Let’s talk about it: Growth, Business & Culture at Ro

11 min readOct 27, 2021

I want to respond directly to the TechCrunch piece written about Ro (Oct. 27, 2021). Before I begin, I want to emphasize a few things.

While I did not speak to Natasha for this article, I’ve spoken to her a few times in the past. We’ve always had great conversations about the future of healthcare and, while I believe that much of the article is inaccurate, I believe she is writing with no other intent other than to genuinely cover a startup in a rapidly changing industry.

It is not my goal to refute specific examples in the article where a current or previous employee describes their experience at Ro. This is how they view their experience and, while our data and conversations with Ro’ers suggests the opposite for the vast majority of people at Ro, it is ultimately how those people feel and I respect that. I can only rely on what is shared with us by our team. I want to share some of that data below, of which I am extremely proud.

Third, I deeply believe in the scrutiny of journalism and the free press. My wife is a journalist and our dinner table for the last eight years has regularly been the site of conversations about the tension, often healthy, that exists between technology companies and the media. Ultimately, our belief is that the solution is simply more speech — another perspective for readers to be informed and make their own judgement. That is what I want to do here today. The article also mentioned an email I sent to employees yesterday knowing that an article would come out — I’ve included the exact email at the bottom of this post.

The article covered three main topics:

Growth & Revenue
Focus on Roman
Culture

Let’s talk about them.

Growth & Revenue

The article described that Ro was having trouble growing outside of Roman and that ARR was stagnant.

The truth is:

ARR is growing and currently above $300M (last year we did just over $200M in revenue).
Non-Roman revenue is on pace to grow over 150% this year. Non-Roman revenue is the fastest growing part of our business.
To avoid the small N perception, non-Roman will be greater than $50M of revenue this year.

With regards to specific products:

Weight management: The article stated, “Plenity [Ro’s weight management product] is growing 1,500% year over year, but it’s unclear what metrics or benchmarks are being used since that product’s 2019 launch.” The benchmark we’re using is revenue. Weight Management’s revenue will be in the 8 figures this year (up ~1500% from last year).
Dermatology: The article stated, “Another vertical that has struggled is Ro Skincare, a prescription dermatology line that was launched in May 2020 but has seen little adoption”. Ro’s dermatology products and services are on pace to do over $20M in revenue this year (up more than 50% from last year).
Smoking Cessation: The article stated, “A current employee says that Zero, Ro’s smoking cessation product, has been shut down for two years and has no employees staffed on the project. Ro denied this, saying that Zero is still available on QuitWithZero.com and through Roman and Rory.” While Zero is not shut down, it unfortunately hasn’t seen rapid adoption. We’ve helped people quit smoking (including Ro’ers) and are proud to offer it, but it hasn’t seen the growth of some of our other products. Of course, I wish we saw more success with smoking cessation but despite our best efforts, we haven’t been able to scale Zero in the way we’d like.

Focus on Roman

“I come back to the same realization: we’re selling dick pills, we’re not curing cancer.” The first part of this sentence from the article is absolutely true. We help patients who are experiencing erectile dysfunction (among 20 other conditions) and are extremely proud of this fact. If anyone reading this is experiencing ED, like I have — head here to speak with a doctor and we’ll take care of you.

Regarding cancer, well, we play a small part in which Workpath, our in-home care API, facilitates in-home clinical trials for cancer research and in-home blood draws for patients. We are not curing it but we take great pride in helping others who are. My sister is a two-time cancer survivor and I’m proud of the work we do, even if it’s small.

The article described that the majority of our revenue comes from Roman. That’s true — the majority of our revenue does come from Roman. Roman is where we started. Of our first seven products, six of them were launched on the Roman brand. As cohorts have stacked over the years, the majority of our revenue naturally comes from returning customers. As a result, it will take time before the scale flips and the majority of our revenue does not come from Roman. We’re in the middle of that flip.

