In this interview, Jeff Tangney, co‑founder and CEO of Doximity, explains why he repeatedly builds physician‑focused software, tracing his journey from the early mobile drug reference Epocrates to the current secure professional network Doximity. He describes Doximity’s core value proposition: a secure, HIPAA‑compliant platform that lets doctors find experts, share contact information, manage on‑call schedules, and exchange messages—including eFaxes—saving time and improving care. Tangney shares vivid use‑case stories, such as a pediatric emergency where rapid medication information was delivered via the app, illustrating the life‑saving potential of fast communication. He discusses the company’s business model, likening it to a LinkedIn for physicians, with revenue generated from recruiter services that provide curated job listings to doctors. Tangney also outlines Doximity’s API and OAuth 2.0 login, enabling third‑party apps to verify physician credentials and pull profile data, thereby increasing platform stickiness. Throughout, he emphasizes a philosophy of building products that save time, make money, and improve care, while critiquing the broader healthcare IT landscape’s focus on administrative efficiency over physician efficiency. The conversation touches on interoperability, the future of individual‑driven medical communication, and Doximity’s growth metrics (over 220,000 U.S. physicians, 30,000 secure messages per day).
Chapters
Ladies and gentlemen, please welcome Jeff Tangney and David Sheawitz. Excellent.
Are we between everybody and dinner or something like that, or drinks?
Well, I think we are holding the group back from cocktails, which we're very cognizant of.
All right, so here's the thing that intrigues me. Silicon Valley is not always known to be super friendly to physicians. I've heard from Shamath that we're— everything about physicians is suboptimal. Their systems are suboptimal. The people are suboptimal, but he used a different word. I heard from Vinod that we're sort of poorly performing algorithms. On the other hand, you, for the second time in a row, have created this new business that's focused on the customer the physician as customer. So is this sort of an act of charity, an act of pity? How did you get involved?
Well, thank you, David. It's not an act of charity. We've done very well focusing on physicians, and to Vinod, who says that half of physicians are below average, I would say 75% of venture capitalists lose money, so you can take that. Yes, this is my second time around on a physician-focused software startup. I guess I'm surprised more people aren't focused on physicians. I mean, let's face it, people, we don't have a hospital administrator shortage. We have a physician shortage. And yet it seems— and I loved the extorminy presentation earlier— but it seems like so much of our investment in health care IT is around making administration easier, more efficient, as opposed to making physicians more efficient. So I didn't have much of a choice. I had 2 physician roommates at Stanford, and I was a Palm Pilot guy. Amateur programmer and database guy. So they more or less held me down and made me produce Apocrates.
So the thing that was— I remember when Apocrates came out and I used it as a med student, I think, and as a resident. And what was remarkable about it is that it wasn't fancy. It wasn't all sorts of graphics flying around the place. But it was just incredibly useful, sort of the way that UpToDate isn't very elegant, but it's really, really useful. So is that sort of the sensibility that you've tried to bring to Doximity? Maybe, I'm not sure if everyone knows what Doximity is, but do you want to explain it?
Sure, sure. So Doximity is the leading secure professional network for physicians. We provide a place where physicians can find experts. So we had one the other day who had a patient who was bit by a lab monkey, and the lab monkey had been infected, and there were maybe 5 people in the world who would know what to do with this zoonosis, and they were able to find 3 of them on Doximity searching for that zoonosis, send them a note and get advice, which was great. We also find— provide a place for doctors to manage their schedule and contacts. So once someone has their on-call schedule on our product, we see that they use it very frequently. And just their contacts, just keeping track of who your colleagues are, and you know, the 200 or 300 different physicians an average a primary care physician will deal with in a year. I'll tell you, part of my inspiration, early inspiration for Doximity, was while at Epocrates, we were out talking to doctors, one of whom still had a Palm Pilot, and this was in 2007, 2008, and I said, "Well, you know, when are you going to upgrade? You know, there's this new thing called the iPhone." And we had been on stage with Steve Jobs, and we were really pushing the iPhone. And she said, "Well, the problem is, every new partner who joins our practice"— she was an endocrinologist— "what we do is we have this great contact list here on the Palm Pilot, beam it over to everyone else. And so they needed to keep using the PalmPilot just to keep track of, in effect, their referral list and phone numbers of other physicians. So today on Doximity, that's been one of the surprise hits. We have over 220,000 U.S. physicians, 5 million different colleague connections between them, but a third of the time, doctors will actually share their private line or their cell phone number with each other, which is just a huge— immediate utility to make it easier to have the cell phone number of that orthopedic surgeon I referred to if I need to get a hold of him or her.
