The 3% Problem: Why Almost Nobody With Alcohol Use Disorder Gets the Medication That Could Change Their Life

The 3% Problem: Why Almost Nobody With Alcohol Use Disorder Gets the Medication That Could Change Their Life

"Recovery is possible. Treatment options are likely more diverse than you may be aware of." – Jonathan Glassman In this week's episode of Compound Wisdom, host Steve Sood sits down with Jonathan Glassman — CEO of Oar Health — to dig into one of the most personal and purpose-driven startup stories in modern telehealth: how a healthcare strategy consultant turned his own decade-long struggle with alcohol use disorder into a platform that has now helped over 75,000 people drink less or quit entirely. Jonathan shares how he went from binge drinking to blackout to finding naltrexone through a single empathetic primary care physician — and how that turning point became the seed for Oar Health. He explains why only 3% of people with alcohol use disorder ever get prescribed medication, how telehealth is uniquely positioned to close that gap, and why privacy isn't just a feature for their members — it's often the deciding factor in whether someone seeks help at all. They also get into the harder side of building in healthcare — what happened when naltrexone went into national shortage during one of Oar's fastest growth periods, how the team made painful decisions to protect existing members even at the cost of new growth, and why Jonathan sees AI as a tool for empowering patients rather than replacing providers. The episode closes with Jonathan's direct message to anyone struggling with their drinking: you don't have to wait for rock bottom, and it is never too late to start. Takeaways Naltrexone works by blocking the reward and pleasure signals that make alcohol feel good — it doesn't require sobriety as a goal. Only 3% of people with alcohol use disorder are ever prescribed medication — telehealth exists to close that gap. Privacy is often the deciding factor — no waiting rooms, no pharmacy lines, and discreet delivery changes who seeks help. Recovery looks different for everyone — Oar Health doesn't prescribe a single program; they build around the individual. When a crisis hits, set one clear, non-negotiable principle and fold every operation around it. A drug shortage can be a crash course — Ōr came out of their naltrexone shortage with deeper pharma supply chain relationships than they ever expected to need. AI belongs in operations, not in direct patient care — at least until patients say otherwise. The best use of AI in healthcare may be helping patients walk into appointments better prepared, not replacing the appointment. Cutting back on drinking is rarely just about drinking — it tends to become a catalyst for broader life change. You don't have to wait for rock bottom. Recovery is possible, and it's never too late to begin. Chapters 00:01 — Intro: How a healthcare insider's personal struggle became a 75,000-member platform 01:27 — What Oar Health does and why it exists 02:22 — From binge drinking to blackout — Jonathan's personal story 05:20 — Finding the right physician: empathy, moderation, and naltrexone 07:50 — How naltrexone actually works in the brain 10:31 — Spotting the market gap: telehealth for ED and hair loss, but not for AUD? 13:02 — Why only 3% of people with alcohol use disorder ever get prescribed medication 15:06 — What telehealth has gotten right — and where it still falls short 17:40 — The fragmented healthcare system problem and where Oar fits in 18:12 — Privacy as a product feature: why it matters more in stigmatized conditions 19:21 — What Oar is building next: coaching, peer support, and smoother care transitions 22:08 — Beyond sobriety: the liver, brain, and gut supplement Oar is launching 24:52 — GLP-1s, peptides, and what the evidence says about addiction 28:46 — The naltrexone shortage: two years of crisis management and what it cost 32:35 — The bright line rule that saved existing members — and froze new growth 35:10 — Compounded naltrexone and the Sinclair Method community 38:22 — Daily vs. targeted use: how flexible is the medication really? 41:05 — AI at Oar: where they lean in and where they draw the line 44:49 — The future of AI in healthcare: better prep, more empathy, not less 47:01 — Advice for anyone struggling: recovery is possible, and options are wider than you think

