EMBRACE THE GATEKEEPERS

Anne Wojcicki,
Co-founder & CEO, 23andMe

Cameo appearances: Daniel Ek (Spotify).

About this episode:

When Anne Wojcicki founded 23andMe, she carved out a brand-new space in personal health. Then federal regulators came calling. But instead of trying to outwit, sneak past, or straight-up fight the FDA in the name of moving fast, Wojcicki slowed down. She made the call to work with regulators directly and honestly. Hear how (and why) she embraced red tape.

"The only way we will ever understand the human genome – the only way we will all collectively benefit from the human genome – is if we trust."

- ANNE WOJCICKI

"Gatekeepers aren’t an impediment that you should outwit, but an opportunity that you should embrace."

- REID HOFFMAN

LISTEN TO THIS EPISODE NOW

< RETURN TO FULL EPISODE MENU

GUESTS ON THIS EPISODE

ANNE WOJCICKI

Anne Wojcicki is the co-founder and CEO of 23andMe. She is the co-founder of the Breakthrough Prize

DANIEL EK

Daniel Ek is the co-founder and CEO of Spotify. Today, Spotify has more than 140 million active users and has raised over $2.5 billion in venture funding. 

“There’s going to be an entire healthcare world that’s predicated on your phone.”

- Anne Wojcicki

EPISODE TRANSCRIPT

REID HOFFMAN: Welcome to the Masters of Scale Movie Club. It’s accepted knowledge that the 1994 Coen Brothers’ classic “Hudsucker Proxy” is one of the best movies of all time, especially for entrepreneurs. Set in the utopian heyday of the late-1950s corporate boom, “Hudsucker Proxy” offers up a witty, wonky take on ambition, luck, and cut-throat competition that every founder can relate to.

 

But there are many other nuggets of gold throughout the history of cinema, sometimes in movies you’d least suspect. Today, I want to look at three scenes in particular. They all come from very different movies. But each of them can tell us something about what we’ll be examining on today’s show. Something every startup can expect to face: gatekeepers.

 

The first scene comes from “Indiana Jones and the Raiders of the Lost Ark”. Indy is racing through a busy Cairo market. Suddenly the crowd parts, revealing a sword-wielding ruffian. He’s clearly intent on cutting our hero to pieces. And he makes this intention clear with an elaborate display of sword swinging. Unperturbed, Indy nonchalantly pulls out his gun, and shoots the guy. The lesson here: Sometimes your best option is to cut through any gatekeepers that bar your way without hesitation.

 

Our second movie is another Spielberg masterpiece: “Jurassic Park”. The scene is set in an industrial-sized kitchen, with aisles of chrome work surfaces. A velociraptor has cornered two children. They scurry around the reflective counters, trying to skirt around the dinosaur to freedom. The predator spots one of the children huddled in an alcove, and leaps to attack. But rather than being rewarded with a tasty human morsel, the dinosaur slams into cold metal. It was the little girl’s reflection. Having outsmarted the dinosaur, she flees to safety. For many entrepreneurs, this is their natural approach to dealing with gatekeepers: find a smart hack or ingenious ruse to get around the obstacle and keep up momentum.

 

Our third scene comes from “Monty Python and the Holy Grail”. The knights have neared the end of their journey. All that stands between them and their destination – the Castle of Arrrgh – is the Bridge of Death and its guardian, the bridge keeper. The knights must answer five questions.

 

VOICE: Three questions, sir.

 

HOFFMAN: Three questions from the bridge keeper to pass. Lancelot answers first, and honestly, and is allowed to pass. But Robin and Galahad overthink their responses, and are flung from the bridge. The learning here is that sometimes dealing directly and honestly with gatekeepers is the most prudent course of action.

 

Of course, sometimes the red tape is so thick that dealing directly with gatekeepers – like regulators, vested interests, or other parties in control – can seem like far too much of a drag when you want to move fast and capture your market. Your instinct is to be more of an Indiana Jones than a Lancelot.

 

But sometimes it is actually beneficial to slow down and deal with all the red tape. Especially if in doing so, you will be charting new territory. Because on the other side, you may find unfettered opportunity.

 

I believe gatekeepers aren’t an impediment that you should outwit, but an opportunity that you should embrace.

