From questions about the effects of cold plunging on the female body to the challenges of securing growth-stage funding, DOC 2025 Faculty and Specialists explored the opportunities and challenges facing women’s health during the session, “The Great Healthcare Correction: Women’s Health,” moderated by Brit Morin, a founding partner of Offline Ventures.
After their individual talks — Roma Van der Walt, on the need for female-specific data, Bailey Renger, on dense breast tissue imaging, and Dr. Daisy Robinton, on therapeutics targeting ovarian aging — participants asked questions about the dearth of funding for women’s health startups, how technology is shifting women’s health care, and ways men can support the field.
Van der Walt, the founder and CEO of Vitelle and a former professional athlete, emphasized that AI and machine learning can bridge the health care and training gaps for women. ”Our goal is really for every woman to have that team behind her,” she said, referencing the kind of multi-modal support professional athletes receive.
Renger, the founder and CEO of BeSound and a physicist by training, addressed questions about BeSound’s accessible pricing model and the evolving insurance landscape for supplemental breast ultrasound screening for women with dense breasts. She emphasized that the cost for BeSound’s scans is a meaningful step toward making this life-saving technology accessible to more women today, many of whom are under 40 or have limited supplemental coverage. Renger also noted that expanding insurance coverage is an important part of BeSound’s long-term roadmap, with the company focused on supporting the clinical entities it works with as they explore appropriate pathways for payer relationships and future reimbursement.
Dr. Robinton, who sold her company Oviva Therapeutics earlier this year, spoke about the barriers facing female founders. The ideas, science, and need are there. The funding and healthcare accessibility, however, are not. “That’s what we need to change,” she said.
You can hear more from the full session in our video, or read our lightly edited transcript below.
TRANSCRIPT:
Brit Morin
Good morning everyone. My name is Brit Morin. As John said, I am an investor, a serial entrepreneur and a women’s women’s health optimist and I was saving the best for last at DOC this year by having these three amazing female founders on stage with us, and we are tackling a paradox. Obviously, women are half of the population. But we are still considered a niche market when it comes to venture capital, among other things.
Today, you’re going to hear from each one of these women about what they’ve been up to, what they’ve been building. This isn’t really about a struggle fest. Let me say this is about the optimism, actually, that these three women have for what is changing and what could change to make women’s health companies and startups more, active and palatable in the space.
With that, I’m going to kick it off with Roma Van der Walt. She’s the founder and CEO of Vitelle. She is turning women’s physiology into actionable intelligence, bridging high performance data and everyday health. Roma.
Roma Van der Walt
Hello, everybody. I’m really excited to be here. I’m also German, so that may not always come across as intended. We had an exceptional women’s health panel yesterday and then listened to Susan [Monarez], obviously. I think two things really stood out to me, which was that the doctor patient relationship could shift to where the patient and technology can take care of 90% of their health. And then the patient, meeting the provider takes up the 10% to really get that human interaction. The second thing that stood out in the Women’s Health panel yesterday was the fact that we have no data. That’s my jam. I love data. So let’s talk about data.
Female bodies, as you may all know, have to adapt every single day. They have to adapt to hormones, to stress, like being up on stage to training load and to life. But despite the fact that that’s our adaptation and the core of our resilience, that is vastly ignored by the data systems that we’re currently working with. So Brit has already introduced me. I’m Roma Van der Walt, I’m an exercise physiologist.
I’m a former professional athlete, and I am also the founder and CEO of Vitelle, where our goal is really to create the data infrastructure to finally decode how female bodies adapt. So in exercise physiology, there’s a term called super compensation that describes the period after a stressor when the body not only recovers, but it actually rebounds to a higher level of function. That’s really important. We’re not just playing ping pong. You’re okay. You’re not okay. But then, as you may have guessed, in women it’s not that straightforward, predominantly because of two hormones called estrogen and progesterone. When our estrogen is high might look like muscle glycogen storage is improved. Mitochondrial efficiency is improved in the cells, and even things like muscle protein synthesis. For body composition when estrogen and progesterone are low, on the other hand, our parasympathetic nervous system doesn’t recover as well. We’re more reliant on carbohydrates, and we’re generally less resilient to stress. But what happens and what you can see here is that if we model a standard and 72 hour recovery window, which is modeled on male data, we could significant the overall undershoot the optimal adaptation window for women.
