GLP-1 medicines such as semaglutide and tirzepatide revolutionized medical weight loss, but getting them meant finding a doctor to prescribe, a reliable pharmacy to source from, and then staying on track for months, mostly on your own. This online clinic put all of it into one monthly program: an adult anywhere in the US could complete a pre-qualification online, see a licensed doctor by video the same day and, if prescribed, get a 4-week supply shipped every month, with labs, unlimited clinician access and health coaching included.
Built from zero to 2,000+ patients in the first 6 months, all bootstrapped. Served all 50 states from day one, with the key partnerships, HIPAA-compliant infrastructure and systems for customer acquisition and retention. I led product, growth and operations, including the clinical, pharmacy and regulatory side, and owned the unit economics.
Doctors and pharmacies, matched by state
A telehealth company runs on two networks: doctors and pharmacies. Every patient has to be matched to a doctor and a pharmacy licensed in the state where they live. The whole setup was HIPAA compliant from the first patient, with customer support and health coaching built in.
Building an acquisition engine
- Channels
- Paid social on Meta, TikTok and Snap, with Google search and SEO, and new creatives tested constantly
- Pre-qualification
- A 30-question online intake, with records tracked in a HIPAA-compliant customer engagement platform
- Checkout
- A custom checkout app (Next.js, GCP) with dynamic pricing and subscription billing
- Ad signals
- Conversion events sent to the ad platforms through a HIPAA-compliant event layer instead of raw tracking pixels
- Nurture
- Abandoned-checkout email and text, an education-focused nurture campaign, and warm leads passed to an activation team
- Measurement
- Attribution from first click to enrollment, tied to each patient’s lifetime value, tracked primarily to CAC, CAC payback and 90-day contribution-margin LTV
Most patients came through paid social media, with Google and SEO alongside. We tested new creatives constantly with tracking and attribution, in a healthcare-compliant framework and technology stack. People who were interested but not ready went into an education-focused nurture campaign, in the event they became ready later.
Building a methodical care engine
- Clinical hand-off
- Each order sent to a care-coordination platform that started the physician’s review in the partner’s EHR
- Activation
- Activation milestones at day 2, 7, 30 and 45, checking for unfilled prescriptions, unshipped medicine and gaps in communication
- Journey testing
- Every step tested the way a patient lives it, from the first message through delivery and refills, with support tickets and data read side by side to close the gaps
- Education and coaching
- Education built for the medical weight-loss journey, such as the weeks when side effects make people stop, and a human health coach and accountability layer
- Membership
- The first refill at week 4, then an ongoing multi-month program with doctors on call and coaching
- Measurement
- Churn and month-two retention, ARPU and LTV
Each activation milestone put the patients who needed attention that day in front of the care team.