 

[THEME MUSIC]

 

HOFFMAN: I’m Reid Hoffman, co-founder of LinkedIn, partner at Greylock, and your host. And I believe gatekeepers aren’t an impediment that you should outwit, but an opportunity that you should embrace.

 

Gatekeepers come in many forms, but there is one thing they all have in common: they bar the way ahead. And anything that prevents you from making constant, accelerating forward motion – particularly in the early stages of scale – is something you must avoid.

 

There are many different approaches to tackling gatekeepers. You may opt for sheer force, battering your way through that gate and consequences be damned. Or you may prefer the more subtle approach, biding your time until you see an opportunity to slip through. And of course, there’s the method that appeals most to the entrepreneur in you: finding an out of the box route that takes you over, under, around, or through the gatekeeper in an audacious manner.

 

But there are times when you will come up against a gatekeeper that is the immovable object to your unstoppable force.

 

I wanted to talk to 23andMe founder Anne Wojcicki because her company is carving out exciting new opportunities in the sphere of genetic testing and health. But to get to this point, Anne faced a number of gatekeepers. She managed to work around these until she came up against one that was unavoidable: the FDA. She realized she had to put her scale ambitions on hold to work with them. In doing so, she has helped build a bridge toward an entire new growth industry. 

 

It is the combination of Anne’s charisma, her belief in her mission, and her pragmatism that has let her take 23andMe so far against the odds. Her journey has also taken grit – something Anne learned as a child on an outdoor ice rink in Palo Alto.

 

ANNE WOJCICKI: I don’t know what it was about ice skating, it was outdoors and you could be group or it was solitary, but I always found it beautiful. You have the steam that rises off in the mornings, I loved it. My parents did not. It was expensive, there was a lot of this pageantry of your makeup, your hair – which is obviously not a Wojcicki trait.

 

HOFFMAN: One thing that is very much a Wojcicki trait is perseverance. Although her parents weren’t keen on her passion for the rink, she kept going.

 

WOJCICKI: I was really determined: “I don’t really care that you don’t like ice skating, I’m going to keep skating.” 

 

HOFFMAN: Her parents were so against it, they refused to buy her skates. But that didn’t make Anne put her passion on ice.

 

WOJCICKI: I had to win the Skate-A-Thon every year to get my skates. And so I’d walk around the neighborhood and collect money from my neighbors and there’d be a day long Skate-A-Thon – how many laps you do – but that’s how I won my skates every year. 

 

I didn’t have a choice, it was like, “I have to win it.” I had a really great skating teacher, who was a single mom and I would babysit for her in exchange for skating lessons.

 

HOFFMAN: It was a perseverance that was admirable but also pushed against limits.

 

WOJCICKI: I was also known at the rink. I often snuck in, and I remember them saying at some point, “Anne, at some point you need to pay for admission.” 

 

HOFFMAN: This is the kind of behavior a cute kid in a thick winter coat and skates can get away with. Anne has continued to be able to push limits while maintaining her charm into adulthood. When you next hear her speak, she’s still talking about ice skating as a child. But she could just as easily be talking about her later experience with 23andMe.

 

WOJCICKI: I loved it. It was one of the first areas where I really expressed, “I’m going to do this whether you like it or not.” I just always figured out ways to keep doing it.

 

HOFFMAN: True to her word, Anne stuck with the skates. She took them with her when she enrolled at Yale to study biology, as well as skate competitively and play on the ice hockey team. After she graduated in 1996, she started a career in healthcare investment. It combined her scientific training with another childhood obsession.

 

WOJCICKI: I was always fascinated by investing, and I didn’t know that you could get paid for it. In fourth grade, I remember calling up Fidelity and saying, “Who picks your stocks?” And I think the sales rep on the other side was confused. But I was so interested in this process of, “Someone is just analyzing companies all day.” 

 

Once I graduated college I discovered you could get paid to do this, which was amazing to me. So I spent 10 years investing in healthcare companies – and I always loved hospitals. I’m one of those people where I walk into a hospital and I take a deep sniff and I love it. I love everything about hospitals.

 

HOFFMAN: But it’s often the things you love the most that you can see the most flaws in.