I mean, one of the things that's sort of so crazy to me about all this is, you know, the killer app for— so this killer app for Doximity is a fax, right? Is you're actually able, because of all the HIPAA laws and stuff, for physicians to communicate, they can't just, you know, email or text. You have to fax things to each other. And so by enabling physicians to to do that, you're able to— that's the sort of—
That's one of our philosophies. David is a physician, for those who don't know. Yes, we began wanting to be a secure texting company, and we failed. What we found out was being a secure texter required you need to have everyone else you needed to text right away, and it was more urgent. So then we moved to more secure email, and that was going better. We have a lot of secure emails. But now we do 30,000 secure messages a day, doctor to doctor, and for better or worse, about half of those are actually faxes. And so we give doctors a way that they can receive an eFax or send an eFax. They can actually sign it right there on their device, and that's a big time saver. And again, I keep coming back to this, but, you know, Hippocrates used to say there are 3 things you had to do to have a successful product. You had to save time, make money, and improve care. Ideally, all 3, at least 2 of the 3, And I can't tell you the number of companies that we would meet with, talk to, who wouldn't do more than one of the three. And at the end of the day, doctors are just very time-strapped, busy, busy people. So I think one of the key things we've done is just made it faster to communicate, and that's a big, big overhead in the system.
And so do you feel like you are, by doing that, you were— the other day we were talking, you sort of gave a— I thought it was a pretty compelling use case of where of all things, the ability to share information rapidly by fax, turned out to be influential for someone in the ER, was it? Sure.
We get a new case a week that one of our members will email us with. My favorite lately is we had someone at Oakland Children's Hospital that had a 6-year-old girl who was coding. I mean, she was dying. She was an epileptic, and he needed to know what medication she was on. And typically, that would take several steps of going and calling and trying to find someone and getting it faxed over and sent around. And on his iPad right there, he was able to message over and get a message back with the medication list and give her the medication she needed. So that's what gets us up in the morning. I mean, it's really trying to cobble together this Humpty Dumpty system we have. I'll tell you, I know Fazal Masashar is here. He said one of the best quotes on this I've heard in a while. It was a few weeks ago. He said, "We can't make it profitable." to hoard patient information. We cannot make it profitable to hoard patient information. And yet this system, which really isn't a system, it's a market, this healthcare market that we're in today, it is profitable to hoard. So we're taking a different tack than the HIEs and some of the EHR interoperability initiatives, which I also hope are successful, and we're going, really, with the power of the individual, the individual doctor who wants to do the right thing for that patient, who is at risk of being sued if they don't do the right thing, who today wastes a lot of their day just hunting down what one healthcare receptionist, she called the 404 errors, you know, the file not found, which happens all the time.
So do you worry at all that to the extent you're sort of building on this sort of a—
on sort of this—
the fundamental properties of sort of an antiquated and hopefully soon-to-be obsolete system by allowing people who are dependent on it to do things a little bit more efficiently. But does it threaten to be— if there really is fundamental change, are you going to be sort of disruptive? Are you sort of scavenging on the problems of the system today? Oh, we can't communicate because we—
Well, here's the thing. Even if we had one EHR that ran the whole country, there would still be the need for individual messages person to person. And we're certainly far away from one EHR to run the whole country right now. Um, Daniel Pink, I know, wrote a book called "Free Agent Nation." He talked about industries would be transformed by the Internet. And they have. Journalism, Hollywood, you know, it's really about the individual contractor with their expertise, knowing what they know, contributing to the project, not having to worry about whether or not I work in the New York Times newsroom or not. I can contribute from wherever I am because I have the Internet and email, and I can do that. I think medicine will get there. It does require authenticating every person, every node, and that takes us a few days per doctor to go and authenticate everyone and then encrypting it. But we've done it in finance. We've done it in other places. I do think it will be disruptive, to say the least, when physicians are just as easily able to share lab records no matter what other doctor you've seen.
