Nov 22, 2024 · 1h 4m · more-or-less
#74: Winding Down From a $400M Fundraise, or How to Move Forward After Forward (with Adrian Aoun) · More or Less Podcast
Adrian Aoun · 31m spoken Jessica Lessin · 11m spoken Dave Morin · 10m spoken Brit Morin · 5m spoken Podcast Theme Singer · 16s spoken
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gold bands on the timeline = statements, start to end. Hover to read, click to jump. CC turns on captions
In this episode of More or Less, hosts Jessica Lessin, Brit Morin, and Dave Morin sit down with Forward founder Adrian Aoun for an in-depth post-mortem on winding down his $400 million healthcare startup. Aoun reflects on the structural obstacles of the healthcare industry, the ethics of 'landing the plane' during failure, and why audacious innovation remains essential.
How this conversation actually went
Every chapter scored 0–10 on four independent dynamics. Hover any point for the reasoning behind the score. The hosts hold 46.3% of the talking time here. How this is scored →
The hosts as informed peer 3.7 Guest teaching 4.0 Guest disagreement 3.1 The hosts pushing back 3.1
speaking balance: gold is the hosts, purple is the guest (3 minute bins)
Sharpest disagreement ▶ 41:45 Adrian rejects learning the existing healthcare system
Adrian sharply dismisses Dave's question about mastering the legacy system, comparing it to Larry Page studying the Dewey Decimal system before creating Google.
Hardest push from the hosts ▶ 51:00 Jessica challenges Adrian on Silicon Valley arroganceJessica refuses the cozy founder praise, directly confronting Adrian with the broader public critique that blowing $400M on audacious failure reflects arrogance.
Biggest teaching moment ▶ 37:49 Adrian schools on billing code perverse incentivesAdrian details how healthcare technology adoption is entirely trapped by billing codes, recalling how even Kaiser's CEO could not adopt body scanners due to human billing rules.
The host holds their own ▶ 32:26 Jessica presses Adrian on Apple and Amazon buyout bidsJessica maintains journalistic discipline, grilling Adrian on whether Amazon or Apple tried to acquire Forward despite his repeated evasions.
the scores for every segment, with the reasoning behind each
| Chapter | Topic | The hosts as informed peer | Guest teaching | Guest disagreement | The hosts pushing back | Why |
|---|---|---|---|---|---|---|
| More or Less Podcast Title Sequence and Theme Song | 0 | 0 | 0 | 0 | Introduction and podcast theme song with friendly introductory banter. | |
| Navigating New York City and Equinox Hotel Banter | 2 | 2 | 1 | 1 | Lighthearted lifestyle conversation about navigating New York and Equinox hotels; Adrian jokingly offers Blacklane service tips. | |
| Big Tech News and the Trump-Musk Friendship Debate | 4 | 3 | 3 | 3 | Discussion regarding Trump, Elon Musk, and tech leadership dynamics; hosts and Adrian exchange predictions. | |
| The Forward Healthcare Journey and the 2021 Bubble | 4 | 5 | 3 | 3 | Adrian details the origin of Forward and explains macro shifts following the 2021 market bubble. | |
| The CarePod Hardware Pivot and Primary Care Sector Collapse | 4 | 6 | 4 | 4 | Adrian explains why clinic economics failed across the industry and why they pivoted toward CarePods. | |
| Concierge Medicine Realities and Unaddressed Acquisition Inquiries | 5 | 4 | 5 | 6 | Jessica aggressively probes whether Amazon or Apple tried to acquire Forward, while Adrian deflects repeatedly. | |
| Care Pods vs. Pure Software and Healthcare Billing Realities | 5 | 7 | 4 | 4 | Dave asks why Forward did not become a pure software play; Adrian explains how legacy healthcare billing code incentives ruin pure software disruption. | |
| Legacy Incentives and the Case for Revolutionary Disruption | 5 | 5 | 5 | 6 | Dave pushes Adrian on whether tech founders should learn legacy systems; Adrian forcefully rejects that evolutionary framing in favor of revolutionary disruption. | |
| The Reality of Unwinding Forward and Investor Reactions | 3 | 5 | 3 | 2 | Adrian describes the brutal reality of shutting down Forward within four hours and placing 150 calls to investors. | |
| Landing the Plane: Destigmatizing Founder Failure in Silicon Valley | 4 | 3 | 2 | 2 | Dave and Brit commend Adrian on 'landing the plane' responsibly, analyzing shame and failure culture in Silicon Valley. | |
| The Arrogance of Innovation and Adrian's Next Venture | 6 | 5 | 6 | 6 | Jessica challenges whether this attitude represents toxic Silicon Valley arrogance; Adrian vigorously defends needing more arrogance and audacious bets. | |
| Rejecting the Zombie Company: Doubling Down on the Future | 4 | 5 | 4 | 2 | Adrian explains why he rejected turning Forward into a low-burn zombie company and discusses planning to go cold. | |
| Guest Farewell: Reflecting on Forward's Broader Impact | 2 | 2 | 1 | 1 | Wrapping up the episode with warm reflections on Forward's inspirational impact on other founders. |
Statements from this episode (24)
Levchin backed Aoun's NLP startup provided it avoided neural networks
“I remember pitching Max Levchin to invest and Max goes, I'm totally in. I'm all for this company. As long as you tell me you're not using neural networks, because those things don't work. And I'm sitting there thinking all we're using is neural networks. And I…”
Aoun: Trump and Musk will be less close in four years
“I'm going to go with less because I think at some point he's going to have to Roughly, you know, screw Elon, and that will create some real tension.”