That’s just one missed opportunity of what we’re not doing to create optimal well-being for female bodies. Because the female body, as we all know, like, well, everybody female in the room knows has to recalibrate itself every single month. And that includes our metabolism, temperature. It’s things like our brain chemistry, and there’s a whole data layer that we’re not currently looking at yet, but what we measure, we can manage or as both scientists like to say, test. Don’t guess. If we start collecting data and we want to create equitable health intelligence, we really have to make sure it’s multi dimensional data. It has to take into consideration hormones, physiology and most importantly context. So that these models that we’re working on, like Claudius and Claude and Claudia, can learn from female adaptation instead of flattening it.
The most popular example that we have I athletes. I was a professional athlete. I know how hard that adaptation is, and they are under pressure adapting every single day. But the one thing that they have that we’re trying to establish in this room they have multimodal teams. So their support is physiological, it is clinical and it is practical. When the team behind the team dials in their health, their recovery and their biology, that’s when the injury risk goes down, their readiness stabilizes and their performance peaks.
When we observe these athletes on the field, we should really think about how we can be creative in designing health interventions for everybody else off the field. When, we look at the market and I won’t harp on it, but there’s an almost $800 billion preventive care market, and 60 to 70% of that is driven by women. But again, as we all know, despite that fact, interventions for women are reactive. They are siloed, and they’re still one size fits all. We can apply the logic from sports science and the way they apply it to their female athletes to try and think about how we can create better interventions, for women and in general. When we model adaptation, we create predictable health. The female body is nuanced. We know that it’s annoying. It’s part of why we weren’t part of clinical trials for so long. But it’s actually also a blueprint. It’s a blueprint for cyclical stress exposure, for variable recovery and for distributed load management.
In my opinion, the next health revolution is and has to be female. Because if we get it right and we cross between siloed metrics, that’s how we optimize health span and lifespan for females. Then when we scale that, we transform health systems, because these women are at the center of our communities and caring for everybody else. After I said all this and it’s obviously very female-centric, what I’m not trying to say, if you take anything away, that the future of health is gendered, I really think that the future of health is adaptive. Thank you. Thank you very much.
Morin
Next up we’ve got Bailey Renger, the founder and CEO of BeSound, which is a new technology using photo acoustic and ultrasound technology to give women with dense breast tissue the imaging clarity they deserve. It’s very cool. Bailey, over to you.
Bailey Renger
Hi everyone. I’m Bailey, and to add a bit more context to that introduction. Thank you. I’m a physicist by training, so my background is actually in quantum computing. I worked at NASA and Harvard and started my PhD in physics at Brown, and I’m currently on leave to build this company. After my own cancer scare, I realized that this is a huge problem and I felt a sense of urgency. Here I am.
Breast cancer screening today is failing women really in two main ways. The technology, but then also the system and the access to that technology. You’ve all probably heard of dense breast tissue. Maybe most of you women in the room have dense breast tissue. The reality is, if you have dense breasts, your breast cancer can be missed on a mammogram alone. In fact, 40% of breast cancers are missed by mammography alone. We’re underserving women with dense breast tissue, but then also women under 40, which flash, if you’re under 40, you can get breast cancer. The rates are actually skyrocketing in women under 40, which is very concerning. But there’s no way to get screening reimbursed, so we’re also serving that group of women. Then, the emotional stress that comes with waiting weeks to get a diagnosis, we aim to solve that through technology, the AI that we’re building, which we really excited about.
I love this image because it’s a really great visual on what does dense breast tissue look like. From left to right, you can see these are four different mammograms of women with increasing breast density. You can see that dense breast tissue shows up as the color white. So does breast cancer. This is a physics problem. It’s just difficult. There’s a masking effect. So it’s difficult for radiologists to actually discern whether or not breast cancer is present. Another fact about having dense breast tissue is you’re actually at an increased risk of breast cancer. We’re doubly failing these women. You’re more likely to have breast cancer and you’re more likely to have it missed.
You can only determine breast density through medical imaging. You can’t tell by looking at a breast. You can’t tell by the size of your breast. It’s post mammogram or MRI. There’s really a tailwind right now, which is the FDA updating its guidelines around notification of breast density.
This happened last fall, and so now women are required to be notified of their breast density status and that mammograms can miss their breast cancer. So what’s next. 40 million women in the US alone have dense breast. This is just 40 plus. There’s a lot of women under 40 who have dense breast tissue, and a lot of them don’t really know what to do next. It’s not reimbursed in most states. We have a solution that we’re really excited about.