 

WOJCICKI: I loved investing in healthcare and getting to know all the aspects of it and how these things work and the in-depth machinery. And as I got to know the space, I became more and more disillusioned, like, “Wow, this is a really awful system.” And that in some ways the system really takes advantage of sick people.

 

HOFFMAN: Anne’s professional career had been devoted to promoting this healthcare system. But as more cracks began to show, her priorities started to change.

 

WOJCICKI: You start to realize the human component of margin expansion or a pricing scenario. I became more and more disturbed by how the healthcare system was. And at some point I didn’t feel like I could morally reconcile that I was investing in an industry that I didn’t think was in the best interest for consumers. 

 

HOFFMAN: Anne took inspiration from grass roots efforts to put health in the hands of the people.

 

WOJCICKI: I did get to know the HIV community really well in the late ’90s, and I was impressed with how they advocated for themselves. This is a community that didn’t just say, “I’m going to sit around and wait.” They were a community that was very proactive. 

 

HOFFMAN: The healthcare system was a monolithic fortress manned by multiple, powerful gatekeepers. Getting it to change though, was tough. Anne began thinking how advocate groups could amplify their voices – and their ability to go up against these gatekeepers – by using the internet. 

 

She found inspiration in her sister Susan’s garage. It was at this time when Anne met her former husband, Sergey Brin, who was working on a small startup with his partner, Larry Page. Its name was Google.

 

WOJCICKI: I happened to see Google starting in my sister’s garage. And then I met people like Caterina Fake who sat me down and was like, “This is the future of the web, people are going to connect, Web 2.0.” 

 

HOFFMAN: Anne put together all these ideas and influences.

 

WOJCICKI: And I kept thinking, “Healthcare’s actually about all of us. And we should have this system where you can get your genetic information” – which suddenly was accessible – “and you can connect with each other the way all these other social networks are starting to happen.” 

 

Why do I need the rest of the healthcare industry? Why do I need the hospitals, why do I need the academics? We, the people, can actually stand up and self-report and we can crowdsource research.

 

HOFFMAN: This was a problem Anne was passionate about solving. And so when she thought she had a solution, she went all in. In 2006 Anne founded 23andMe with Linda Avey and Paul Cusenza. Its aim was to give people direct access to their genetic information, and then use it to make decisions about their health. 

 

WOJCICKI: And so 23andMe really came out of this idea of social activism based on the HIV community; that patients actually really want to come together, the social networking that was happening on the internet; and last, the fact that there was actually a technology where you could affordably get access to your genetic information.

 

HOFFMAN: 23andMe would help patients get around the gatekeepers that barred the way to their health information.

 

WOJCICKI: The consumer should actually have more control. They should have control of their medical records. They should have more… Why do I have to go to a doctor every time I want a blood test? I should just have more control – within limits. 

 

Largely, we should have a better attitude about how we represent the consumer and the potential. That was the big picture. I want to change that. I want to have that trickle down effect in all kinds of other aspects of health care.

 

HOFFMAN: Now patients would be able to identify diseases and conditions that they might be susceptible to and then take measures to mitigate these risks. They would be able to look at an entire body of personalized knowledge and seek out precisely the right experts to help them.

 

It would transform the current healthcare system that had at first enthralled and then repelled Anne. 23andMe would provide easy-to-use genetic test kits to its customers. People would just need to provide a sample of saliva and return it. This would then be tested and the results would flag any potential health issues that had been discovered. It was an unprecedented level of access to the very building blocks of life. Surely everyone would leap at the chance. 

 

Well, if getting traction for ideas that promote the greater good were this simple, we’d already be living in a world without war, famine, or hate.

 

Anne had fallen into this common trap. Her training and experience had put her in the ideal place to see what was wrong, and how to fix it. However, this same training and experience meant it was too obvious for her. Her potential customers weren’t even aware of the locked gates that 23andMe was offering them the keys to.

 

WOJCICKI: We did no market research. In some ways, it was really cute how we launched this company. One of the things I actually also realized, a lot of great scientists are just really awful business people. 

 

I would talk to scientists and they were like, “Wow, if you could launch a company like that, you would make so much money.” The thing that we realized in those early days is that most people have no idea why they’d ever want their genetic information. 