Aoun predicts JD Vance has a serious chance of winning next presidency
“JD Vance is going to become president in the next election, which I think has a very serious possibility”
Morin: Trump and Musk will be closer friends in four years
“I'm gonna take the more on this. I guess all the things you've all have said are quite true. I think he's a pragmatic long-term player. Elon and likely, I think just what you said earlier is probably true as well that, you know, it's hard to find friends when …”
Morin: Tesla Optimus is marketed to consumers but is military technology
“They're pitching it as a consumer thing, but it's very clearly military technology.”
Aoun: Forward raised $225 million in 2021 at super high prices
“We raised two hundred twenty five million, super high prices. And you got to remember the world has corrected from there.”
Aoun: Purely virtual healthcare companies like Teladoc will not succeed
“All these virtual care companies that took off during, call it, you know, 21 during COVID all those Teladocs of the world, I said, they aren't going to be able to succeed in the long run. Because fundamentally, healthcare is physical, right? Like, you can't de…”
Aoun: Physical healthcare clinics are not a venture-backable business model
“And frankly, what we learned is you can make clinics like a reasonable business. They're not really a venture backable business is what we found. These are not like, this is not, you're not going to go find a tech company building clinics everywhere everywhere…”
Aoun: Almost all recent retail acquisitions of primary care clinics failed
“Well, over the last kind of call it 12 months or so, pretty much every single one of those has failed. Right. And so Walgreens just completely wrote down village MD CVS. Well, you know, they just fired their CEO. You can go look at their stock Walmart, shut th…”
Aoun: Primary care is the front door to healthcare, like Google to search
“The insight is you go to Google as kind of the front page of your experience to the internet. And so any kind of downstream thing you want to do, you type restaurants, they can capture those queries. You type travel, they can capture those queries. And so that…”
Aoun: Concierge medicine ($15k–$40k/year) should not be venture backed
“I think that you can kind of bifurcate the market and you can say,
You can say, Hey, I want to go super expensive, 15, 20, 30, 40,000 dollars a year per person.
Don't venture back it.
and say, I'm going to build a nice, like slow growth, reasonable business.
…”
Aoun: Routing routine care to automated pods is highly scalable
“A doctor fundamentally doesn't need to be dealing with like your colds, your rash, your flu, your normal checkup. Like you should save the doctors for the most important complex things. And if you kind of detach them from the doctor's office where you start wi…”
Benioff urged Forward to drop hardware and sell pure software
“Benioff is one of our big investors. And I and I've known for many, many years and Benioff was like, just take this damn software. He's a software guy, right? He's a SAS guy. Take this damn software and sell it.”
Aoun: Healthcare technology adoption only occurs in service of billing
“Technology adoption in healthcare only really goes in service of billing.”
Aoun: Forward intentionally avoided becoming experts on legacy healthcare systems
“The industry of healthcare, we have never chosen to become experts on it. And kind of intentionally, right?”
Aoun: Continuing to lead people after hope is lost is unethical
“When you're asking investors, when you're asking customers, when you're asking employees to follow you and believe in you, The second you don't believe that you have a chance of success, you're being unethical and having all these people follow you.”
Aoun: I made 150 phone calls to inform investors of Forward's shutdown
“I had to make a 150 phone calls. Literally. That's not an exaggeration. One five zero phone calls to our investors to inform them.”
Aoun: Forward burned $500M and investors immediately offered next checks
“We just burned, you know, not quite half a billion dollars on an idea, and every, no, I shouldn't say everybody, but a lot of people's reaction is, What are you doing next? Let's do it again.”
Aoun: Silicon Valley needs more arrogance, not less
“I think we need more arrogance in Silicon Valley, not less. And by that, what I mean is not this outward obnoxious be an asshole kind of arrogance, but look, it takes a special kind of arrogance to sit down, look at something like healthcare and be like, well,…”
Aoun started his next company immediately due to investor demand
“Tuesday morning after this all happened, I said, I'm taking a break. And by Wednesday morning, because the investors said they want to come in and the employees said they want to come in. I said, I'm starting a company like without, and not only am I starting …”
Aoun: Healthcare peers cut burn but have no technology or future
“The amount of peers in our space that did that, that have no tech story, have no future is pretty real. Some of them have continued because they're like, well, we don't need a bunch of money, but they're not interesting businesses.”
Aoun: I would have quit Forward rather than run a zombie company
“If you had told me to just sit in that company, I would have quit that company. Like, there's no way I wanted to sit in a company where I already don't believe in the future, but I've somehow managed to get it to continue for in perpetuity.”
Aoun: Spinning Forward's CarePod assets into a seed startup is viable
“And so I think if you took those care pods, if somebody wanted to go buy those assets, maybe me or somebody else and spin that into a new company, that's not what I'm working on right now to be clear. But if you did, I actually think that would be a good idea.…”
Aoun: Vertically integrated startups cannot easily cut burn through layoffs
“If you're in a vertically integrated business like us, like employees are a cost. Don't get me wrong, but they're not 80% of your cost, right? They're 30 or 40% at best. And so, you know, we have everything from leases to AWS contracts to you name it, and we c…”