Just to double click on the current breast imaging technologies, what exists today and the sensitivity and specificity and where we’re seeing problems. So screening mammography I mentioned has a low sensitivity. In women with dense breast tissue, and also is not something that’s reimbursed for younger women. It’s not recommended for younger women because there is radiation involved. So exposure to that is also concerning. Screening breast ultrasound is a great adjunct tool for women with dense breast tissue. However, it’s not reimbursed in most states, as I mentioned. Even though it can detect more breast cancers when paired with mammography, it decreases specificity. You might be flagged for having a lesion that, is actually just assessed for fiber adenoma, and, there’s a staggering statistic around here, which is that 80% of breast biopsies are benign. So this is not scalable. We can’t have all these 40 million women now getting a breast ultrasound, and then a lot of them have to get a breast biopsy. It would flood the system. We’re in need of both a technology that can improve the sensitivity of breast cancer screening and the specificity. We also have a solution here, which is, ultrasound-based.
It’s photoacoustic imaging, and this has been demonstrated to reduce false positives and the way that it works is, it’s an ultrasound transducer, and there is near-infrared laser. It’s a dual wavelength probe. Because oxygenated hemoglobin and deoxygenated hemoglobin have unique absorption coefficients, the result is actually this color map overlay. In this color map overlay gives the radiologists information on oxygenation and vascular parity. Functional information. You can think of like a contrast-enhanced MRI except to contrast-enhanced ultrasound. No gadolinium is required. No injections with contrast using light. Functional MRI in a way that’s kind of an analog. On the top row you can see this is a benign lesion. The bottom is malignant. Pink and red indicate regions of hypoxia or that are de-oxygenated. The radiologist can then make the decision to, downgrade or upgrade the lesion based on that data. This is the technology that we are hoping to use diagnostically to help reduce false positive breast biopsies while at the same time, both increasing and then maintaining sensitivity so less cancers are missed.
This is just an overview of there’s a lot of different technologies in this space. We believe that we have found the solution for both best sensitivity and specificity. Contrast enhance MRI is great. However, not very many women can afford that technology or opt out of it because it requires an injection or intravenous contrast and, or they’re claustrophobic. This technology is not painful. No injection is required. We believe it’s a scalable solution for women with dense breast tissue, women at intermediate risk, and then younger women. As I also mentioned at the beginning, we’re building AI to help radiologists read these images more quickly. Acting as a decision support tool so we can drive down the cost of this technology to make it more accessible to more women. So with that, I’ll hand it back to Brit.
Morin
Thanks, Bailey. Very cool. All right. Last up, we’ve got Daisy Robinson, co-founder of Oviva Therapeutics, which actually sold a couple months ago. Oviva is redefining how we treat and prevent ovarian aging, bridging reproductive biology and longevity science.
Daisy Robinton
Hello, everybody. Do I have to use this? Can I stand here? That’s better. I’m Daisy, it’s such a pleasure to meet you all. Thank you for staying for the very last session. I know there’s been a lot of information and content, and you’re all baking and simmering in it, and I’m actually quite excited that we get to be last so we can have that last word and be the last thing that you’re really thinking about as you leave and, are inspired and percolating and all of these incredible ideas and conversations and of course, thank you, Jordan and Kevin and John, for having us.
To the working group that enabled our panel to be here talking about what we’re talking about. I’d love to tell you a little bit about Oviva and what I built and why. But I’m more excited to talk about the opportunities, aka structural barriers that companies like ours face and have faced and continue to face and what the roadmap is to seeing more success and innovation reach the hands of patients and people in this space.
I’m a molecular biologist by training. I did a PhD and a postdoc, really looking at the intersection of early developmental biology and aging and pathology. When I was 31 years old, I went to a reproductive endocrinologist just to kind of figure out what my fertility journey might look like, and was horrified to learn that despite having a PhD in human biology and translational medicine, I was shockingly ignorant about my own body and physiology, and that sent me down a rabbit hole to better understand ovarian physiology and the science of female physiology and, I think Brit will probably be pleased to learn that the thing that horrified me most was that when I went through menopause, my sex life would tank. I was like, this cannot stand. I must do something literally. That was one of the main drivers. I can’t handle that for 40% of my life. I went on this deep dive just to better understand what is it about the ovaries that support overall health and well-being?
