:32] I said sounds like kind of a sad pessimistic story, I am fundamentally an optimistic person

[00:16:36] as you probably gathered. And so I'm like, look, the very single optimistic question

[00:16:41] of the core forward is this. Don't ask me how, but imagine that you would just magically

[00:16:45] flip the order. Imagine you would have invented a computer before a doctor. If you would

[00:16:49] know that we're going to live in the world I described, I guarantee you wouldn't build

[00:16:52] a health care system we have today. In fact, I guarantee you wouldn't try to build a bespoke

[00:16:57] labor service. You'd build a technology product. And in particular, you would probably try

[00:17:02] to look at every single task that a doctor is doing and shuttle as many of them as you

[00:17:06] can into hardware or into software. So what you do is you would build forward. And so

[00:17:10] I wanted to give that context in terms of why I think the system is so broken and also

[00:17:14] why I'm optimistic that I think it can be improved because this starts to set the stage

[00:17:18] for care pods and what we're working on right now. Yeah, well said. And you know, when I

[00:17:22] choose my words carefully about the state of health care, because more I don't care

[00:17:27] if I offend anyone. That's not the thing is like, I don't, I don't want to sit here

[00:17:32] and say our health care system is broken when I have health care, right? And a lot of like

[00:17:37] you mentioned 6 billion people have nothing. So there's not anything there that's broken.

[00:17:42] It's just on it. It just doesn't exist for them. And that's, you know, I think that's

[00:17:45] something that a lot of people can, because you know, I live close to Canada, right? And

[00:17:49] everyone's like, Oh, you know, teens come down and they complain about their health

[00:17:52] care system in the United States. We're always complaining about our health care system.

[00:17:55] We wish it was more like Canada's. I can tell you right now, a ton of them are health

[00:17:57] Canadians like, ain't that great. Yeah, that's not what you think it is. So you know, it's

[00:18:02] just that fact that we can even have that conversation is is still, you know, beneficial

[00:18:06] to people who live here. So yeah, I mean, I don't think anybody listens this would disagree

[00:18:10] that health care has some major problems. And it's probably one of the biggest challenges

[00:18:14] and problems that we have as a species to this point, which means that the opportunity

[00:18:19] to fix it is also one of the biggest and most exciting opportunities out there, right?

[00:18:24] And let's start with this. Like from a base level, what is Ford, you know, an agent was

[00:18:29] on the show, we talked about, like you said, health care is a product, not a service, right?

[00:18:34] Like some clear distinctions to help us, you know, start from a fundamental piece. How

[00:18:38] do we start to understand why you're different? And then we can dive into all the intricacies

[00:18:41] of what you guys do. Yeah. So when you talk to Adrian, the product that we had live and

[00:18:47] the thing that he could actually talk to you about was a doctor's office, a doctor's office

[00:18:51] with a lot of technology, body scanners, a huge smart screen in the exam room, a mobile

[00:18:56] phone, lots of sensors, et cetera. And so basically what we were doing was we were just

[00:19:01] trying to learn as much as we could about what does a doctor do and how could we turn

[00:19:05] it into hardware or software, exactly what I mentioned. And so you can imagine it's

[00:19:08] like someone comes in and like, I have a rash, we're like, wow, it's crazy that a doctor

[00:19:12] looks with their eye at that rash. And immediately then asks you, has that changed since last

[00:19:16] time? It's like, I don't know, take a picture and like track how it's been changing. Obvious

[00:19:19] example, you can imagine somebody then comes in and they're like, I have a cough. And it's

[00:19:24] like, Oh, I bet it's the flu. It's flu season. They go through this analysis, and it turns

[00:19:28] out sure enough, it's the cough. It's like, okay, well, take the first one, turn it into

[00:19:31] like a camera with like computer vision. Take this cough, turn it into like a series

[00:19:36] of questions on your mobile phone. Don't even come into the office. You have problems

[00:19:39] with your heart, let's build a heart scanner, like all of these things are what we were

[00:19:42] learning over the beginning of forward. And so that's kind of where we were. As I mentioned,

[00:19:48] we launched a product recently called a care pot. And before I get into exactly how it

[00:19:51] works, so I think I should try to describe that at least, let me kind of give you like

[00:19:55] the insight behind the care pot. If you want to try to get healthcare to billions of people

[00:19:59] for free someday, the world's best health care to billions for free someday, you've got

[00:20:03] to think about the problem differently. You can't be saying a bespoke labor service.

[00:20:07] So you start asking yourself, what has like ever gotten to billions of people? Like, what

[00:20:11] has ever been a truly great product that gets cheaper over time, and has gotten to billions

[00:20:14] of people? There's actually lots of examples. They're all around us. They're just not in

[00:20:17] healthcare, right? So let's use the example of your phone. Like, your phone is a good

[00:20:22] example of something that literally was invented 15 years ago. And now 5.5 billion people

[00:20:27] in the world have a smartphone like that is insane. That's mind blown. And so if you

[00:20:30] think about it, every truly great product at the limit looks the same. So for example,

[00:20:35] you want to make a piece of hardware that can be distributed out into the everyday lives

[00:20:39] of people. So that piece of hardware is a phone or in my case, a care pot, then that

[00:20:44] that piece of hardware needs more and more capabilities. So on your iPhone, this was

[00:20:48] them saying, Hey, let's get a cellular connection. Sounds really useful, right? Then they're

[00:20:52] like, okay, let's add GPS. Oh my gosh. Now Uber is possible. Now like Lyft is possible.