So in a sense, you're creating this peripheral— or this peripheral system that's able to allow doctors at least to share information with each other and sort of make their lives easier. But what's interesting is the way, at least my understanding is that the way you make money now is sort of like LinkedIn for doctors. Is that right? So maybe explain that a little bit.
It is. So two things. First, back to communication for a moment. Warren Buffett has a good quote, which is that healthcare is the tapeworm on American productivity. You know, his view— I mean, being an investor in Coca-Cola and GM, he sees the healthcare costs, you know, spiraling. And I would argue that if healthcare really is the taper around American productivity, then medical communication is sort of the compound fracture. It's so obvious, it's so out there. You see the fax machine humming. It really is a big pain point compared to other systems. So now the how we make money. This is a West Coast audience, so I assume no one cares about monetization.
Organization, but we could—
we could at least talk a little bit about— We're doing pretty well. We launched here 2 years ago at Health 2.0. We've been mainly focused on, again, saving doctors time and growing our user base. We're over 220,000 now, every specialty, every hospital. Earlier this year, we started piloting working with recruiters, mainly hospital system recruiters. There is a physician shortage. People are trying to recruit physicians. And it's been going really, really well. I don't want to go into too many details about this. We are going to be announcing some client milestones shortly. But suffice it to say, we're, you know, on track to turn a profit at our current expense rate, you know, next year. And the best part is, I think physicians have actually enjoyed the service. That's why we tested it first. Today, if you're a physician and you're looking for a new job, a career, you would have to go to a job board. Which hasn't evolved much beyond, you know, the back of the journal classified ads. It will say something like, "Here's a job within 3 hours of hunting and fishing and competitive salary." And that isn't very helpful to you. By making the recruiters not have more than 30 messages a month, we require them to put the salary, the call duty, and the location of the position into the actual, you know, core text of the email. We've had really good responses from doctors. It's a way for them Even if I'm not interested in the job, I know what an interventional cardiologist would make in Texas now, and that's interesting to me. So they view it as a value-add.
And so it's definitely the— exactly the Daniel Pink turning everyone into free agents and empowering them. But does that give you really the headroom to kind of get the exponential growth you really kind of want? I mean, how many people can you get, and how much disruption— more disruption can you have in the physician recruiter market? I mean, do you get to become the next LinkedIn by disrupting every last physician recruiter?
Well, I'll say this. It's plenty of headroom for us to be, I think, a profitable, sustaining, ongoing business. And so we can focus on our social mission of giving every doctor a free eFax, which will hopefully become free secure email as more and more of them join. But it's just the start of what we'll do financially. I think there's plenty of other systems around sharing data and being that— I think that Visa for healthcare, the company that keeps the network authenticated, in control, encrypted, but allows patient data and secure messages to move.
In the last 30 seconds, you want to just say you had a pretty interesting announcement today about your API. Do you want to say something about that?
Yes. So we do have a login with Doximity API. It's been available for several months in beta. We're now launching it. We announced it earlier today. We have over 50 different API partners on it. If you are setting up a new app or a site and you want a quick way to verify that someone is a physician and know where they're state licensed and know what their research is and have a nice full CV on them without having to make them go through this full hideous registration process—
Because you already did that for them.
We've already done that for them. We, you know, have nearly a third of U.S. physicians already as active members. You can just put that login with Doximity. It's OAuth 2.0. It's a very very straightforward.
And the cool thing about this, as I understand it, is that it's not really part of your direct monetization strategy. You're not making money off this specifically, but you're just using it to encourage other people to use the resource to make it more sticky, and then to encourage more users and to sort of then to monetize it that way.
Yeah, it's very much like Facebook Connect or other OAuth strategies.
All right, well, thank you so much. I see Matt out there, so wrap it up. Great.