What can we do so that a second half of our lives can be as rich and vibrant and sexy as the first? Well, maybe not the first half, sexually active part. That got weird. I ended up starting a company called Oviva Therapeutics in partnership with my co-founders, David Pepin and Pat Donahue from MIT and Harvard, who are two incredible, fabulous minds that built the foundation of the biology around the protein called AMH, which we heard a little bit about yesterday, currently in use as a clinical biomarker marker to approximate ovarian reserve.
Now, the cool thing about AMH is it’s actually a regulator of how quickly our eggs are lost throughout the course of our lifespan. If you’re a cycling woman before menopause, you’re losing about 1000 eggs per cycle. That’s to ovulate one. So there’s this enormous waste. We don’t really understand why we want or need a thousand eggs to be lost with every cycle.
And AMH actually controls if we have a high number or a low number of eggs that are being released every month to mature and potentially be the one that ovulate. Our thesis advisor was, could we use this as a therapeutic strategy to reduce that number of eggs that were lost every month, as a means to extend the runway of time, that our ovaries are able to function before they then fail and go into menopause.
As Brit mentioned, we sold our company earlier this year to Granata Bio. They’ve sort of carried the mantle. But I’ll just say briefly, as a company that really built a framework around, single asset therapeutic strategy with a much broader potential and long term goal for how we’re going to improve health span and women, we really struggled in the awful market that has proceeded the last couple of years, to find investors that were willing to take that risk and carry forward the incredible science we had to see the fruition that is possible.
In many ways, that’s actually what led us to sell the company, it’s because the risk, is able to be born by a different structure. Somebody that has a diversified portfolio. It just wasn’t going to work as a single asset play, and there’s a lot of companies in the women’s health space that suffer from this because they have this really deep focus. They’re trying to solve the problem, and you have to do that with really high specificity, because complexity is already so enormous that when you start broadening too much, you really lose your ability to be effective.We start getting into some of the reasons that we see failures in this place. There’s five that I really want to talk about.
The first is funding, which I won’t belabor because everybody talks about it and it’s a little bit boring, but I’ll just say briefly that we are seeing improvements in funding for women’s health, but we’re still seeing a failure at the growth stage. A lot more capital is going in for these early stages, seed and pre-seed, even series A, and we’re not seeing that convert of series B in large part because of the broader structural needs that are enabling scaling.
The second is diagnosis. This goes to Roma’s points around data. We don’t have the data. Paired with that we don’t actually have the language. So we don’t really understand how to talk about many of the conditions in women’s health, much less at the biological level, what’s really happening and how to diagnose and treat those. Without diagnoses we can’t have ICD codes.
This is another enormous barrier for anybody, especially in the therapeutic space. If there’s not an ICD code, there’s not a mechanism for reimbursement. So who’s paying for that? That’s why we often go direct to consumer and why there’s a lot more direct to consumer plays coming up. But again this gets to the scale program. If we’re going to solve for the female population in the country and on the earth, we really need to solve this problem.
Next is the adoption and reimbursement. We talked a lot yesterday about adoption and clinical training for OB/GYNs and other physicians and how to get them up to speed on managing and understanding female physiology. But we also have a huge reticence to adoption for technologies and therapeutics in women’s health. In large part because the clinical practices that focus on women’s health tend to be the most financially stress and the least incentivized to adopt something new certainly, if there’s not strong reimbursement. So these are some of the pillars of structural barriers that I think are really flagged and important for companies in our space and for people that are interested in supporting companies in these space to really have an eye on and a plan for in order for there to be a path to success.
What I’m really excited about with all of these is that you cannot be successful as a company in women’s health without having an eye on these, and at the same time, these problems aren’t necessarily unique to women’s health. They’re problems that exist, at least in the United States broadly. As we all know, our health care system deliver some of the poorest value among our peer groups.
Globally, we’re spending $5 trillion a year for national health expenditures, and that’s to get four years lower life expectancy than our peer countries, and 20% of our GDP for having increased maternal mortality rates, infant mortality, hypertensive chronic disease, to name just a few. We all know that there’s reform that’s needed. I think what’s exciting to me is that women’s health companies are really poised to be the leaders of this charge, because we already have to be thinking about that.
If you don’t have a plan in that, you’re not going to be successful. I think, generally speaking, we need reform. We need that radical transformation to be brought forward by some of these companies that are thinking about how to innovate broadly as well as innovate technologically in the lanes that we’re in just a few ideas to see this.