[00:20:57] Now Airbnb is possible. Then they started saying let's add a camera and let's add like all

[00:21:01] these new features over time. Those are the capabilities. Then you say, let those capabilities

[00:21:06] be available to build people building applications. Those applications are solving a user problem.

[00:21:11] So maybe it's Lyft. Maybe it's Airbnb. Maybe it's TikTok. Maybe it's YouTube. Maybe it's

[00:21:16] Instagram. Like all of those applications are what basically use these amazing capabilities

[00:21:20] to build better and better products over time. And basically, then you want a platform.

[00:21:25] So it's like, if I want lots of apps, if I don't want to have like 10 or 20 or 100,

[00:21:29] I want to have a million apps, I might need lots of people to build these applications.

[00:21:33] So that's kind of like the mental model. And if you think about it, that's exactly what

[00:21:36] we've built at care pot is a piece of hardware that by the time we're done should be as common

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[00:23:00] Inside of that carapod, there's more and more capabilities. The ability to scan your body,

[00:23:05] the ability to use computer vision, the ability to like give you a self-serve stethoscope

[00:23:09] or a self-serve like, I don't know, EKG someday. And so you add more and more capabilities,

[00:23:14] then you build applications. Those applications could help you say, I'm going to solve your

[00:23:17] diabetes. This one will solve your hypertension. This one's about helping you improve your

[00:23:21] VO2 max. This one's about helping you sleep better. And of course, all those applications

[00:23:26] should be built not just here and forward but by more and more people over time. So what's

[00:23:30] cool is if you think about it, healthcare will be 10 times better someday. As soon as you

[00:23:33] assume that you will rebuild this entire thing as old computers are coming first, you know

[00:23:38] that's going to be a massively better system. And we actually even know how to build it.

[00:23:41] We know the principles of how to build this system. So that's kind of like the impetus

[00:23:45] or the origin of the carapod. If you want, I can start to shift into like, how does this

[00:23:49] thing work? Well, what's the experience as a user? But I wanted to kind of explain like

[00:23:52] why I think this is such an important step towards that mission.

[00:23:55] Yeah. Yeah, I do want to get into that. And I guess I want to pick a step back because

[00:23:59] you know, about a year ago when I talked to Adrian, it was in the clinics. He was more

[00:24:03] of a clinic that you guys were building and you're expanding those. And you know, I had

[00:24:07] some friends who, you know, the Martins from anyway, they love it. And a bunch of people

[00:24:13] were telling me how they love it. There's nothing near me in Northwest Montana yet.

[00:24:17] Right. So that's why I needed a carapod. I can't make me next clinics near you. I can

[00:24:21] absolutely put a carapod there. Yeah. So explain to me why the transition, like why

[00:24:26] you guys refocused and everything iterates over time, right? I mean, you live in startup

[00:24:30] capital universe, like everything iterates, right? You're always kind of shifting and

[00:24:35] finding out new things and moving. So walk us through that path. Like, what was the,

[00:24:40] what's surge that renewed focus on the pause? Yeah, I mean, look, the clinics that Adrian

[00:24:46] mentioned were always the plan and the carapods that I just mentioned were always the plan.

[00:24:50] The point is like you needed to go through the clinic portion to learn the lessons to

[00:24:55] then go build a truly scalable version of this product. And just to kind of to give an

[00:24:59] analogy or two that I think reinforces this point, a lot of times like truly transformative

[00:25:04] products, they seem like they kind of come out of nowhere, right? It's like, oh my gosh,

[00:25:08] like the iPhone literally started an era of mobile computing. And it's like, yeah, that's

[00:25:11] true. But it's also true that everything in that iPhone had its precursors in like a

[00:25:16] MacBook Pro. Like they literally had to think about how do we build batteries and then how

[00:25:20] do we build screens and then how do we build like, I don't know, processor chips and like

[00:25:25] cellular chips and all of these things, even a camera, there was a front facing camera on

[00:25:30] the MacBook Pro. The point is, all of those discrete capabilities did exist at Apple.

[00:25:34] They were just in a different form factor. And at some point they said, we have enough

[00:25:38] of the puzzle pieces to consider completely repackaging this thing. And it turns out

[00:25:42] that whereas maybe a MacBook Pro can get to 100,000 users or a million users, it turns

[00:25:47] out that an iPhone can get to a billion users. And that sort of massive change was made possible

[00:25:52] by taking what you'd learned and repackaging it into a new product. Tesla's a very similar

[00:25:56] story. Tesla started with a Roadster and then a Model S and then a Model 3 just kind of

[00:26:01] stylized the problem. I know there's some other letters in there. But the point is,

[00:26:04] like before they could launch the Model 3, which was actually a much more transformative

[00:26:08] product that actually could scale and could get some more people at a price point they

[00:26:12] could afford, they needed to build the Model S. Because in that Model S was the beginnings

[00:26:16] of self-driving and the beginnings of learning how to like build the chassis. And the ability

[00:26:21] to build out a manufacturing plant, they could start to stamp these things out at high volumes.

