Superpower Healthcare Startup Analysis

A comprehensive analysis of my experience at Superpower, a healthcare startup focused on diagnostics and personalized health. This document covers the company's vision, execution challenges, and key learnings from working with the founding team in San Francisco.

Introduction

I finished HSC exams on 25th October 2023, with SOR II. Got smashed with a good friend that night. Woke up in a paranoid state, so messaged Max Marchione. Sent him one message about his law post, and he said to WhatsApp him. We talked over the next 2 months. I started tutoring in Mid-December, about 6 weeks after exams ended. Then, we talked while I was in Italy & he offered me an internship on the flight home. I took it without thought about what the role could teach me, or any knowledge of what startups were, what tech-companies were. The first three months weren't all that insightful in Sydney. It was the three months in San Francisco that were really exciting, and where I learned a lot. In hindsight, this was a good thing. Tomorrow, I start a part-time role with Dom Reardon at Cable Energy. In an attempt to be conscious about what I learn in this company, I want to think quite deeply about what I did learn & how I can try and learn a lot at Cable Energy over the coming weeks/months in this role.

Background on Superpower

I started in January. On the first day, Max wanted me to send DMs throughout his LinkedIn account to other healthcare CEOs & people from different companies. Then, we were tasked with the concierge side of things. This looked like sales calls with velocity black, bird, twilio + investigating different concierge models like SummerHealth and listening to their podcasts + sending out campaigns to existing members to try & reactive them (0 responses) + writing product specs for the concierge & thought leadership esque blog posts about them. This was all quite marginal and I didn't learn a whole lot. It also looked like watching, reading & listening to the group chat. This was fairly useful as they had videos from Joumana & other people critiquing brand choices, product direction & where the company was going over the coming months/years.

A lot of learning took place when I was in SF. Not tactical skills around marketing, product or back-office, but more so being immersed in their world and getting to see the day to day a lot better. The tasks were sending out personalised emails to healthcare CEOs (which I largely failed at), managing the concierge (syncs with Dr.J, slack integration from bird, selecting bird as the primary tool, launching bird with message on launch day & transferring from Openphone, email activation waitlist flow & coordinating this with Nikita on Bird) + helping Jacob getting onto podcasts via reachouts + setting up furniture.

Again, the act of setting up a 2-way SMS system & building out an operation around it is very niche, is linked to operations (back-office task) — it's not generalisable across lots of companies. In many ways, had I been at Superpower 6 months later, I would've had a partnerships role, some more formal ops role or growth role. The skillset still wouldn't have been that valuable. Still, I would've learnt from a team of 60 not just Marchiones' advice that is usually theoretical because he doesn't have any hard skills.

Why They Could Win

Healthcare probably needs to change. Grandma Greg shouldn't have to go through the pain she's endured over the previous 10 years. Generally, the healthspan of humans should improve & we should be cognitively and physical adept for a long period of time, without rapid decline & not having the ability to enjoy the last 20-30 years of our life.

To solve for this, it seems we have to collect & understand more data about our biological state at any given time. Aside from the blood test I had from Superpower last year, I understand virtually nothing about my body. Whether I am healthy across my biomarkers, what my biomarkers actually represent, the daily actions that cause fluctuations in my biomarkers, if there is anything I need barring my biomarkers & other tests that could have helpful: gut microbiome testing, cancer testing, full-body MRI scan, environmental toxin tests, heart calcium test, DEXA scan, full genetic sequencing — all the tests previously safeguarded to professional athletes & billionaires.

Most people should have access to these in due time at a very cheap cost, or even subsidized by health insurance. Presumably, the testing itself would have to become cheaper, the supply chain across information getting transferred would have to converge on ~$0, machinery would have to be cheap, the government would have to take a smaller % cut. Similar to how Amazon made products much cheaper & quicker to access.

Needless to say, Superpower has a chance to solve this. The first health wave was consumer services: gyms, physios, dentists. Then, the supplement wave came with creatine, magnesium, AG1s & then Ozempic. Peptides should follow soon. Easy to access consumer diagnostics without necessarily having to go through bureaucratic measures like public health waiting rooms. The primary care system seems inherently perverse: reactive not proactive care, no personalised care, no digestible consumer information, valuable information about our biology gatekept by regulation & degrees. It feels inevitable this will change.