I ran out of time. I’m sorry. I’ll take 30 more seconds. Just a few ideas to see this discussion and get everybody here thinking, one of the things that we need to be doing is generating the regulatory and adoption pathways. So thinking from the regulatory stance standpoint, but also for the clinicians, clinician training, reform the reimbursement. Generating pilot ICD codes so that we can actually incentivize the adoption of and pay for these new innovations, expanding the FDA flexibility for technology in the women’s health space. I know that’s something that there’s at least been conversation around and interest in for the last couple years, at least in some of the interactions I’ve had with the FDA and and in rooms that I’ve been in with folks from the FDA, and just an acknowledgment that this dilution is very complex and multifaceted. It requires everybody in this room and all of the health equity stakeholders to have a hand in. That’s going to be the innovators, that’s going to be the government, that’s going to be the patients and the providers. I do think an enormous part of the ask is really bringing this awareness forward. Because certainly when I started in this field many years ago, none of this was visible to me. I just thought, oh, there’s unmet need and really amazing, strong science. Of course this can work. How naive. Right? That’s just not true. This is not driven by unmet need. Our field is not driven by unmet need. It’s driven by the market and the structures. That’s what we need to change. I think it’s an invitation for our companies to lead that charge. Thank you.
Morin
We’ll do a few minutes here discussing. But we do want to preserve at least 15 to 20 minutes for Q&A. So start percolating to those questions. But Daisy I want to go back to you real fast? You sold your company. If you were going to start all over again and and knowing what you know now that like you said, Granada Bio is actually this nice home for it because you can have like more resources to scale it the way it should be. Is there a construct that you would start over again with in that vein, like strategic partnerships or strategic financing to make that longevity of your company longer?
Robinton
I absolutely think that a way I would do it differently today is just having it be a lot bigger and a lot bolder. I was taking a scalpel to an iceberg. You need a scalpel that is also a sledgehammer. I think building coalitions early in partnerships early, working for a lot more capital and, you know, getting out of the constraints of the work life cycle. Because I also think the fact that we need a lot of data, there’s a lot of time and work and careful, thoughtful consideration that’s going to go into creating successful, rigorous, science driven products. But I just think the 3 to 5 year fund cycle is not particularly supportive of. Like you said, I think a big part of it is really just having this bigger, broader vision that very early on engages multiple stakeholders that have the same incentives that you do and desire to see the change, so that you can go from start to finish with that ecosystem. You’re building it as you go. I think, one of the only ways, certainly for therapeutics. There’s different models here, but certainly for therapeutics that you need to be thinking about and implementing from day one.
Morin
Bailey, I know you are more direct to consumer as a business model decision. And I assume it’s due to everything Daisy just talked about, but were you sort of forced into that or was that a proactive decision?
Renger
We do have insurance reimbursement on the horizon that’s important to us and in building a product that’s accessible. But, initially we are a cash payer because most states don’t reimburse screening breast ultrasound yet. It’s also on the horizon. So that’s exciting. We’re hoping to build out the infrastructure such that we can just turn on that capability once different states start mandating it. January 2026 New York is next. That’s really exciting. And that’s actually where we’re headed in January as well. This technology, the photo acoustic imaging component, the diagnostic to downgrade and upgrade lesions, that can oftentimes replace breast biopsies, which is a revenue stream for hospitals and providers. That’s been interesting. But we do know that the we are aligned with obviously the patient, and that is something that payers are excited about to reduce unnecessary breast biopsies. Cash pay initially, but a low cash pay price, a few hundred dollars, not a few thousand dollars. And insurance reimbursement definitely is on the horizon.
Morin
Does that impact your view of how many people you can address in the market and it’s $300, right, for one of the screenings? You go to certain states. Can you can you get to these people the same way, or do you ultimately need to get these providers and these health systems on board?
Renger
I think $300 is pretty reasonable price. For more context, I’m also from Iowa, so I know what it takes to serve Middle America and that type of patient. Really this is just like short term next 12 to 24 months. You see MRI scans, like those are much more expensive, and if you read the fine print, they don’t screen for breast cancer. The most common cancer in women. This is something that women are frustrated with. They’re now getting this letter from their doctor that says they have dense breast tissue. Their mammogram alone is not enough. The need is there. Hopefully this cash pay is just like a crutch to building a reimbursable model that can serve more women.
Morin
If you could snap your fingers, you would have that be reimbursed, direct to consumer.
Renger
Yeah.
Morin
Roma, I know you’re building more of a B2B model. With what you’re doing, how much is I and everything that we’ve talked about during this conference influencing all the decisions you’re making right now about where the future is headed?