[00:26:26] And by the way, they had to build a like a lithium ion battery factory and they had to

[00:26:30] build charging infrastructure around the country. All of those things were necessary capabilities

[00:26:35] to get to the Model 3. And so in the same vein, you look at a forward clinic that Adrian

[00:26:39] talked to you about last time, every single capability that now is manifested in a carapod

[00:26:44] was right there. That's how we learned that. So we basically learned how to build hardware.

[00:26:48] We learned how to build software. We learned how to build robotics and we learned how to

[00:26:51] build sensors. We learned how to build data monitoring systems. We learned how to build

[00:26:55] our own electronic medical record from scratch to be able to teach computer's medicine. All

[00:27:00] of those steps were necessary to then at some point say, "Shoot, we've taken so many

[00:27:04] things off of the doctor. I'm not even sure we need a doctor in the doctor's office anymore."

[00:27:09] That's a pretty profound realization.

[00:27:10] And once you come to that conclusion, you say, "Okay, let me rebuild this doctor's office with no doctor in the middle, all of this hardware and software front and center, and be able to give you an amazing product, but that can be far more affordable, far more scalable. If I want to get healthcare to northwest Montana, much less to rural parts of Kenya or to Chile or to Pakistan, I have to start to imagine something that looks a lot more like an ATM and a lot less like the original Wells Fargo Bank in 1900."

[00:27:38] Nice, nice. So yeah, let's get into the user experience when I was reviewing the press release that you guys had, and my first thought was like, in a minute, this is super simplistic.

[00:27:47] But I was like, "Oh, this is like the tiny home of healthcare." Right? It's like, it's modular, it's mobile, it's condensed down to what you need, not probably a whole lot that you don't need.

[00:27:57] So yeah, walk us through like, what is it as best you can over an audio medium? What is the experience? I like that tagline, "Forward, the tiny home of healthcare." Yeah, I'll work on that.

[00:28:08] So basically, let me kind of just describe how this would play out for a user. So imagine you signed up for "Forward" in northwest Montana, and again, these should be everywhere, they should be as common as an ATM. Obviously, we're working on rolling out more of these.

[00:28:20] But you walk up, first of all, it's like, healthcare today is so reactive, like it's kind of crazy. We literally just wait for the human body to break down, we're like, "Oh, that sucks. Let me see if I can help save it."

[00:28:30] And it's like, well, that's crazy. We don't even do this with our cars. Our cars have all kinds of like sensors and lights going off. Frankly, I don't always listen to them, but like, there's all of these things happening that try to help you be proactive on your car and nothing on your body. It's kind of crazy.

[00:28:43] So the whole point is like, I want to be proactive. I want to get you, Eric, in front of the things that actually matter for you. And so you walk up to this carapod, and the first thing we're going to do is call it a baseline. So you walk up to this carapod, and first of all, it's really small as you said, it's a tiny home, if you will.

[00:28:57] I think it's like 10 feet by 10 feet. It's probably even a little smaller than that. It's tiny. So you walk up to this thing, you tap your phone on the outside, and it authenticates you in right away. Welcome, Eric.

[00:29:06] You walk into this thing, and the voice says, "Welcome, Eric." Time for your baseline. And so you walk into the carapod, and it's all self-serve. It's like a beautiful experience.

[00:29:15] So you stand in the middle of this carapod, and basically what we're going to do is the voice starts talking to you and playing like an educational video.

[00:29:22] It's like, "Hey, Eric, before we get to know you, I just want to let you know we know the three big killers for almost everybody." It's some combination of your metabolic health, your heart health, and cancer risk.

[00:29:34] So let's go ahead and learn about those risks and try to teach you what you can do to get in front of them.

[00:29:39] And so we start gathering data, and it does ask you some questions, but most of this, honestly, is just collecting information from your body.

[00:29:45] So you've got like a slow spin on a turntable, and then there's sensors that build a 3D model of your body.

[00:29:51] Then there's like a drawer that opens up and says, "Please grab the heart scanner."

[00:29:55] You pick up this heart scanner, and by the way, remember, there's no doctor. This is all just you doing it yourself, working with the screen in front of you.

[00:30:01] You pick up this heart scanner, think of it as kind of like a really advanced stethoscope, and you just put the thing on your chest, and you watch your heartbeat on the screen in front of you.

[00:30:09] Like, it's kind of amazing. Like, literally the tool of the medical profession is in your hand.

[00:30:14] You are like holding your health in your hands, like literally speaking.

[00:30:17] You put this thing back into the drawer and now understands a little bit more about your heart health.

[00:30:21] Then the drawer opens up, and it's like, "Time for a blood jaw."

[00:30:23] And it's like, "No, I'm not going to have somebody walk in and stab you with a needle.

[00:30:27] We've actually got a way to draw your own blood."

[00:30:29] And literally pick up this thing. It's like the size of a golf ball, or like this microphone.

[00:30:33] And it basically just has a little piece of sticky tape on it. You just take off the sticky tape, you put it onto your arm.

[00:30:38] There's no needles. It doesn't hurt at all. You literally just turn on the vacuum pump, and it draws your blood automatically.

[00:30:44] It just sucks it out of your system into a little suit.