 

HOFFMAN: The term “market research” probably conjures up images of carefully-selected focus groups picking apart your product as you watch horrified from behind a two-way mirror. 

 

It’s no wonder that many founders see it as an obstacle in their path to bringing their great idea into the world. But this is a narrow view because market research is about far more than letting a cross-section of your target audience prod and poke at your prototype. 

 

I like to call it “viability research”, because it will tell you how much of an uphill struggle you will face in getting people to latch on to your product or service and all its possibilities.

 

Most ideas are iterative, they will improve upon a known product. You may need to educate your customers on small things, like which buttons to press. But the overall point of your product, well, that’s obvious.

 

Other developments can be far more transformative. Think of the internet. It would transform society in unimaginable ways. However, it was still iterative in its development. You didn’t need to understand all the ramifications of instantaneous worldwide communication in order to send an email. 

 

However, something like 23andMe doesn’t fit in either of these categories. People may have had an understanding of genetics, but they had no idea how to use that information. No inkling of how having access to it could transform their entire way of thinking about health.

 

23andMe had huge potential power. But that power could only be realized in a future where systems and attitudes had shifted. So when 23andMe launched in 2007, it was met with a shrug.

 

WOJCICKI: Those early days, we launched the company, we sold 1,000 kits those first couple days – and then we saw it trickle down to 10 to 20 kits a day. It was so sad.

 

HOFFMAN: But Anne didn’t lose faith in her mission. This lack of understanding among her customers was another obstacle she was determined to overcome.

 

WOJCICKI: I never once doubted that this was a viable business. But to me, it was always that we have to take a different path. The path we approached of just putting out a scientifically really interesting product and we thought there was big consumer interest, that there had to be more education.

 

So for me, it was like I failed my customers more because I failed to properly educate them about the potential. So then we had to take a step back to say, “What are we going to do?” 

 

One of the things my marketing team will say is, “You need to take it from the weird to the wonderful.”

 

HOFFMAN: 23andMe had enormous potential. But the concept behind it was too weird. Very few people could see the point of paying to have their genome analyzed. Anne needed to educate people about the benefits, and then get them to sign up for 23andMe.

 

Education doesn’t mean putting together tiresome tutorials or laborious workshops. Think of it more in line with the filmmaking adage “show don’t tell”. If you can put a product in your customers hands, they may not ‘get it’ immediately. But they can immediately start becoming familiar with it. And then fall in love with it.

 

For 23andMe, the trip from weird to wonderful was achieved by letting people learn about their ancestry. 

 

WOJCICKI: I think one thing we were really clear about is that no one wants to sit around and talk about their disease all day. I carry Hashimoto, I have Hashimoto’s, I take thyroid, you would never want to do a podcast just talking about my Hashimoto’s and all the interesting aspects of it. 

 

But if I came in and I was like, “Guess what? I found out I have ancestors from Thailand and West Africa and I’ve met all these relatives.” Holy cow, we get stories all the time about that. The ancestry side really opened up massive numbers of stories and exploration, sense of identity, that’s changed. 

 

HOFFMAN: This took genome testing from the weird to the wonderful, and also injected an urgency for people to share. 

 

Note how helping people explore their genetic ancestry wasn’t directly part of Anne’s mission. But it was additive to giving people more power over their medical histories. 

 

WOJCICKI: People always ask, “Are you a biotech company? Are you a science company? What are you?”

 

And I said, “We look at genetics holistically. Your genetic is just the digital manifestation of you. And you are really interesting.”

 

HOFFMAN: You sometimes need to take oblique, yet complementary, approaches to reach your goal. This helps you gain scale rapidly. It prompts you to diversify. It can also be a lifeline if you hit any unexpected – and powerful blocks, like the powerful gatekeeper Anne was about to run into. We’ll hear about that after the break.

 

[AD BREAK]

 

HOFFMAN: Before the break, we heard how Anne and her team took 23andMe from alien concept to must-try marvel. In 2008, Time magazine named 23andMe’s personal genome test kit “Invention of the Year”. 

 

People were excited about exploring their ancestry. And they were being introduced to the concept of using genome testing to gain more information about their health. But although consumers were coming around to 23andMe, there was a group that was proving tough to convince: doctors. 