Van der Walt
achine learning and AI allows us to really create that Multi-Modality. It’s especially in women’s health, it’s very fragmented and Daisy’s point, you know, we have companies that have to go hyper focused in on one stage or one condition. AI and machine learning really allow us to bridge the gaps and put that all together. The reason why we decided not to go direct to consumer is because the noise in the space is already pretty loud, and the responsibility of figuring out of whether we’re well or unwell is already on women. That’s not just for ourselves, but it’s for our entire family. When we talk to women, what they really wanted was this extension of the physician or the provider into their life to oversee all the hard work that they were putting in and, and then being able to take that into consideration. Machine learning and AI allows us that. I will always go back to the model that I know from High Performance, which is within their care, and as a professional athlete, you know, you know that you have a physician, you have a head of performance, you have an athletic trainer, someone who does strength and conditioning, physical therapist, dietician, psychology.
You basically just rest knowing that your prevention is taken care of, and that’s a wonderful way to be. Our goal is really for every woman to have that team behind her. While she can run from one person to the next, if each person knows exactly what’s going on with her. That’s what machine learning allows us.
One step beyond that agent AI, because someone touched on that yesterday, goes one step further. It actually allows us to understand, as studies are finally emerging, both in women’s health and in women’s high performance, to shorten the time from those studies coming being conducted to making them actionable. We’re not relying on one provider who read one paper to interpret that for their own practice. Then it’s only his patients who are benefiting from it. Again, the same in high performance. FIFA is now conducting a study on athletes ACL tears. Why did it take this long? And how long is it going to take for that study, that I’m connected to, to then land broadly in the NWSL in, in other soccer leagues around the world. But also it needs to trickle down. It needs to come down into colleges. We’re relying on young women to both study and be active. Now we’re already conditioning high schoolers to become super specialized in their sport, because there’s all this opportunity that you can unlock when you get a scholarship, when you go to college for sport. At that time, they’re not even menstruating, and we’re still expecting to work off of male physiology that has always benefited from context.
If I may just give an example, everybody here knows Usain Bolt. He’s much taller than most other sprinters. And there’s this crazy statistic about the fact that Usain Bolt, in order not to fall flat on his face, had to hit 300 steps per minute coming out of the starting blocks to then, as we all know him, two rise up and then overtake the field. But that’s the context his team was able to build into everything for him. And that’s how he unlocked multiple Olympic medals. And can we do that for women, please?
Morin
I love it. Questions from the audience. Yes, we have one right here.
Audience Member
Thank you. This was such a great panel, Daisy. I know how hard it is to build what you’ve built, especially in this market. Congratulations on your exit. It’s awesome. I have questions for Bailey. Your DTC model. I totally get. Who interprets the results?
Renger
Board certified breast radiologists.
Audience Member
On site?
Renger
Not on site.
Audience Member
Follow up?
Renger
Within 24 hours.
Audience Member
Awesome. And then Roma, I have a question for you. I totally agree that we need to figure out women and exercise and health and all that. There’s all this debate around cold plunging for men versus women. It’s great for men, not great for women. Do you have thoughts on that?
Van der Walt
I’ll quote what most other female physiologists will say, which is it depends on where you are in your cycle. You can be at a higher temperature and still unlock good results for yourself. But with any other adaptation, I wouldn’t force you to do it. I just think that if it’s something you absolutely cannot bear, there are many other ways for you to unlock the benefits from activating your parasympathetic nervous system. And that’s part of the personalization. If you tell me I absolutely do not want a cold plunge, maybe cryo is an option for you because it’s dry. It might be easier. If you like it, do it. I would say don’t go down to 40 degrees because there’s a level of diminishing returns. But I love contrast therapy and I’m in perimenopause and it’s okay.
Audience Member
I think the business models for, you know, diagnostics and then of course therapeutics are obvious. But you know, when we think about healthspan, I struggle with the business model for companies that aim to collect and interpret data. Health optimization you cold plunge, you reduce the risk of chronic diseases. The big four that will kill you, cancer. Then you want to predict risk. Modifiable risk prediction is going to help us all live longer. So you take the example of exercise physiology, and you collect your data and you track. But in building these companies the value is in the insights. You don’t know what the value will be. You can collect all the data, multimodal data, but we don’t know. But down the line. If I put my ex-clinician scientist’s brain on there might be only so many routes. If the health care system to this consumer health and well-being and then there’s a health care system so you can track all the data you want. The machine learning models can tell you this your risk. But if the solutions on their down the line, how do you get there? Serena Williams is very tracked. She still had a massive pulmonary embolism after childbirth. Now, no one can tell me that doctors make mistakes. But she has everything tracked food, health. You can’t predict the things that are going to kill you, and you can die from a pulmonary embolism. So how do you build a business model that is based on collecting data, when we don’t know the value of the insights in the future.