[00:30:46] Yeah, it's so crazy. And so it's like, "Great, now I've got your blood."

[00:30:49] And as you can imagine, it's like, "Okay, with all this information, we're now calculating your wrists."

[00:30:54] And it searches away on the screen in front of you. And then it says, "Here's your personal risk, Eric, for metabolic issues, for heart issues, and for cancer risk."

[00:31:03] And of course, I'm not going to just leave you hanging and say, "Man, that stinks for you. Good luck."

[00:31:07] I'm going to then say, out of all of the dozens of applications that we have, here's the four that I'd recommend for you.

[00:31:13] And so imagine one of those applications. Well, maybe the application is diabetes management.

[00:31:18] Maybe you're like on the borderline, or maybe you're a little bit high, and this thing is this application is going to basically say, "Okay, I know your hemoglobin A1c levels, which is a measure of blood sugar in your blood."

[00:31:28] Then I'm going to tell you how we're going to get that down over time. We're going to go from here to here over the next three months.

[00:31:34] And here's what I want you to change. This is what we call a plan.

[00:31:37] So that plan says, "We want you to change your diet this way. We want you to change your exercise this way. We want you to take this medication or not, and we're going to follow up and actually check on your progress."

[00:31:47] Like if you use a care pod, maybe it's every three or six months when you draw your blood.

[00:31:52] But maybe have a continuous glucose monitor plugged in. Okay, cool. I'll give you progress every second and tell you how you're progressing towards that goal.

[00:31:58] So that's the idea. We should be much more proactive. We should get in front of the issues that matter.

[00:32:03] We should personalize everything based on your data, not generic recommendations for a man of your age.

[00:32:09] And then we should tell you what to do about it and support you all along the way.

[00:32:12] So whether it's inside of a care pod, whether it's on your mobile phone, these health apps are with you all the time and helping you get in front of and make progress on the issues that matter.

[00:32:21] So let me kind of pause to see if that's helpful, but that's sort of how the experience works.

[00:32:25] And you can see a lot of similarities to what Adrian mentioned in the flagship, but also some key differences in terms of how affordable, how scalable this is, and the apps you can build in here are pretty amazing, to be honest.

[00:32:35] It makes perfect sense. And I think, you know, just with the consumer trend for health knowledge, right, I think the timing is really good.

[00:32:45] I mean, you look at talk about it all the time, like the humor and effect, right, which is now a spawn people, you know, Dr. Ron Patrick's been around for a long time.

[00:32:54] Dr. Gabriel Lyons, you know, all these major sources, Atea, right, is probably one of the biggest ones with his book that he came out last year.

[00:33:02] And people are really starting to understand. And, you know, there's such early positive signs that people are wanting to take preventative measures in their health care, which is perfectly, you know, aligned with what you guys are doing.

[00:33:14] Question I have is like, and maybe this, I think I know the answer, but I'll let you do it.

[00:33:19] Like, what about some of the big stuff that happens, like, you know, trauma, you know, a car accident happens, or you need, you know, a media emergency, a heart surgery.

[00:33:30] Any of those, those things, you know, that, that tend to be what people rely on health care now, the, you know, the sick care, the emergency care.

[00:33:38] How does that tie into your guy's system of preventative health?

[00:33:41] Yeah, a couple of thoughts. One, before we jump into the question, I was just thinking about your Atea comment and the other authors that you mentioned.

[00:33:48] Like, why is there medium of book? Why isn't that an app? Like, what if you could literally have Peter Atea just build an application that recommends that every fork along the way, what you should do.

[00:33:58] And that would be a far more scalable, far more helpful way to manifest his knowledge in the world. That'd be amazing, right?

[00:34:04] So, so this is why I think it's so powerful to build tools for creators to then manifest their medical knowledge, their guidance, et cetera, on the thing that could be available to anybody in the world instantly.

[00:34:15] It doesn't require them to read a book and try to remember every day how to change their life. That'd be awesome.

[00:34:19] So, in terms of, in terms of like the questions you asked around, kind of the more catastrophic side of health care, first of all, I think if you had to choose one,

[00:34:27] you should choose proactive health care. If I want to maximize the good that I can do for humanity, I certainly would prefer to prevent the heart attack, then improve the heart, the heart surgery.

[00:34:37] Right? Like, it's just a much higher quality way or a much better way to inform somebody's longevity, the quality of life, et cetera.

[00:34:43] But I said I want to rebuild all of human health for billions of people for free. That does also include like handling those things over time.

[00:34:49] So, let's use an example like heart surgery just to imagine how this could work. Now, I don't have heart surgery today, so maybe I'll start with how it happens today and then I'll talk about where it could go.

[00:34:58] We don't have heart surgery today, no problem. We just say, "Hey, I noticed that you might need heart surgery based on these apps you've been using. I want to refer you to a specialist in Montana, or maybe we'd have you fly to Boise, or maybe even fly to San Francisco, or, you know, wherever's closest to you.

[00:35:13] Here's a great person who we know can do this heart surgery, you should go to that." And so, that's kind of the starting point. And then if you think about it, in some ways, this is very akin to your first iPhone.

[00:35:22] The first iPhone had, I don't know, 15 apps or something. There was like a clock app, there was a notes app, there was a calculator app.

