Thirty Madison – Urgent Care before Urgent Profits

A look at Thirty Madison’s efforts to utilize their resources for a positive impact in times of COVID-19

A historic tragedy such as COVID-19 calls leaders into responsibility to look beyond the “growth” of their own businesses. It is rather a time to consider the greater good beyond shareholder value that each of us, and those considering themselves leaders in particular, can contribute. 

Demetri Karagas and Steven Gutentag, the co-CEOs and founders of Thirty Madison, didn’t just see COVID-19 as a threat or opportunity for themselves, but managed to use their existing resources to help where they could.

The company 

Demetri and Steven are two serial entrepreneurs who previously founded several companies together, including a home cleaning company they sold in 2014. In 2017, they started Thirty Madison, a health company focused to provide better solutions to chronic problems using telemedicine. The company combines diagnosis and ongoing consultation via tele-medicine with a branded drug via a simple subscription service. While launching under distinct brands, they have built a playbook focused on treatments that can be treated by generic, over-the-counter drugs, and that can be diagnosed remotely.

As such, the company is trying to disrupt a whole value chain previously consisting of doctors, pharmacies, various middlemen and wholesale drug stores – enabling them to offer the whole process not just at higher convenience, but also at lower cost and higher quality. The first doctor conversation is free and online – and with a real physician. Partnerships with pharmacies make collecting any prescription drugs easy and fast. From there, a long-term relationship is built, bringing in predictable returns.

So far, Thirty Madison has launched 3 such brands:

  1. Keeps focused on preventing hair loss among men before it starts.
  2. Cove fighting migraines.
  3. Evens treating acid reflux.

The company has seen rapid growth in particular in the hair growth segment and raised a $15M Series A in late 2018 from investors Maveron and Northzone, having previously raised two seed rounds over a total of $7.5M.


Urgent Care Initiative

As COVID hit the United States in March, the New York-based company consulted with Emergency Response doctors on how to best use their resources: A battle-tested telemedicine platform and a large network of physicians.

While the company usually focuses on chronic problems due to the high customer lifetime value, they now launched an offering focused specifically on needs that put a strain on emergency rooms – a resource under immense stress due to COVID patients.

In over 30 states, Thirty Madison enables patients to telemedicine around-the-clock to consult with doctors regarding a wide range of issues, including stomach issues, back pain, or eye infections – all of which oftentimes end up in the ER. This makes life easier not just for those in emergency rooms, but also for patients that might not feel safe to go to the ER and risk being infected with the Coronavirus.

More remarkable, the company decided not to charge for those services – instead implementing a “pay what you can” model with a recommended fee of $10, and ensuring sufficient funding by donating $100,000 to the initiative – a huge amount given the size and stage of the company! Recognizing that even $10 does keep people from seeking much needed help shows exceptional understanding, and their leadership encouraged many doctors in their network to offer their services for a reduced fee – sharing the burden.







Why Thirty Madison is uniquely positioned to help

As a tech startup at heart, the company was uniquely positioned to offer its telemedicine expertise and technology for this cause. Telemedicine in the United States has traditionally lagged behind other countries, a disadvantage the crisis might help mitigate, as bureaucratic red tape has been cut in response. While only 1 in 10 Americans had used telemedical services, while providers across the board now see a huge rise in adoption.

Seeking help from the safety of your own home is more efficient, faster, cheaper, and most importantly safer, and innovation in this field should be encouraged. It also enables doctors that need to quarantine to keep helping.

The pandemic offers a unique chance for a step-chance in this process, something the company would certainly benefit from and should be at the forefront of. 

While it is unrealistic to believe that ‘Urgent Care’ will be a growth-driver or results in the clichee ‘win-win’ situation, positive side effects for the company can include the collection of valuable email-addresses and physician leads, positive media coverage, and the above mentioned friendlier legal environment. 

By testing a whole range of additional services quickly, valuable data can help guide crucial decisions on future product expansion. Most importantly, acting without hesitation for the good of the community should generate a long-term loyalty among patients and doctors that would otherwise be hard to imagine. Many crucial decision makers throughout the medical industry, the media or political decision makers will remember how companies reacted during COVID – if they saw it as a chance to ‘experienced significant growth during the outbreak’, or as a chance to help where people were dying.

I believe a business leader’s job during a pandemic (and beyond) is not seeing a threat, opportunity, or even “win-win” for their own company – but thinking of the broader societal impact being ready to sacrifice growth when needed. Demetri and Steven have proven true leaders in this context, no matter if their actions result in any growth – sustainable or short-term – for their business. In fact, they acknowledge that ‘Urgent Care’ does not help them with their revenue goals, which is why it deserves being highlighted.

Any doctor or organization feeling inspired to help, reach out to Thirty Madison using this form.




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Student comments on Thirty Madison – Urgent Care before Urgent Profits

  1. This is such a great reason to change ones operating model. Most businesses are doing so to survive and weather through COVID-19 and social distancing. The fact that these guys are not doing is for money is amazing! Do you think it can be sustainable in the long run though? If they do well, they could expand to other fields in telemedicine which could be good for them and also for patients ( as you point out that it isn’t a very popular channel in the US). But they would need to charge more than 10$ I believe if they want to pay high quality doctors and therapists. Was thinking what would be the willingness to pay for patients ( or insurance providers) for telemedicine services?

    1. The explicit goal of the subsidized service is to help the healthcare system not to get overwhelmed. That will (one way or the other) not be necessary for the long term, so I don’t see a scenario where they would need to run this unprofitably in the long term

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