Max seems to think that diagnostics is the wedge. This seems logical. Hims & Hers is a supplement company with the flash new supplements like ED, Ozempic, but they are still not personalised. It is a higher form of Vitadrop. Largely because they have no data about the consumer, and therefore no legs to actually stand on. Beyond the supplements, how could this become a bigger, generational company. They have to control the implementation & results. You can only do this through analysing changes these supplements & other protocols have on the participants. Diagnostics are like pre-training data for an LLM. There will be a scaling law here, pattern-matching across their customers & ultimately creating a action-plans & better health outcomes.

Fundraising Success

As Max said, they raised $30M series A on the back off:

  1. Jacob having 2 previous co-founder companies, kevin being YC-backed founder & Max having decent credentialing like Goldman & some highly exacerbated previous work like Angel Investing Syndicate & NextChapter (very mid community)
  2. +1m impressions on LinkedIn & Twitter largely from Max — barring the fact that 60-70% of Max's previous audience was Australian which is useless for Superpower
  3. Really strong, idiosyncratic consumer brand. It is quite distinctive, which is largely a testament to Hannah, Max & Daybreak
  4. Healthcare being a market that is bound to change & evolve as it has done over the last 10-15 years

But the main reason is:

If superpower becomes the default platform for consumers to access diagnostic testing & certified supplements, meaning that consumers do not have to think about where they go to test, it could be a $100BN company. It could be the front-door to healthcare, where you only use a hospital/GP/doctor if you have a serious issue. The older generation, think 65+ year olds are going to die over the next 20 years. Everyone younger than that would still change if paradigms shifted (Sean is 55). They could become the go to platform.

Things I Wonder About

Is there genuine demand for this type of platform?

There will be considerable change in healthcare, but is this going to move the needle against biological change. New drugs that come out to cure cancers, chronic diseases that 74% of people lose their lives to, and 90% in wealthy countries. Novo Nordisk, inventor of GLP-1s is worth $400BN compared to the whole gym industry being worth $110BN. Mind-due, GLP-1s have only been around for the last 3-5 years, and popularity boomed in ~2022ish.

Point being, when something requires no sacrifice & no time to delay with a strong likelihood of the dream outcome, people prefer it over something more manual. I wonder if the same holds true for superpower. Do people actually desire having lots of diagnostics? Is that something a lot of people would actually want? If I could get cheap diagnostic testing, blood-testing & have all my data in one place, it seems cool. But how many people actually care about their health?

What assumptions have to be true for this model to be feasible:

  1. Consumers actually have to want to understand about their bloods, biomarkers & all the data that comes along with that. Even if the price of this company converges on $0, and theoretically there was a $49/year membership including the blood test, people would fundamentally still want to understand their health.
  2. People will have to want a lot of diagnostic testing. If they're a blood-testing company, they will fail because it's a very replicable model and won't result in a juggernaut platform.
  3. Consumers will have to want premium supplements/goods like peptides & health accessories because the prices are generally higher and therefore you have to be bought into this idea
  4. Their data will integrate with chatGPT & this will be compliant. Chat seems to think this is fine, largely because of permission from the end-user.

To me some of these seem quite counter to human behaviour. The world has never been more obese now, and yet quality food has never been cheaper as a resource relative to other resources.

Is the team competent enough to win this market?

It feels quite winner-take-all dynamics because of the amazon attitude where platforms gain network effects from data, and they can also develop economies of scale via bulk-pricing lab tests, 3rd party agreements, or if they end up owning the supply chain then they can gain economics of scale on equipment. This field is quite competitive: Function Health & inside-tracker are the obvious competitors. Function based on Hyman's brand & Inside has major gym partnerships. Neither are great. There are a bunch of other healthcare companies that are more specialised like K-health, Summer Health. Though, Neko Health could become quite a big competitor.

Engineering constraint. Only one of the founding members is technical. Because they are in healthcare, and not in pure software or hardware, this is less important. Largely, they are in the business of (1) Brand because they are consumer-facing company (2) Operational Rigour — healthcare will remain intertwined with services for at least a little while longer (3) Gaining network effects by being the clay-like integrator of all other services & providing a cohesive thread to monitor and interact with the data.

Starting in SF? They bought 150k waitlist members from other healthcare companies. This inflated "waitlist" metrics. Ultimately, conversion is still really low. They have <1000 total members as of the start of this year. This equates to less than $500k revenue. This isn't even excluding those from the initial event, friends & team members.