Van der Walt
It goes beyond insights. There was a time frame, a short time frame as AI and machine learning was coming out, which was the LLM knows best. Just like, ChatGPT is very, confident in telling you their response, there was this flattening of the experts. I think the real opportunity in machine learning and AI lies in augmenting the experts, keeping the humans in the loop, and then it’s actually not just measuring or looking at insights, it’s measuring the feedback loop of interventions.
If you look at what the physician has decided to do, what the dietician has decided to do, figuring out the outcome that came from that, and then being able to grade how that intervention worked, I think that’s the future and that’s what I’m really excited about.
Robinton
I’d also just like to add briefly that I think this is also one of the issues is that I think we all assume we’re going to have insights. We’re going to get more information. These data will bear fruit. We don’t know what that is. We don’t know what direction it will be in. It’s really hard to build a business model around that. It’s nearly impossible in some cases. I think that’s really an invitation to people that have the means to have there be patient capital associated with these and really put your dollars behind the people that you think can be good problem solvers and do a good job of collecting that data and then using that to create a strategy that will return whatever it is you might be looking for, whether it’s money or impact.
But that’s essential because I mean, I loved the talk yesterday on the science behind women’s health. There’s so many other things about that we didn’t have the time to talk about. One thing that I’ll just call out as an example is when we think about female physiology, we think about the endometrium and the ovaries as two tissues that remodel constantly throughout a woman’s reproductive life every month, whole tissues remodeling. We don’t understand why or how. Just the fact that there’s all of these biological mechanisms that are incredibly adaptive and dynamic and powerful, and the ways that we can then utilize some of those mechanisms to develop therapeutics for things that relate to those pieces of our biology, but also more broad, I think is just absolutely insane, as one example. It’s just going to require some patients to really understand those on a deep level and then be able to translate from there.
But especially in this environment, when there’s decimated NIH funding, we’re never going to get there. we need dollars to move to the people that are the innovators and thinking creatively and thoughtfully with an eye towards translation. But really, their focus on the basic foundation.
Audience Member
First, I just want to challenge the men in the room to at least ask one question, that this is a human, this is a human health issue, and I can guarantee you that this impacts someone in your life. Start getting curious. That’s what we hear. And then plus one, something Daisy just said I think the patient capital in the early stages is what we need in health innovation in general, but specifically with women’s health. My question is actually for Bailey. I recently discovered on my mammogram report that I have dense breast. I appreciate that the FDA is now making that, mandatory, but I also got, notes from my doctor saying your mammogram is normal. I’ll see you next year, or in two years. I know the answer of this? But I want your point of view. It is so difficult for us, as someone that I happen to know that with dense breast needs to go do that additional imaging and I’m going to be seeking it out. But the system and our doctors are not paying attention in the same way. And this is my OB/GYN.
Renger
I think not all OB/GYNs but a lot are recommending and placing that order for supplemental breast ultrasound screening for their patients that have dense breast tissue. I think the answer is in the guidelines, and it just takes time for those to update. Also we’re seeing, reimbursement is happening slowly state by state. California is not reimbursed. That could be why. I think I wish it would happen more quickly, but I think it is a matter of time and talking about having dense breast, what that means. I think a lot of people don’t even know what that means. It’s perfectly normal. More than half of women have them. I don’t know that answers your question.
Morin
Bailey was telling me about an amazing, ad that they created of, showing men’s testicles squeezed in a compressor. And how lovely it was of an experience. And shouldn’t everyone go do this? Which I thought was genius.
Renger
Actually, we haven’t announced that yet.
Morin
Sorry. No sneak peek.
Renger
Roma saw it. It’s called the manogram. Still get your mammogram. Don’t skip your mammogram.But they do use radiation. It’s not comfortable. Often times women find them painful and they can miss breast cancers and so many other, qualities. Every year.
