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Alto Pharmacy Technician

Alto Pharmacist

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Blog | Alto Pharmacy

Why We Prioritize Diversity at Alto

The Alto team has been growing quickly, doubling in the last 6 months, and we are thinking a lot about the importance of diversity to building a world-class company. We are putting a lot of time and energy into making sure we build a diverse team and an inclusive culture, and one of the foundational discussions we’ve had is why diversity matters to us. Aside from the fundamental ethical reasons, having a diverse team is particularly important for us as a healthcare company because it allows us to to empathize with our patients, innovate on our product, and hire the best teammates who share our values.

I wrote an internal post codifying how we prioritize diversity, which we presented at an all-hands meeting, and subsequently in every new hire’s onboarding.

I’m sharing this publicly in hopes that it can help frame how other companies discuss the business case for diversity.

Most of any success I’ve had comes down to luck. My family prioritized education and had money to spend on it. I went to an elite prep school, then MIT, then had my first ever job at Facebook. Each step led to the next, with a lot of help along the way. In my time in Silicon Valley, I’ve seen the limits of my well-off, millennial, straight, white, male perspective. I’ve seen the ways that my type of privilege leads to the proliferation of companies building photo sharing apps and other tools that make life easier for the 1%. The massive changes in technology in the last decade have dramatically increased my quality of life, but those who don’t share my privilege have not seen nearly the benefit. Healthcare is clearly broken and hasn’t seen many improvements from improving technology, and many of those most affected by bad healthcare are also the most underserved by the tech industry. We founded Alto to use our backgrounds in tech and our skill sets to try to give some of the benefits of technology to those underserved by the current state of the healthcare industry.

I can have a hard time understanding the thoughts and feelings of our diverse patient base, given my life story and the fact that I’ve never had prescriptions. In the early days of Alto, we primarily dispensed birth control. We thought it was a good beachhead market of young, tech-savvy users, with a long lifetime of monthly refills. We discovered very quickly that birth control has a lot of different brands, some much more expensive than the generic equivalents. I assumed everyone would want the cheaper form, given that they have chemically identical active ingredients. Fortunately, though, some of our earliest teammates were women, and they helped me understand that when dealing with hormones, small differences can really affect how you feel. We then asked our patients about side effects they’d encountered switching to generics and found out how common these issues really were, and how frustrating it could be when the pharmacy tried to switch them to a generic. Now, we make sure to stock every brand of birth control.

In trying to empathize with our patients and my teammates here at Alto, I have seen firsthand the benefits of a diversity of backgrounds and perspectives. We realize that we are a company founded by millennial white males from relatively privileged backgrounds. This makes it even more pressing that we focus our energy on building a diverse team and inclusive culture.

Diversity means many different things to different people, so I think it’s important to define exactly what we mean here. What we’re really after is diversity of thought and skills applied towards a singular mission with unifying values. It’s not always easy to know whether someone has a different way of thinking about the world, so we often use proxies to accomplish this. By attempting to build a team with a broad representation of ability, age, education, gender, race, ethnicity, religion, sexual orientation, socio-economic status, and personality type, we can hopefully build a team that also brings a diversity of thought and experiences.

As a pharmacy, we have one of the most diverse user bases of any product. Almost everyone uses the pharmacy at some point in their life, and so the population of people that we serve is just as diverse as the entire population. We serve patients of every age, race, religion, gender, sexual orientation, ability, and socio-economic status. Having a diverse team allows us to understand and empathize with the people Alto serves. We are building the best pharmacy for everybody, everywhere.

One of our core values is “Patients come first,” and in order to truly embody that value, it is imperative that we have a diverse team. Whether we are designing a new feature to improve our fertility onboarding flow, or talking through a complex prior authorization with an elderly medicare patient who knows English only as a second language, having a diverse team helps us to put ourselves in our patients’ shoes and empathize with their challenges.

As a healthcare company, we are often interacting with patients when they are at their most vulnerable.

We have a responsibility to our patients, and the best way to serve them is to be sensitive to their needs and experiences.

Real innovation happens when you combine people from diverse backgrounds, with different skill sets, to solve a hard problem together. Research has shown over and over the positive effect of diversity on innovation (here, here), and diversity played a key role in many of the greatest inventions of all time. The transistor, a critical building block of the modern computer, was invented at Bell Labs in the 1940s, by a diverse group of scientists and engineers. According to Walter Isaacson,

“The lesson of Bell Labs is that most feats of sustained innovation cannot and do not occur in an iconic garage or the workshop of an ingenious inventor. They occur when people of diverse talents and mind-sets and expertise are brought together.”

Fixing the broken pharmacy industry is an extremely difficult challenge, and we will need a broad range of people, with different ways of thinking, to help solve it. An engineer can quickly write code to automate a tedious task that a pharmacist has to do everyday, like looking up patients to reach out to those who may want a consultation. A pharmacy technician can easily help a designer figure out what the right packaging looks like for fertility ancillary items. By building a team where people with different backgrounds, skill sets, and ways of thinking collaborate daily, eat lunch with each other, and form relationships, we enable more of these interactions, where teammates help solve each other’s problems from different perspectives.

We have hired many of the best people from the tech and healthcare industries, from many different backgrounds. We want to keep doing that.