[00:35:30] Like, they were pretty basic things, and one could reasonably say, like, it doesn't do that much more than a blackberry. Right?

[00:35:36] And in fact, a lot of people didn't switch initially, because like, "Wow, it's kind of expensive, and like, I don't know if it does that much more than my flip phone. I'm good.

[00:35:42] I don't need an iPhone." And actually, the common critique at the time was an iPhone is a walled garden. It's what everyone likes writing.

[00:35:49] They're like, "Steve Jobs is a control freak. No one else can do anything on here. It doesn't have enough apps." Okay.

[00:35:53] But on the other hand, it's like, fast forward 15 years, there's 4 million applications on the iPhone. Right?

[00:35:59] Obviously, the seminal moment was when they said, "We are going to open up a platform to all developers to come create the future of mobile computing on top of this system."

[00:36:07] And so those first 15 apps were not important because they were the best apps. In fact, most of them, you don't even use today.

[00:36:12] Like, all the best apps on an iPhone are built by someone else. But they did teach the Apple Engineering team how to build the platform and how to create the common things that everyone will need to be able to go build an amazing constellation of applications.

[00:36:24] So that's kind of the same evolution that I imagine here, which is you start with a basic set of things that teach you how to build these applications, and then you open up to more and more people to accelerate the rate of which you create.

[00:36:34] So that's kind of how I see this evolving is we should have a million apps on forward in 10 years.

[00:36:39] Now, to come back to your question, so let's use an example like heart surgery. Heart surgery seems pretty extreme, like pretty hard to do, right?

[00:36:45] How are you going to turn that into something that can get to billions of people for free and be really high quality?

[00:36:50] Well, I'd flip this question on its head and say, "Think about how crappy heart surgery is today. It's kind of crazy."

[00:36:56] Like, literally the way heart surgery works today is you lay on a cold table and somebody stands over you with a butcher knife.

[00:37:03] And then the incision that they're about to make on your body is so big that everyone's worried you're going to die.

[00:37:09] So now there's not just the incredibly smart expensive heart surgeon. There's like five other people in the room.

[00:37:14] One of them has a crash cart. One of them has like generally anesthesia for you.

[00:37:18] Like all these people are worried you're going to die. So now there's tons of people in the room.

[00:37:21] Oh, by the way, because the incision is so big, everyone's worried you're going to get an infection.

[00:37:26] So now they have masks on. They're wearing bunny suits. They're in a clean room. That's super expensive.

[00:37:30] And even if somehow the heart surgery is successful, you're so like crippled by that heart surgery.

[00:37:36] You have to stay in the hospital for another three or five days or whatever to get your legs back under you

[00:37:41] before you can even start to like limp back into the world. That's a terrible product, right?

[00:37:46] And actually the only reason we could even debate whether or not your $200,000 heart surgery was good enough

[00:37:52] is because you happen to live in a country that has heart surgeons.

[00:37:55] If you have that heart attack in some of the wrong place in Africa, you die.

[00:37:59] You don't get to ask if it's good or bad or expensive or cheap. You die. Okay, but how might that work someday?

[00:38:04] I'm not going to put a timeline on us, but let's talk about how that would work in the world we're building.

[00:38:07] Like that surgery shouldn't be done using a butcher knife. It should be done using tiny little robots.

[00:38:12] Right now we have the early version of this. Have you seen these Da Vinci robots?

[00:38:16] These things are like big robotic arms that are controlled by a surgeon around the world. It's pretty incredible actually.

[00:38:21] So like there's already the idea of doing robotic surgery. In this case, heavily augmented by a human surgeon behind the wheel.

[00:38:27] But if you keep thinking about where this is going, like these robotics get smaller and smaller and smaller

[00:38:31] and more and more autonomous over time. So what you're going to do at some point is literally just like inject some little robots into your chest.

[00:38:37] And they're going to go around and do like a tiny little cleanup. And they're going to do it by the way based on the surgery of every surgery on every heart ever done in human history.

[00:38:47] That's the knowledge that they're working off of not just what's in that doctor's head. And by the way, you don't have an 80% or 90% blockage.

[00:38:53] It's like a 4% blockage. It's just going in and cleaning up proactively. Like we don't have to wait until it's a catastrophe.

[00:38:59] And because the incision is so small, you're not laid up for like days afterwards. You just walk out of your heart surgery and go on with your day.

[00:39:05] And if you ask yourself like, okay, that quality sounds amazing. Okay, what's the cost?

[00:39:10] The cost is the electricity to charge the robots. Like put a solar panel outside, it's $0. And if you wanted to ask yourself, what about the person who died in Kenya because they had no heart surgeon?

[00:39:21] Who cares if you have a heart surgeon living near you? All you need is an ATM, like a care pod, the tiny home of healthcare.

[00:39:27] If you have one of those near you, you have the ability to get heart surgery by the world's best heart surgeon wherever you live, like for the cost of nothing.

[00:39:35] That's where that should evolve over time. And so if you just take that example, you can start to imagine how over time, every single thing that you're imagining does get pulled into the system and rebuilt as a product, not a labor service.

[00:39:46] So the question of timing is a separate question. You've got to wait for the right hardware. You've got to write the right sensors.