Audience member
Hey, guys. First of all, I really want to applaud, DOC for emphasizing women’s health this year. I think that it’s wonderful to see that. I hope that, this isn’t just a one year thing, but it’s a pillar going forward. In 2021, which was a banner year for VC funding, the average deal size for a women’s health company was $4 million. So Daisy’s an absolute hero. She stood up there with a smile still on her face. But the reality is that she sold her company prematurely to a male founder, who was told by the VCs who backed him, there’s a lot of great starving on the vine therapeutics companies out there. Go vacuum them up. And Daisy’s was one of the gems that he vacuumed up. I’ll start with that.
What I will say is that we have a collective action problem. I’ve been in this field for over 25 years, and there’s never been a more exciting time to innovate in women’s health. We’ve never had more data, more experienced CEOs, and more interest philanthropically, policy wise, etc. But the downside of that is that we can walk away thinking the problem is being solved. I am telling you that it is not, and that in particular, female entrepreneurs in the space are not okay. They are starving at their growth round phases. We have to get out of the cycle of founding early stage after early stage after early stage, and then handing them over to either pharma or mostly male founders.
I’m sorry to say it, to vacuum them up and often separate them from people who have Daisy’s spark and passion, because we need that founders spark to stay attached to these things, to really take them to the finish line. The last time we took a drug that was just developed specifically for women from scratch, from concept to market, was the birth control pill in the 1950s that predates the VC industry by decades.
The VC industry has actually never done this from start to finish. What I would argue is that the next huge exit that is in the distance for VC in this room is someone who will have the bravery to give Daisy $1 billion for her next startup.
Morin
Almost want to end on that. But we can’t go without a man asking a question. We have two. Oh, here we go.
Audience Member
So first question would be for Daisy. So let’s say you could talk to the or CMS or even like the AMA team creating CPT codes. What would you want?
Robinton
That’s good. I don’t want to get into super hyper specifics, but I actually have a list of about 20 indications that aren’t captured in the current ICD codes. Often what’s done by clinicians is they sort of jerry rig and like pick a different ICD code that loosely approximates what the condition is that allows to get the reimbursement. It’s a mapping of what are the codes that are used for the conditions that we understand. Then there’s the wish list of codes that just don’t exist at all, partly because the conditions themselves, the diseases, the indications don’t have high enough resolution for a proper diagnosis. So it’s kind of a two part.
Audience Member
It would be great to have that list. The second question would be for Bailey. So one of the preventive screenings that has the lowest uptake is actually screening for breast implant leak after implantation. I’m wondering if you think that, what you’re doing could be an opportunity to address that low uptake preventive screening.
Renger
Yeah. 100 percent. Ultrasound is actually was recommended for that instead of mammography. That’s a younger market too. So that’s definitely something that we’re working on.
Morin
Last one.
Audience Member
This one’s for the whole panel. Given some of the challenges that you described, language, established norms, what are some of the things men can do in daily life to to support the great health care correction as friends, as fathers, husbands. What are some things you’d like to see more of?
Robinton
I think asking questions and giving space to women is a really easy one in any room. Whether that’s at your dinner table or in places like this. I think a lot of female people have felt that we’ve not only been silenced, but a lot of times we’ll say something and then ten minutes later, a man will say it and they’ll get credit for the idea. Just so annoying. It’s really understanding that we have something to say, and it’s actually quite powerful, and if only anybody would listen, then everyone would benefit from that. That’s probably my strongest takeaway. Second to if you have money, please put it into this field.
Van der Walt
I’ll say as a partner, my husband can tell my symptoms of low iron before I can, and he has my iron in his, like, favorites on a very popular shopping app. I’ve run into anemia or low iron, low ferritin at time and time again since I was a teenager. It takes me a good two days to catch on to it. I’ll be wired, but I can’t sleep. I have dragging, I get irritable and he just goes, you know, I’ve got you. If you can like, look, interpret, collect your own data support. Where we model this is in pregnancy where the partner gets really elevated to be the support system. There’s so many other stages in our life where we need that.
Morin
Bailey, did you have an,
Renger
I would just say probably investing in women’s health and investing in women founded companies that are led by women. I know we didn’t want to focus on this, but the reality is most of venture capital dollars are in the hands of men. Just listening and, actually acting and investing in those companies does make a difference.
Robinton
I just want to add one more thing that I thought of that relates to that, which is when you have the option to bring a decision maker to the table, let that person be female.
Morin
Wonderful. Unfortunately, we have to ended up there. I think they’re going to put us out of this room. Santa, please give a warm round of applause for Daisy, Bailey, Roma. Thank you guys.