Overarching Learnings

Max Marchione

I didn't mind working underneath him. Some of his redeeming qualities are his thoughtfulness on quite a range of topics, he's very opinionated & good at sales, he works reasonably hard, he is reasonably charismatic. Notably, he has succeeded because he (1) shares in public which increases status + he has engineered this by connecting with lots of folk on LinkedIn (2) he reads a lot & is always learning new things about various topics which makes him dangerous (3) he is extremely good at selling himself; he sounds smarter than he is because he speaks with such conviction & acts like he has accomplished a lot (4) he tries a lot of things: HSC → school leadership positions → gap-year/tutoring → law → goldman → property dev/real estate → vc places → angel-investing → private community → superpower.

However, he didn't help me learn a huge amount. He was too salesy & good at it so he ended up giving me useless tasks & not enough of them to learn about different skills. LinkedIn DMing, building random webflow pages, sending healthcare CEO automated email campaign, jacob podcasting — all useless, EA-type tasks. The tasks on the concierge were almost at the other end of the spectrum where I was expected to manage Richina, Sofi, Bea etc. When I told him about this he called me a "lazy shit". This was far enough to some extent.

I'm sure he'll do good things. He inspired me to think about

  1. networking more & reach out to more people
  2. becoming an obsessive autodidact: max has quite a broad range of declarative knowledge about a lot of things, it makes him seem smarter & more able to connect gaps in different domains
  3. he is very opinionated about the world, forming theses & take tonnes of risk which is helpful
  4. he obsesses over design & how products should be beautiful, not merely functional.

Importance of Creating Good Culture

Essentially when I was there they attempted to build good culture. Daily stand-ups to unblock various issues that popped up, friday weekly meetings, constant praise for work being done on Slack, being responsive & receptive to different people on Slack.

Unfortunately, because of Johnny being net-negative on issues & conservative (wanting to start his own clothes brand as well), Jonah being pessimistic + a bit of a loser, Richina being extremely conservative, quite lazy & people like Dan not being bought into weekends, it was basically impossible to build culture. I guarantee with people like Abe, Jamal, Hannah & other growth bro, the culture would be far far better.

They effectively couldn't build good culture because of the personnel. $800 taco dinners & $500 Japanese meals could not overcome the fact that the employees didn't care, they weren't bought into the mission. Essentially, they almost needed a clean reset & to bring in a new wave of people that had a clean slate to this.

Generating Hype as a Means of Attracting & Recruiting Talent

They have a good brand. Especially on LinkedIn & Twitter for young-kids that don't understand hype, virality & the like. 1m impressions on LinkedIn. You'd think they have tonnes and tonne of customers.

It really helps. It helped raise $30M. It helps people talk about & think they're going places. Hype begets hype. Perhaps that hype begets attraction to the company & fuels growth. It doesn't always work. Basis had 200k views & failed after 6 months. "500 customers = 500k ARR". LOL. High Churn. No ways of getting new customers.

Importance of Brand & Taste

Max obsessed over the brand. 2 calls every week with Alvin & Tracey. 1 hour calls that went-over all aspects of the UI & how a user would navigate through the superpower app. The website took 6 months to design & develop. They spent $200-250k with Daybreak & even hired Hannah full-time to work inside Figma.

Max always talks about good design being distinctive, not conformist. Most SAAS applications look & feel too similar. A good clean UI, but nothing more than that.

Applying Learnings to Cable Energy

Essentially, this post more veered toward opinions on what they did well, what they did wrong & learnings. Ultimately, I will learn from Dom in a serendipitous sort of fashion but ultimately most learning comes from (1) insider industry knowledge that you cannot learn on GPT (2) how to build a product according to that knowledge (3) how to sell that product. Everything is downstream of that & therefore most work should be related to that.

So, for Cable Energy:

  1. Industry insights about energy: Climate-Tech, DERs, future of the Grid: is it enough? will the govt de-regulate?, could data centres play a role here, will trad-retailers survive? how does energy here compare to the EU? compare to the US? is basepower replicable here?
  2. What does product look-like? how do we get good installer partnerships to maintain quality of battery installation? what does managing a team of data scientists to optimise grid timing look like?
  3. What does LTV:CAC look like here? will initial affiliates & partnerships work? do paid ads work — basepower seems to run a lot of them to residential? does content work here (doubtful)? does d2d sales team work? that would seem quite effective? how do you navigating pivoting to residential if SMEs really are hard to get as customers?