 

WOJCICKI: We’re direct to consumer, and I think that that is one of the biggest controversies about the company, is that we don’t go through doctors. So most of your health information today, access is controlled by physicians. If you look at the history of medicine, things like pregnancy tests, it was seen as highly controversial at the time whether or not people should get direct access to their pregnancy results.

 

HOFFMAN: Doctors have been the established gatekeepers when it came to the medical system. It was a setup that had, until now, remained unquestioned since the days of Hippocrates.  

 

WOJCICKI: So for physicians, they’re used to having information come first to them and then they’re used to deciding whether or not you should have information. So it was shocking, that people were walking in and saying, “Look at all these things I learned about myself, what do you think?” 

 

For me, it wasn’t shocking because I remember so well when I was investing in WebMD and physicians had a very similar opinion. Like, “Wait a minute, I’m the one who will tell you all the different potential diagnoses.” 

 

HOFFMAN: There was another problem: 23andMe’s focus on encouraging people to take preventative measures.

 

WOJCICKI: At one meeting, a doctor stood up and he said, “Look, the biggest problem with 23andMe is you generate non-billable questions.” 

 

This is where I have the empathy for the physicians because a lot of what we do is we bring up risks. And risks are not something that’s usually well covered in the healthcare system. Doctors are really trained to treat the disease, but thinking about prevention, in some ways, that falls on you. We’re playing in a world that’s outside of traditional medicine.

 

HOFFMAN: 23andMe was facing a systematic and cultural block to their business. And if doctors wouldn’t come aboard, then consumers might be turned off. It’s an issue that the company is still dealing with. 

 

WOJCICKI: So I recognize it was more of a transition and we took the direct to consumer approach because frankly, it’s a much more scalable approach. It’s what I’ve learned in Silicon Valley, consumers can drive behavior change. 

 

I was never going to be able to afford to have a physician education campaign, so we created all kinds of support materials for physicians and we wanted to make sure they understood what we were doing and it was scientifically valid, but the medical community definitely has been slow to adopt genetics

 

HOFFMAN: However, there was one gatekeeper even more challenging than the medical community: the Food and Drug Administration. 23andMe was offering raw genetic info, ancestry, and reports on genetic diseases. 

 

The ancestry aspect was the ‘wonderful’ that was helping people understand the weird. However, in 2010, the FDA told 23andMe that it classified genetic tests as medical devices. This meant 23andMe would need federal approval to market them.

 

WOJCICKI: The FDA story is always really interesting to people. I do this class every year at Stanford Business School. They survey the students and they’re like “Was this, did 23andMe get their warning letter because of Silicon Valley arrogance or just totally ineptitude?” Overwhelmingly they vote on Silicon Valley arrogance. I always… I kind of love it.

 

HOFFMAN: I can’t blame them for voting that way. “Silicon Valley”, unfortunately, has become a byword for arrogance. And I think it’s unfortunately justified. But I also think it’s a shame. Because putting up a spirited fight for a product you believe in isn’t arrogant in itself.

 

Disruption has become a negative term. But the flipside is that it is disrupting vested interests and gatekeepers, and making the world better for everyone. I want to get back to that sense of disruption.

 

It’s not that Anne and her team had arrogantly decided to ignore the FDA. In fact, right from the start they had been speaking with both state and federal regulators. 

 

WOJCICKI: We got multiple different state level warning letters. We had a cease and desist from the State of California. We’d gotten letters from New York. 

 

HOFFMAN: Okay, when I said that Anne and her team hadn’t arrogantly decided to ignore the regulators, this wasn’t exactly true. They’d had multiple run-ins with state-level regulators. And each time they had found ingenious workarounds that kept 23andMe’s business in full swing. For example, collecting saliva to test for DNA.

 

WOJCICKI: We had this issue where you couldn’t legally spit in the state of New York, but you could spit on the George Washington Bridge. So I remember that was our work around there. We were kind of clever at coming up with, “Okay, let’s figure out how we can make this work.”

 

HOFFMAN: Though I would say it was more playful than arrogant.