Most A-players who share our values do not want to work on a team as the only member of a small minority. Neither do they want to work on a team of only people like themselves.

By recruiting a world-class, diverse team, we are in turn enabling ourselves to recruit more world-class, diverse people. It has a compounding effect.

Many of the most talented people who share our company values of empathy, humility, and putting patients first also enjoy working with teammates with different backgrounds and experiences. We enjoy learning from each other and being open minded, and believe that we learn things from each other that actually make us better at our jobs. We feel that a diverse team makes us happier and more productive, and that the best people who share our values feel this way too.

We are all working at Alto because we care about helping people and care about making the world a better place. It is well-known the tech industry has a massive problem with under-representation. Women are under-represented by a factor of 4, and Black and Latino minorities are under-represented by a factor of 2. Women leave tech at more than twice the rate men do, and women are under-represented in leadership positions in tech by a factor of 10.

A study by the Kapor Institute earlier this year found that the primary reason women and under-represented minorities leave their jobs was due to unfairness in the workplace. At Alto, we value fairness and equality as important moral foundations, and work to promote those values in the workplace. We find it sickening to read over and over again about sexual harassment, stereotyping, and unfair treatment in the tech industry, and we want to do something about it. By actively committing to diversity and inclusion at Alto, we hope to do our small part in helping to change the industry for the better.

This post is all about the “why” when thinking about diversity at Alto, and in the future we will be sharing more about what we are actually doing to make sure that we have a diverse team and inclusive culture. We’ve put a lot of work into diversity and inclusion so far, and made some great progress, but we understand there is always more we can do and this is a challenge that will never be “done.” This post is intended only to lay the foundation for taking initiative to improve diversity here at Alto. Without actual changes this is all just talk.

As a mission-driven healthcare company, there are clearly many important reasons why we care about diversity. It helps us empathize with our patients, innovate on our product, hire the best teammates, and change the tech industry for the better. We are growing quickly, so now is the time to double down on our commitment to having a diverse team. It is not something that happens on its own, and will take a lot of work from all of us to foster the inclusive environment in which a diverse team thrives, but we wholeheartedly believe it will be worth it.

ScriptDash is a modern pharmacy that delivers your prescriptions, same-day, to your home or office. We’ve automated most of what your local pharmacy does and we deliver. It’s pretty rad.

My First Week at ScriptDash

Beginnings are special. After four amazing years building the Optimizely rocketship, I’ve begun a new journey with ScriptDash.

A Slack bot posts every NPS survey response we get from a patient that’s just received a delivery. Throughout the day these will light up Slack, and they’re a joy to read.

What’s struck me most this week is how deeply everyone here cares about patient outcomes and improving healthcare. The current system is outdated. Broken. It not only causes millions of headaches, it also costs thousands of lives. Hundreds of thousands, in fact.

When people don’t take their medication as directed (or at all), the results can sometimes be fatal. This is called non-adherence. The CDC says non-adherence causes 125,000 deaths annually, or ~340 deaths per day. How does this happen?

The patient isn’t able to get to a pharmacy on time, safely, or at all.

The patient can’t afford the copay because their doctor inadvertently selected a drug that wasn’t covered by their insurance.

The patient can’t afford their meds because the pharmacy didn’t apply a coupon making the drug free or affordable. This coupon process is murky and manual.

The drug prescribed isn’t covered by insurance and requires special approval (“prior authorization”) from the insurance provider. Either the pharmacy or the doctor dropped the ball in this manual, shitty process, and the patient never got their prescription.

The patient didn’t take their prescription as-directed because they were given multiple meds with different instructions (this can be confusing!)

ScriptDash is a pharmacy built for 2016, from first principles, as a software company. We’ve built our own Pharmacy Management System that lets us solve patient and doctor issues that have been lingering for decades.

We automagically find and apply relevant manufacturer drug coupons, prior authorizations, and renewals. If there’s an alternative medication that’s cheaper or covered by your insurance, we’ll contact your doctor to switch the prescription.

We offer same-day delivery to your home or office via our own fleet of in-house couriers so you don’t have to burn time at the pharmacy waiting. Many people can’t get to a pharmacy safely or at all because of their work hours, and this makes a huge difference in their lives.

Others had same-day surgery or are suffering from ailments that limit mobility or energy.

We offer SmartPacks that group multiple drugs into easy-to-take little packets. It’s pretty cool.

When I’ve explained ScriptDash to a few friends, they think we’re just picking up your prescription from a regular pharmacy. We are the pharmacy! No pickup! Just delivery! From our pharmacy!

We love software engineering, operations, design, pharmacy, and pizza. Every other Thursday we volunteer at the nearby SF Marin Food Bank. This week our group and a number of others re-packaged some 3,000 lbs of cashews. Hella nuts. It feels good to do good.

Most of the hard work lies ahead of us. We’re looking for a few more good humans that want to explore the intersection of software, logistics, and healthcare. Check us out or say hi the cool way:

// Send a POST to https://www.scriptdash.com/careers/apply
{
  "name": "Your name",
  "about": "Tell us about yourself!",
  "email": "Your email address",
  "links": [ "link to your resume", "link to anything else cool" ]
}

Blog

Why We Prioritize Diversity at Alto

My First Week at ScriptDash

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