We’re extremely encouraged by the progress. When we look at the forward looking indicators, we see that point on the horizon. A few facts:

More than half of new treatments is for something other than ED
Non-Roman revenue is growing faster than Roman (150% YoY)
Almost 20% of our patients use Ro for something other than what they signed up for first within the first 30 days of joining.

Before I dive into our culture, I wanted to add a bit of context to a few more pieces in the article I find important to correct:

“One employee said that Ro’s at-home COVID-19 tests, which had a landing page and still has an active waiting list, never officially launched, thanks to pushback from Ro’s medical team.” The truth here is very straightforward: We did not launch our partner’s covid tests because the FDA has not approved Gauss’s covid tests yet, not because of our clinical team. When they are approved by the FDA, we’re excited to offer them.

“Another employee told TechCrunch that Workpath, which was acquired in December 2020 for its home-based care services, was used for Ro’s in-home vaccination service and then tossed aside.” The first part is true, we did use Workpath for our in-home vaccination program. As part of the program, Ro worked closely with the New York State Department of Health to administer several thousand vaccines to elderly New Yorkers who couldn’t make it in person to a vaccination site — which hopefully sufficiently responds to this quote as well “Everything we launched [in 2020] was a complete failure.” In regards to the second part, here is a quick Workpath growth chart showing their monthly numbers of in-home appointments this year. We’re incredibly proud of this small and mighty team that has helped companies reach patients in-home for everything from clinical trials to checkups.

Culture & Morale

The article interviewed ten out of the 850 people who work or have worked at Ro in the past, one of whom left the company “a few years ago” (we’re turning 4 on Friday). While I’m sorry that even a few employees feel that way, it’s important to put into context the number of people sourced for this article represent 1.1% of our total historical team population.

The article described a culture of low morale and exodus. It wrote, “The company said that its voluntary turnover is 8% year to date” but “an analysis using LinkedIn, and corroboration by former and current employees, suggests that dozens more have left the company.” An export of our Zenefits data seems unreasonable at this point. We stand by the facts we provided, it simply is not true that “dozens more” have left. I’m not sure what else to say on this front.

Regarding our survey results, I’m extremely proud of what we see from our yearly survey (every fall), our upward feedback (every summer), our “great place to work” surveys and our exit surveys, which have an average participation rate of 87%.

Just this month, our team took the Great Place to Work survey (fielded by Great Place to Work® Institute) and 95% of employees marked favorability for “I would say this is a great place to work” and 93% favorability average for all questions. Additionally, for our exit surveys (taken when an employee leaves Ro), we have a close to 100% participation rate. Even upon exit, 73% of departing Ro’ers say they would recommend Ro as a great place to work and only 5% disagreed with this statement. And 92% said that their manager genuinely cared about their well-being.

The article also includes a quote from someone who said they were afraid of their department getting a ‘talking to’ if their culture survey results were low. We absolutely do follow up with leaders that have lower than average culture and/or upward feedback survey results. We do this to make sure that any concerns surfaced are addressed and to offer them coaching and support to address those. As a result, over 80% of our team feels confident that improvements will be made as a result of the feedback they provide, which is more than 10% above top quartile tech benchmarks.

Building Philosophy

Ro has a pace. One of the most common things we hear from people who are new to Ro is that there is an extremely high bar for performance at a pace that can be demanding. This is not something we will shy away from. What I, and many Ro’ers believe, makes Ro extremely special, is that we pride ourselves on being a rare combination of being extremely ambitious and extremely kind at the same time. Someone who is too much of one but not enough of the other will likely not be a fit here.

While we work hard, we do not believe we ask people to work unreasonable hours. The past two years have tested the world’s reserve of everything from our empathy to our creativity to our resilience. And we strongly believe we have taken considerable measures to support our team’s wellness and overall health.