[00:39:51] You want more and more people working on this problem over time to help accelerate it. But the idea that all of this should be transitioned is the whole point of forward. That's the mission.

[00:39:59] Yeah. I mean, I'm a sci-fi nerd. So I keep envisioning one of the alien movies where someone goes into the medical bay and they just sit down and they scaners and all the things happening.

[00:40:14] The arms are moving around next to 30 minutes later, the person is perfectly fine. They're recovering.

[00:40:21] Sometimes I feel like we're in the future. Sometimes I feel like the future is taking too long. I don't know about you, but it's like in different things.

[00:40:28] I can't envision it as always different than where I'm at. The fact that I'm in 2024 right now is bananas to me because when I was in my high school years, I thought this was like, "Oh, we're flying around in cars and flying cars for sure by now."

[00:40:43] Anyway.

[00:40:44] I think the thing that you

[00:40:46] mentioned really resonates. Like as a founder, you kind of constantly live with like the little

[00:40:50] miniature like double and angel on the shoulder. You have one that's saying like, wow, like you're

[00:40:54] not going fast enough, the world's not getting here fast enough, the future, etc. I agree. On the

[00:41:00] other shoulder, you like, but my God, it's incredible the stuff we've done already, the progress that

[00:41:04] we've made, the fact that we're here is kind of amazing to me. And of course, my optimism about

[00:41:08] where we can go is amazing. So yeah, I feel the same tension, you're constantly trying to balance

[00:41:12] those two, letting the like the pessimism and the critiques spur you to move faster and to be

[00:41:16] more impatient, while also letting the like your better angels guide you to say, this is all worth

[00:41:21] fighting for a startup is pretty brutal, as you may know, and it's like, okay, you need something to

[00:41:26] get you through the down moments, but you also need to be like incredibly impatient on behalf of the

[00:41:31] six billion people who have nothing. Right. So on the one hand, I think what we're doing is

[00:41:34] incredible. And I'm super proud of the team and how far we've come. And on other hands, we still

[00:41:39] have not affected the lives of those six billion people, and we need to move faster.

[00:41:43] Yeah, I will say it. So one last question about that, and I think it's probably very similar to

[00:41:47] the heart surgery example, but like trauma, like the unfortunate kitchen accident, a torn ACL,

[00:41:52] where it's like, you know, it's not you can't really wait and fly somewhere to get it done. Like,

[00:41:56] it needs to be done right away. Like, how was that? How do you guys plan on tackling that?

[00:42:02] Yeah, it's as you suggested, very similar to the answer previously, which is to say,

[00:42:06] so you live in it sounds like a relatively small town in Montana. How do you handle that today?

[00:42:10] Like, however you do that today is how it needs to be done right now. So it's like,

[00:42:14] if you need to go an hour to the nearest city to be able to get that surgery,

[00:42:17] then that's how it would work until we can rebuild that labor service as a technology product.

[00:42:22] Some of these things like are a little bit easier to imagine. So maybe not a knee reconstruction or

[00:42:26] a heart surgery. If you need stitches, like, I don't know, you could imagine doing self-serve

[00:42:30] stitches pretty easily. Like, a lot of times what they literally do is they use like a binding agent

[00:42:34] or, like, a glue. So you basically, like, hold it in and you just glue it down. And then that

[00:42:38] basically gives you enough cohesion to start to recover. Now that can only be done for a certain

[00:42:42] size laceration. Like, that's pretty easy to imagine just doing in a carapod. But it's just,

[00:42:47] it's all going to continue. I mean, you basically say the really simple stuff,

[00:42:49] you'll use that to get starting and get learning, and then eventually you evolve and migrate over time.

[00:42:53] So the, uh, the thousand pound elephant in the room here is the health insurance

[00:42:59] angle, right? And it sounds like you guys are essentially just cutting it out. So talk to me

[00:43:04] about that. Like how, I mean, is it even there's going to be pushback at what you're doing, right?

[00:43:09] There's a lot of money in our current healthcare system, a lot of people who and companies who

[00:43:14] don't want change, right? So how are you guys approaching the current health insurance model?

[00:43:21] Are you interacting with it? Are you ignoring it? Or are you, like, how does that settle with you?

[00:43:28] Yeah. I, uh, you're correct that we are ignoring it. I think that insurance is an incredibly

[00:43:34] dumb, uh, incentive structure to drive healthcare. And it is part of the reason that we ended up

[00:43:38] with the system we have today. I talked about the sort of more, uh, product oriented version.

[00:43:43] We invented a computer, or sorry, a doctor before a computer. This is the other cardinal sin.

[00:43:47] And we let a financial middleman sit in the middle of what actually constitutes healthcare.

[00:43:52] It's crazy. So, uh, we do not take money from insurance because if you think about it,

[00:43:57] an insurance company literally doesn't care if you die of a heart attack someday.

[00:44:00] That might sound crass, but think about their economic incentives. It turns out those are pretty

[00:44:04] crass too, because on average, uh, remember that in the US, like your insurance, uh, your health

[00:44:09] insurance tend to be stapled to your employer. Uh, and on average, you stay with your employer

[00:44:14] for like two or two and a half years. So this means that you're changing insurance every two

[00:44:18] or two and a half years on average. So with a two and a half year investment horizon,

[00:44:22] that insurance executive is correctly saying, I don't care about Eric's heart attack when he's,

[00:44:27] you know, 72 years old. I care about whether he's at work for the next two days this year.

