Amy Fan is the co-founder of Twentyeight Health, a mission-driven women's health startup. Her company’s goal is to make reproductive and sexual health accessible to all, starting with birth control. Her team has built an online telemedicine platform where women can learn about birth control, have online doctor visits, and get birth control delivered to their homes.

They are currently operating in six states and looking to expand coverage to the rest of the United States. We spoke to Amy to discuss her startup journey, perspectives, and personal life philosophies as a female founder. 

Jenny Zhao: So tell us, how did you first come up with Twentyeight and what was your journey prior to starting the company?

Amy Fan: My cofounder Bruno Van Tuykom was inspired by his work at the Gates Foundation. He saw startups in Kenya and Rwanda that were leveraging telemedicine to provide affordable reproductive health care while overcoming stigma. Bruno was interested in leveraging this model in the US where we have so much infrastructure that they’ve become barriers preventing women from navigating and accessing proper care. 

My journey to Twentyeight was more circuitous. Previously, I was the General Manager of a DTC skincare startup in New York and I loved working on the consumer side. The fun thing about beauty is that you get really deep into understanding your users. What are your users’ needs? What are their lifestyles? Their pain points? Every step of the product development process is really created in service of your users. But that’s something that’s very different in healthcare. 

I grew up in Vancouver, Canada with a vastly different healthcare system. I remembered trying to see an OBGYN in New York and finding it incredibly difficult because my insurance plan had very limited in-network options that took new patients. I thought to myself “There must be a better way to do this”. I left my role and pursued an MBA and a Master in Public Health at UC Berkeley, which is when I connected with Bruno. My boyfriend, who was also at UC Berkeley, had worked with Bruno at the Gates Foundation and BCG. I was excited by Bruno’s idea and the opportunity to leverage my consumer experience in healthcare. I had started my career at Bain as a consultant, and working together, Bruno and I took a consulting approach to identify where the gaps in healthcare were, identify existing needs, and determine what was appropriate for telemedicine. And from there we slowly created Twentyeight Health.

Our mission at Twentyeight Health is to increase access to reproductive and sexual healthcare focused on under-served communities where there are the biggest gaps in care. We started in telemedicine for birth control and are active in 6 states. In these six states, we are the only online provider that accepts Medicaid. Medicaid provides much needed coverage to reproductive and sexual healthcare, but it can be really difficult for individuals to figure out how to navigate it. For example, one in three doctors in the US do not accept Medicaid, so even if you want the care, it can be difficult to find an accessible option.

Jenny Zhao: That’s amazing that Twentyeight takes Medicaid. Are you planning on expanding your services into other states? 

Amy Fan: We have been expanding to new states throughout our company’s lifetime. We launched in December 2018, starting in New York and New Jersey. Then we added Pennsylvania, along with Florida, Maryland, and North Carolina. The plan is to continue with the expansion in order to serve as many women as possible, but always being thoughtful so that underserved communities are included. Despite many innovations in digital health, an issue that persists is that many telemedicine services are being built only for people who have a high ability to pay and this is what we want to change.

Jenny Zhao: What was it like running a young startup from the ground up? How did work impact your work-life balance?

Amy Fan: That’s a great question. One of the reasons why I left my previous startup job was because it was getting to the point where I felt burnt out. I had started off my career in management consulting, where I was used to working 60, 70 and even 80 hours per week. As a GM of an early stage startup in my mid-twenties with few responsibilities outside of work, I whole-heartedly dedicated my evenings and weekends to working. 

I was in a fortunate position to be able to take time off between jobs and I used the break to reflect on what a sustainable work-life balance would look like for me and for others who are in different life stages. I don’t subscribe to the idea of working to live or living to work. For me, I’m someone who really enjoys work, and wants to get meaning out of it. 

With Twentyeight, my cofounder and I have the opportunity to not only build a business, but to shape a working culture. Inclusivity is one of our key values, and our goal is to create meaningful roles that are sustainable for folks across different life stages. We want people to feel like it’s a place they can work at sustainably and not just for people in their early twenties who might be able to dedicate a lot of their time because they may have fewer responsibilities outside of work. Sustainability can mean different things to different people, and at our startup’s stage, we are able to provide a high degree of flexibility. 

For a lot of startups, I know that they move fast, break things, and work a ton of hours to get things out — which can work in some industries. But that doesn’t work in healthcare because at the end of the day you’re dealing with peoples’ lives, and you just can’t launch something without having fully tested it. 

Many of our team members were attracted to Twentyeight because of our mission. To express the impact every member of the team is making, we share user feedback during our all-hands meetings every Friday. This is my favorite part of the week because it reminds us why we are doing this: we’re bringing accessible services to women, especially during COVID-19 where many women have lost their jobs and health insurance, but they were able to use Twentyeight to get needed care. Those are the times where it feels like what we’re doing matters and what we’re doing is helping people on a day to day basis, which is another piece of building workplace sustainability. 

Jenny Zhao: Speaking of rejuvenating, as a founder do you have any self-care practices you take part in?

Amy Fan: For me, working from home has made self-care easier to incorporate daily. I try to do a quick 10-minute yoga session every morning to feel fully present before jumping into my inbox. This is a definitely silver lining of working remotely. As an introvert, I appreciate being able to take a few minutes between meetings to go stretch or meditate in order to slow down and refocus for the rest of the day. I think having the flexibility is nice compared to the usual work environment. 

Jenny Zhao: Do you have any personal healthy living practices for yourself? 

Amy Fan: One of the things I do with my high school friends every year over the holidays is to set New Year's intentions - not goals! The idea is that you pick a perspective you want to adopt for that year. Rather than feeling like you have a to-do list to check off, you apply that perspective to your typical routine and see what might feel different. My New Year’s intention for 2020 is to incorporate the idea of “play” into my day to day life. It can be in many different ways like telling a funny story at the beginning of a meeting or karaoking to my favorite 90s jams while getting ready in the morning. It’s about bringing in those little elements. I think it’s helpful for me because I’m such a goal oriented person in other parts of my life and setting wellness goals was adding more pressure to myself. I prefer adopting an intention because I'm not trying to add more things into my day, but instead I go through ordinary days thinking "How can adopting this intention change what my day looks like"?

Jenny Zhao: Going off values, is there someone who’s informed your core philosophies and mantras? Who’s taught you the most in life?

Amy Fan: My aunt Evelyn has been one of my biggest influences on my outlook on life. From sharing how one of her favorite childhood snacks is fried flour — because they didn’t have any food other than flour and water at home — or how she loved going to the beach at sunset — because they could not afford the fees during the day — she focused on the positive aspects in every story she recounted. There were a lot of things that she could have thought were lacking in her childhood in terms of the opportunities available to her. However, she always kept a very sunny outlook on life. 

When I was younger, I didn't fully understand or appreciate it, but now that I’m older, it’s something I try to think about daily. I feel grateful for the job I get to do — not everyone gets to work at a place that’s mission-driven and where you get to create the organization’s values and culture. I think that positive overall perspective has been the most significant influence on me yet especially as I’m building up Twentyeight.

Follow Twentyeight Health’s journey here.