This mission is deeply personal to me, my co-founders, and many Ro’ers. We believe we have the opportunity to change the way healthcare is delivered and, in doing so, radically improve the lives of millions of people. We believe in the mentality of working hard with rest to maximize potential and we will continue to give it our all to help patients.

What makes Ro special for some might make it suboptimal for others. It does not make anyone good or bad if someone is not a fit. It is absolutely on us to both continue to set expectations on the way in and, in addition, for us to improve every single day. While we are already an introspective group, there are always areas of opportunity and we will continue to look inward.

While it was of course frustrating to read this article at first, I ultimately know that good will come out of it. If this conversation helps us to more clearly articulate who we are as an organization, we are better for it. If this helps some people to realize this isn’t the right place for them and others to realize that there is no better place for them, we are better for it. And most importantly, if this helps Ro’ers to give us even more feedback on how we can improve, we are better for it.

To Ro Employees

The article said it spoke to ten former and current employees. I’m writing this to all current Ro employees (and of course I will share this privately as well). For those that agree with the contents of this article and do not feel comfortable talking to myself, Rob, Saman, Meg, Amy, your manager, our people team, or our anonymous feedback forms, and feel that your only outlet is a journalist, I’m sorry you feel this way.

As I mentioned above, I believe people and companies vote with their feet. Many Ro’ers love Ro. I know it in my heart and I see it every single day. We want to build with them. For those who don’t, and decide to move on, we will learn from your departure and become better for it. There will be no hard feelings.

PARTING THOUGHTS

There is nothing in my life I am more proud of than the environment we’ve created at Ro and the impact we’ve had on patients’ lives across the country. We’ve helped one patient in every county in the U.S., facilitated 50M patient-provider touch points, and saved lives of the elderly homebound during the pandemic with our in-home vaccination program. And we’re just getting started.

This post will end as all others do — with a link to our career page to join us in our efforts.

To a patient centric healthcare system,

— — — —

NOTE SENT TO RO’ERS THE NIGHT BEFORE THE ARTICLE

Ro’ers,

We caught wind this week of a pending TechCrunch article that we believe aims to paint Ro in a negative light. In an effort to be as transparent as possible with you, we wanted to let you know this was happening and that we expect the story to come out soon.

While we aren’t yet sure of the story’s exact contents, we wanted to share with you what we’ve learned so far based on questions the reporter had for us.

At this point, the angle of the article seems to be around:

The details of our business such as ARR and information about our various verticals. As you know this is information we have been sharing transparently within the company. We are proud of this commitment and we will continue to be transparent with Ro’ers.
Turnover. We shared with the reporter that Ro’s YTD voluntary turnover is 8% (including Care + Pharmacy + Providers) which is very low compared to the macro trends of 20%+ and in line with our projections for the year, which are part of our company OKRs.
Culture at a high-growth company. We shared a number of examples of culture survey results, workplace awards and exit survey trends — all of which tell us we seem to be doing something right compared to similar companies as our scores are well above industry benchmarks.

All that said, we want the bar for Ro to be extremely high. And we also know Ro isn’t for everyone. People will leave voluntarily and people will be asked to leave. This is the reality at any fast-growing company.

We are hopeful that the article will be accurate and balanced, but regardless, we will take this in stride and continue to learn from it. We will keep relentlessly focused on our mission of helping patients but also use this experience as motivation to continue to look under the rock and see ways we can improve Ro.

If you or anyone you know at Ro has feedback that you want to share or are in need of additional resources or support — or just an ear to listen — please know we are here and want to help. As always, you can submit a ticket to the People team or you can reach out to us, Amy, or Meg P.

Last but not least, we deeply respect journalism and believe in the free press. I married a journalist and this work is something I believe to my core. As a company and a founding team, we believe in taking the high road. When the article comes out, we will take a moment to determine how to best respond publicly, if at all. If we do respond, it will be factual and uphold our company values.

If any of you have questions or concerns, we remain available to listen.

We’re here if you need anything.