 

WOJCICKI: By the time of our warning letter from the FDA, we were used to controversy and used to also knowing how to deal with it.

 

HOFFMAN: In 2013, the FDA sent a cease and desist letter to 23andMe. Anne was going to treat it like all their previous run-ins with the FDA. 

 

WOJCICKI: So when we got it, my first reaction was, “Oh, it’s not a big deal. This is manageable. No one panic. It’s fine.”

 

HOFFMAN: However, this time it was a big deal. The FDA claimed that because 23andMe was offering medical advice, it was a healthcare product. It was a clash that had been brewing since 23andMe had launched. 

 

WOJCICKI: But by Monday morning when the FDA published it and press came out, and some of that original team from FDA advisors had called and they were like, “This is no joke.” It was the first time in my experience where the problem was not solvable. I really had to shift mentality.

 

HOFFMAN: At first Anne took the classic approach of any entrepreneur. She tried to find the smart workaround that would let her get back to scaling as quickly as possible.

 

WOJCICKI: I was like, “I don’t know what the solution is.” I called around. I spent weeks in my pajamas calling people and getting advice. 

 

HOFFMAN: With her back against the wall, Anne’s first instinct was to do what many other impassioned founders have done in the face of gatekeepers: Fight.

 

WOJCICKI: My first instinct was, I represent the consumer and the consumer has a First Amendment argument here. It’s their information and they’re just interpreting their information.

 

HOFFMAN: But then, Anne had a revelation, sparked by an encounter with one of the very regulators she was preparing to do battle with. 

 

WOJCICKI: I had one very wise regulator who asked me, “What do you want to do? Do you want to sell this company in two years? If you want to do that, this is your strategy. But if you really want to change health care, you just sit down and you work with the FDA and you do the hard work. And it’s gonna take you years. And you’ve got to be ready. At the end of those years, you will have really changed society, but you’ve got to know that you’re committed to doing that.” 

 

And I said, “Look, I’m 30-whatever. I’m not going anywhere. What else do I have to do? I’m committed.”

 

HOFFMAN: We tend to see gatekeepers as obstacles that we need to circumvent. But a gatekeeper doesn’t just block the way. They can also open it for us. 

 

Years of working through and around various run ins with State and Federal regulators meant Anne had very good contacts with these various gatekeepers – enough to have kept from being totally stopped in her tracks, until now.

 

But what if she hadn’t cultivated those contacts? Knowing who to talk to is important when dealing with gatekeepers. It’s a problem Spotify founder Daniel Ek ran in to when he was trying to convince the music industry to get on board. 

 

DANIEL EK: I slept in these like $30 a night motels where the wallpaper falls down on you and there’s all sorts of things in the bathroom that you don’t want to know what it is running around. It wasn’t a very nice time. I did sleep outside of the conference room for a few nights, waiting for an executive to turn up at one point. 

 

The reason why that happened was that the way the music industry works is there are certain things that the local teams can take a decision on. There are certain things that the European or international team can take decision on. There are certain things that people at the global headquarters need to take a decision on.

 

This was one of those hairy things where no one really knew where we would fall under. I’d never worked on trying to sell anything to a large company before. Understanding who’s who in the hierarchy and who influences the decision, who the stakeholder is – and it took me a good bunch of time before I realized who I was even talking to in the room.

 

HOFFMAN: It was a long process that put the brakes on Spotify’s early expansion. But by taking the time to learn the ways of the music industry gatekeepers, Daniel was setting Spotify up to lead the way in music streaming. This is the strategy Anne followed with the FDA.

 

WOJCICKI: If you can change regulators and you can help them understand and you can prove out, then you’re going to have a much bigger impact on society. 

 

HOFFMAN: Anne came around to seeing the run-in with the FDA as an opportunity. But it was a long task.

 

WOJCICKI: I have to say, it was painful. There were some early days that were awful. That were just really painful.

 

HOFFMAN: It was a distraction from the mission, the kind of distraction that would raise the hackles of any founder.

 

WOJCICKI: Trying to get a nimble tech system where you’re just constantly used to iterating and calling and doing all this stuff, to suddenly saying “No, you have to do this validation work.”

 

HOFFMAN: But if they could get through to the other side, they would be first, and they would have a clear head start.

