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No One Cares More About Your Health Than You: Part 1

Written by Andrew Le, MD

PublishedJuly 8, 2021

Welcome to the CEO Corner, where Buoy CEO and Cofounder Andrew Le, MD sits down with industry leaders to chat about the provocative topics of healthcare today. Andrew recently spoke with Anne Wojcicki, the cofounder and chief executive officer of the personal genetics company 23andMe. They discuss the company’s genesis, how growing up in an academic community fostered her life-long curiosity, tips for collaborating with the FDA, and the importance of empowering individuals to participate in their own healthcare — even if it means getting bad news.

This interview has been edited and condensed for clarity.

Andrew Le, MD: Everyone knows who you are, but could you tell us about your story?

Anne Wojcicki: I’ve always loved science. I first learned about genetics when I was quite young. I remember waking up in the morning and thinking, “Wow! We have this machinery that works because of a code. My heart and kidneys work, but I'm just a guest who gets to hang out in this body. I don't even have to manage it.” I’ve always loved that.

After I graduated college, I entered the investing world. Learning about everything from nursing homes to biotech companies to xenotransplantation was fascinating. At the same time, I became increasingly disheartened by how the healthcare system worked. The more I talked to CEOs, the more I realized how much moneymaking comes from people being sick.

I wanted to do something that was in the best interest of us, the people. It seemed the individual didn’t have a voice in healthcare and was often taken advantage of at vulnerable times. I learned a lot from HIV/AIDS activism, and the rebellious spirit that moved people to drive change.

The idea for 23andMe came to fruition when human genome sequencing became cheap enough. At the same time, online social networking was rapidly advancing. Low-cost genetic analyses made it possible to crowd source and bring people together. My dad, a physicist, says science lives on big data. If you want to understand the human genome, it’s a simple math problem. How many humans do you need to understand what exactly the genome means?

So 23andMe started with the idea of empowering people with the potential of genetics and engaging them in this quest to understand the essence of what it means to be us.

It seemed the individual didn’t have a voice in healthcare and was often taken advantage of at vulnerable times.

Anne Wojcecki

Andrew: I love hearing about the genesis of the company. What do you like most about your job?

Anne: It's the people. They are all experts in their areas, and I learn from them every day. Everyone should have a job that teaches them something every day. If you are no longer learning, you should quit. I want our people to always keep learning, too. It’s critical to provide that kind of environment for them.

Andrew: I read an article about you and your family. Everyone is so accomplished. What was it like growing up with that group?

The Wojcicki family: sisters Janet, Anne and Susan in front, Esther and Stanley in the back. [1]

Anne: My dad's a Polish-born physics professor. My two sisters and I grew up among academics on the Stanford campus. There were several families that also had three girls of similar ages, and we’ve remained good friends. The common thread between the culture I grew up in and the culture of our company is the hunger to do interesting things while pursuing knowledge.

Everyone I grew up with was interesting. My best friend's father was a law professor but pivoted to focus on the environment. Another friend's father—a physician and oncology researcher at Stanford—said, “If you have to do something every day, you might as well love it.” That’s when my love of learning and passion for pursuing interesting projects—and research—began.

We grew up around scientists and our mom, a social butterfly, so we dealt with all kinds of personalities. The way I manage the company is similar. There are different phenotypes, and people want to work in different ways.

Andrew: I was reading Measure what Matters, which is one of our favorite books at Buoy. It tracked your experience with the FDA. Because more companies in digital health need to work with the FDA, what advice would you offer for a successful collaboration?

Anne: I learned several important things about working with the FDA. One is that governments and policies always change. For instance, at first they didn’t want to regulate us. That mindset has changed. We’re currently dealing with the question of whether laboratory-developed tests must go through the FDA.

Also, there is a formal element to the process and culture of the FDA. I used to take selfies when I visited their building until a security guard told me they weren’t allowed. I would communicate informally, and that was frowned upon. When you work with the FDA, you do what you're supposed to do. They would request analysis on 20 samples. We would present data on 17 samples, along with the reasons we didn’t need 20. They had zero interest in that. You do what they say. So, I had to learn obedience—and I hired people who knew what they were doing.

Andrew: People who start companies are generally willing to break the rules and push the boundaries. So, it sounds as if the FDA runs counter to that core instinct you have.

Anne: I have a lot of respect for the FDA and how they see the big picture. They need to ensure public safety. At the same time, there is an ability to innovate and to grow with them; you just need to back it up with data.

In Part 2 of the conversation, Anne talks about how her company builds trust with customers by being honest about their mistakes — even when it comes to their own DEI&A practices. She shares her predictions for the accessibility of science and how 23andMe has successfully supported difficult conversations about health. She goes on to share her perspective on why individuals should have access to their own genetic results and discusses new areas of the business she's interested in pursuing.

About the participants:

Anne Wojcicki is the cofounder and chief executive officer of the personal genetics company 23andMe.

Andrew Le, MD, is the CEO and cofounder of Buoy Health.

[1] Image courtesy of Anne Wojcecki, courtesy of CNBC. https://www.cnbc.com/2018/06/18/how-the-wojcickis-parents-raised-23andme-founder-youtube-ceo.html