[00:44:31] And this is, so they end up making tons of crazy choices about what they will pay for and what they

[00:44:36] want. So the whole idea that insurance billing codes that are sort of focused on a two year

[00:44:41] return on investment is how we incentivize the system today is on fundamentally unethical.

[00:44:46] So this is why when we started forward, we said, no chance we're taking money from insurance.

[00:44:51] We're going to have our patients pay us directly. We call them members, right? And so the reason

[00:44:55] that that's so important is because I don't give a shit what insurance companies tell me they want

[00:44:59] to pay for. It doesn't matter to me. I don't get paid by them. I get paid by hardworking people

[00:45:04] who decide where they want to give their money to forward in exchange for a longer, better life.

[00:45:08] And so every single day, my feet are held to the fire by asking did I build something so good,

[00:45:14] so helpful, so beautiful that that person wants to pay $99 a month of their own money

[00:45:19] to be able to use forward. And if not, then we die. And that's how it should work. And if you

[00:45:23] have a good incentive for long enough, every single day, those little good choices or bad

[00:45:28] choices you make, they stack up. And if you take money from insurance and you work on what we did

[00:45:32] for last eight years, you end up with a way worse product than if you just ask every single day,

[00:45:37] what is my user wants? And so that's why it's so important me to not take money from insurance

[00:45:41] and instead let the people getting the health care decide what it is they want to pay for.

[00:45:46] And I am accountable to building something good enough that they will part with their heart and

[00:45:49] money. Well, I feel like if we are just doing that in front of a live audience, people will be

[00:45:53] standing up clapping and cheering. I got a little emotional, but yeah, because I can

[00:45:59] hate health insurance companies. I can't stand it. It's a crime against humanity, what they've done.

[00:46:06] And having seen my father towards the end of years life go through the health insurance fiasco

[00:46:12] of what it is. And just causing more and more suffering and pain is really what it did.

[00:46:18] And I'm not the only person who would have been touched by that. So kudos to you guys.

[00:46:24] I'm obviously I'm cheering for you here. What kind of just curious question, I called the

[00:46:29] bells and whistles of longevity and health span, right? The peptides and the HRT and the cold and

[00:46:35] sauna. Are you leaving that up to other people? Are you going to get into more of the lifestyle

[00:46:40] factors? Are you just going to suggest that something that maybe they do if like someone's

[00:46:44] in optimal health be like, Hey, here's what you can do. You can do these things. Is that

[00:46:47] anything you guys it's on your radar that's just not in the core mission of what you're doing?

[00:46:52] I want to rebuild all of human health and in so far as that's true,

[00:46:56] everything that you mentioned should be in scope. Now, my personally would like to see

[00:47:01] does that stuff work or not? Right? Like, first of all, I think that all of us should have a choice

[00:47:06] over what we choose to do with our bodies. It's our bodies. It's our lives. And so I'm not going to

[00:47:11] be prescriptive. I will say, here's what's recommended. Here's the data on how well this plan performs.

[00:47:16] But here's two or three other options, right? You can imagine giving a user options and saying,

[00:47:20] here's maybe one that relies on medication. Here's one that really doesn't use medication that relies

[00:47:25] instead on lifestyle changes. Maybe here's one that relies more on the cutting edge of biohacking.

[00:47:29] You could imagine presenting options to a user. And if you start to think about what that would

[00:47:32] imply, forward is like already the world's best clinical trials platform. Like we have insane data

[00:47:38] on what happens to our users, what plans they choose, what happens to them after they walk out

[00:47:43] of our doctor's office. So you could imagine actually doing incredible clinical research over

[00:47:48] all of that data using artificial intelligence to try to sift for the patterns and find like

[00:47:53] what's connected and what's not. And then sort of surfacing that to researchers and saying,

[00:47:57] here's what we observed, but we'd love you to understand the bio mechanical mechanisms under

[00:48:01] GERD, this correlation and see if it looks valid. And you could imagine massively advancing sort

[00:48:05] of medical knowledge across all these dimensions. So whether it's some of the more biohacker oriented

[00:48:09] stuff that you were mentioning, whether it's actually aspects of Eastern medicine, like I suspect

[00:48:13] there's some real truisms in there. But we don't know which ones which, because there hasn't been

[00:48:16] good scientific studies done on top of that, forward should be able to provide incredible data on like

[00:48:22] what were the choices made by a user? What were the eventual end results? What were the side effects?

[00:48:26] How fast did it happen? Did they achieve their goals or not? So yeah, like I think that we should

[00:48:31] be incredibly inclusive in terms of what is considered. We should show the user the data

[00:48:36] about whether this has worked in the past or not, let them make informed choices. In the same way

[00:48:40] that you go to the app store and you decide between two or three apps, when you're choosing

[00:48:44] your favorite photo sharing app or whatever it might be, that's how you can build a very sort of

[00:48:48] rich and robust system that it constantly is improving over time by having these apps competing

[00:48:53] on each other to solve a problem for a user. Yeah, awesome. Well, I guess one of the last questions

[00:48:59] I have for you here, Rob, is now that you've got me excited and probably a bunch of people

[00:49:02] listening, very excited about the potential here in wanting to shift to this model. What's the

[00:49:09] timeline look? When do you think, how does the rollout? When can we hopefully expect something

[00:49:15] like this in a town near us? Yeah, so I won't give business specifics, but the answer is we're

[00:49:21] moving incredibly quickly. And I'll give you a little bit of like, why, why even build a carapod,

[00:49:26] why build health apps, why fight for any of this change from a labor service to technology product?