 

WOJCICKI: Everyone in this building believes in the potential of the consumer and the potential of this direct to consumer pathway. One of my lawyers used to say, “Anne, you’re on the right side of history.” 

 

It was almost like law and the beauty of a case and a beautiful position and story. It’s a matter of what is the data that I have to put together that’s going to help us reach that end point? But it’s going to take years. 

 

HOFFMAN: Anne could have gone in guns blazing and fought the FDA. But instead they decided to pull back, and slow down iteration. Usually this is the last thing a founder should do. 

 

And I think this is where a lot of the bad vibes around disruption come from. Disruption doesn’t need to mean destruction. Your disruptive wave may initially set all the boats on a lake bobbing up and down frantically. And it could upturn them. But it can also raise the water level higher for everyone.

 

But some founders can lose sight of this. Rather than believing in their wider mission, like Anne does, they fall into the trap of believing solely in their narrow product.

 

But in 23andMe’s case, no one else was going to grab market share – the FDA was a hard ceiling that someone would need to break through. Although working with the FDA would be slow, it would build trust that would allow 23andMe – and those who followed it – to grow rapidly in the long term.

 

WOJCICKI: The FDA sees a lot, and there’s a lot of bad actors out there. I have a lot of respect for them and having gotten to know them now better, they have a tough job. It is a tough job, you’re constantly dealing with people who are trying to trick you. 

 

And so it is, like it’s our responsibility to show that what you’re doing is safe, that people can understand it; and the more you show it, the more comfortable they get with it. The more we can establish, like hey, consumers in broad swathes of the area of healthcare can understand this information, the easier it will be.

 

HOFFMAN: By working with the FDA, Anne has made it easier for other firms entering the field. For the FDA to understand their aims. And for consumers to get on board with 23andMe’s weird and wonderful mission. 

 

WOJCICKI: I think the trust element is one of the biggest. In part because we are a company that works with really sensitive information. I have your genetic blueprint and I ask you lots of questions about you. Then I want to do research. I want to make discoveries on depression and allergies and asthma and fun characteristics. 

 

But we have a lot of really sensitive information on customers and we have to prove that we’re responsible every day and that we’re making good decisions and our customers trust us on this. So because we have this research mission, the only way we will ever understand the human genome – and the only way that we will all collectively benefit from the human genome – is if we trust. 

 

HOFFMAN: Trust won, the floodgates are open for wave after wave of new possibilities.

 

WOJCICKI: Once we got to that first million, we learned that there is a really natural viral component to it, that people want to learn about their ancestry, they want to connect with friends and family. 

 

I look back on the decision that we made pre-FDA to get to a million people, it’s the most important thing for us to do, because you’re disruptive. Like I don’t know how it will happen but I know it will catch fire. 

 

HOFFMAN: Because Anne and 23andMe took the time to work with the FDA, they helped set a roadmap for the wider industry – although there are still limitations they face.

 

WOJCICKI: I have to say, I’m really proud today. We don’t have our full product back. We suffer lots of pain. I can see other companies doing things that I wish we could do. But fundamentally I feel like I’m speaking the language of regulators and scientists and that I’m proving out my position with data – and we’re succeeding.

 

HOFFMAN: They can now focus on all the exciting possibilities ahead.

 

WOJCICKI: A lot of those things come with scale, health is one of those things. People are still figuring out how to use this information and what does it mean for me to step up if I’m higher risk for Type-2 diabetes, like what do I do? There’s not a huge support system yet. That’s one of the things I think Silicon Valley will have more and more of a role to step up in. 

 

And so I see the next decade in some ways as like driving a lot of the viral connections, there’s going to be a different healthcare world than the world that we know today. The world we know today, that is predicated on physicians, and hospitals, and in-person visits – there’s going to be an entire healthcare world that’s predicted on your phone.

 

HOFFMAN: It’s a grand vision that will not be easy to make a reality. But it would have been impossible if Anne hadn’t taken the time to work with the gatekeepers. 

 

I’m Reid Hoffman. Thank you for listening.

Thank you for your interest in the Mastercard Impact Challenge and being a force for good!

Join our community

Find out more

mastercard_inclusive_challenge-copy