[00:49:31] Like I mentioned earlier, I don't want to work on a system that can be 10% better. I want to play

[00:49:35] for 10x. And actually, I'm a little bit greedy. I want to try to play for 10x in my lifetime.

[00:49:40] I'm not positive we'll get there, but like, I want to play for it much faster than linear progress.

[00:49:44] So the whole point of turning something from a labor service, which at best can improve 10%

[00:49:50] per year. Frankly, I'm not even sure health care has managed to do that over the last century,

[00:49:53] but let's let's say 10%. I want to play for something that goes exponential that gets actually

[00:49:58] massively better every single year by leaps and bounds. I want to play for something that has a

[00:50:01] chance to go from like 15 apps to 4 million apps over a decade, right? So that's the whole reason

[00:50:07] to fight to turn this into a technology product. Now, the good news about a carapod, for example,

[00:50:12] like through the entire history of forward, we launched like, I don't know, 25 of those clinics

[00:50:17] or something like that. Awesome work. Blood, sweat, and tears. Great job by the team.

[00:50:21] On the other hand, 25 carapods, we're going to do that in like the next year. Like, it's just so

[00:50:26] much easier to manufacture and print these out. And the year after that, we're going to go from

[00:50:29] 25 to 50. And then we're going to add 100. And then we're going to add 200. And then we're going

[00:50:33] to add 400 and then 800. The idea that you could launch that many doctor's offices is unheard of

[00:50:38] if you're going to treat it as a bespoke construction project. But if I told you you want to manufacture

[00:50:43] 800 iPhones, you're like, yeah, give me a couple minutes and we're done, right? It's just a completely

[00:50:47] different sort of scale and perspective. The same is true of applications. It took us like a really

[00:50:52] long time to build our first application. Maybe let's say it took a year. Then it took us like a

[00:50:57] quarter to build the next one. Then it took us a month and then a week. And now it's like a day

[00:51:02] to build an application. It's insanely fast. You're on an exponential curve. So all of these things

[00:51:07] come faster and faster over time if you really do the hard work to turn it into technology product.

[00:51:12] So there's this quote from like, I think it was Bill Gates that said this that really resonates

[00:51:16] approaching a decade into a startup, which is people routinely overestimate what is possible

[00:51:21] in a year and routinely underestimate what is possible in a decade. If you are on an exponential

[00:51:26] curve, which is everything the forward has been fighting for, it is shocking how much the world

[00:51:30] will change over the course of a decade. So with that in mind, I can't say when exactly we're

[00:51:34] going to get to Northwest Montana, but I am positive it will be like 10 times faster in a

[00:51:39] carapod than it would be if we were building those sort of old clinics, much less, the sort of like

[00:51:44] traditional clinics of the old world health care system. Awesome. Awesome. Okay. Last question.

[00:51:50] As a community, you know, with the people who listen to this audience or just, you know, kind of

[00:51:54] the fitness and wellness sector, how can we help you? What do you, what would you like to hear people

[00:52:00] hear from people about? And then where would you like them to go? Yeah, I guess I would say there's

[00:52:04] there's sort of two ways I could imagine this being interesting. One is if you are somebody who

[00:52:10] thinks that this sounds like an exciting idea and an exciting sort of vision and mission,

[00:52:14] if you're somebody who's really smart and who really cares about trying to help the world,

[00:52:18] like reach out and figure out how we can work together. Like, if that means joining the team

[00:52:21] here and building these carapods and building these tools, sounds great. Shoot us a note.

[00:52:26] I'm easy to reach. I'm Rob at Go Forward. Our website is goforward.com. You could also

[00:52:32] imagine there's people out there who like, I have an idea of like what I would build in this world

[00:52:36] with carapods and applications. Sounds great. You could also be kind of contributing to the world

[00:52:40] that we're imagining. So yeah, I would say if somebody is listening to this and thinks this is a

[00:52:45] world that's worth fighting for and going after, I'd love to hear from them and see how we might be

[00:52:50] able to go build that together. Awesome. Awesome. Well, this has been everything I hope to be as

[00:52:54] far as updates go, Rob. It's been really exciting to follow you guys and see what you're up to. And

[00:52:59] I'm super, I'm just grateful that you guys are doing it. I really appreciate that. I can

[00:53:04] spend a ton of fun chatting and yeah, it's honestly a real privilege to be able to work on a problem

[00:53:09] that's this importance that has a chance to be this much better and where I feel like we're on the

[00:53:13] cusp of something really transformative. Awesome. Awesome. Well, thank you for your time. Ladies and

[00:53:17] gentlemen, Rob Sebastian. Thank you. Hey, wait, don't leave yet. This is your host, Eric Malzone.

[00:53:25] And I hope you enjoyed this episode of Future of Fuminous. If you did, I'm going to ask you

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