The Heartbeat of Game Day: Shea Fears on Scaling, Sacrifice & What Comes Next

In this week's episode of Compound Wisdom, host Steve Sood sits down with Shea Fears — Director of Corporate Locations at Game Day Men's Health — to dig into one of the most remarkable scaling stories in healthcare franchising: how a small team of believers turned 5 clinics into 998+ franchise locations across North America in just two years. Shea shares how she joined Game Day six years ago as one of the brand's earliest employees, helped open their second location in Southern California during the height of COVID, and built the operational infrastructure that made hypergrowth possible — all before franchising was even on the table. Shea explains why TRT clinics weren't mainstream when she started, how COVID unexpectedly accelerated demand for men's health services, and how a simple whiteboard session revealed they'd sold 600 franchise locations in a single year — a number that shocked even the most seasoned franchise experts they knew. They also get into the harder side of scaling — what it's really like managing medical compliance across multiple states, why running healthcare franchises is nothing like running restaurant franchises, and how Game Day built a medical advisory board and provider network that keeps clinical standards tight at scale. The episode closes with Shea's vision for Her Way — the women's health companion brand she helped build — and her personal journey of reclaiming her own identity and health after six years of being, as founder Evan Miller puts it, "the heartbeat of Game Day." TAKEAWAYS 1. The best opportunities often don't look like opportunities — Game Day grew fastest during COVID when everyone expected it to slow down. 2. You don't need to know everything about franchising to start — Game Day's first franchise buyer was a patient who simply believed in the brand. 3. Speed matters in healthcare franchising — the ability to make fast, decisive decisions separates operators from administrators. 4. Medical compliance isn't optional at scale — different states have different regulations, and ignoring that will break your model. 5. Your first franchise owners set the culture — Game Day's earliest franchisees came from their own patient base, which built instant brand loyalty. 6. Corporate locations are your guinea pigs — test everything there before rolling it out to franchisees. 7. A strong medical advisory board is non-negotiable — clinical credibility protects both patients and the brand at scale. 8. Expanding into women's health isn't just a business decision — it's a natural extension of a proven clinical model. 9. Your identity and your company are not the same thing — the healthiest leaders know where one ends and the other begins. 10. When you're the heartbeat of something bigger than yourself, personal growth becomes part of the mission. 00:00 — Intro: 998 US franchises, 46 in Canada — and why they stopped selling 01:27 — Shea's origin story: From healthcare admin to Game Day's earliest employee 02:13 — What Southern California looked like when TRT clinics weren't a thing 03:34 — Joining during COVID: Why they expected red lights and got green ones instead 04:46 — How COVID accelerated demand for men's health and membership-based care 05:12 — From corporate clinics to franchising: How the idea was born 06:57 — The first franchise sale: A patient who just wanted to be part of the brand 07:52 — The whiteboard moment: "Holy crap, we just sold 600 franchise locations" 08:21 — Why outside franchise experts couldn't believe what Game Day was doing 09:18 — Scaling from 600 to 998+ locations — and the decision to stop selling 11:24 — Why medical franchises are exponentially harder than restaurant franchises 16:17 — Multi-state compliance: How Game Day manages regulations across 50 states 17:41 — Building the provider network and medical advisory board that holds it together 18:42 — Stem cells, peptides, and what Game Day won't touch until regulations catch up 21:05 — Her Way: Building the women's health companion brand from the ground up 23:01 — Handing over Her Way and shifting back to Game Day corporate operations 24:49 — Being the "heartbeat of Game Day" — what that title really costs 26:21 — Personal transformation: Health, identity, and rebuilding a personal brand 28:12 — Final thoughts: What's next for Game Day, Her Way, and Shea personally

Don't ask what the other guys are doing. Ask what's best for your patient – Anthony Kantor

In this week's episode of Compound Wisdom, host Steve sits down with Anthony Kantor — co-founder and operator of Ivím Health — to dig into one of the most overlooked secrets in telehealth: building something that actually works for patients, not just for growth metrics. Anthony shares how he and his brother, Taylor, bootstrapped a family-run telehealth company from the ground up, pivoted into the GLP-1 wave at exactly the right moment, and built a high-touch care model by keeping providers in-house when everyone else was outsourcing. Anthony explains why they started with peptides after his mom's Crohn's remission on BPC-157, how a single TikTok video took them from 15 patients to 150 in a month, and why they turned down external provider networks to maintain full control over patient experience. They also get into the messier side of scaling — what it's really like visiting compounding pharmacies in person, why female HRT is more symptom-based than people think, and how AI is already changing what providers can handle at scale. The episode closes with Anthony's belief that the telehealth space is about to see consolidation — and that the companies obsessed with patient outcomes, not exits, are the ones that will survive it. Takeaways 1. Start by understanding the patient problem deeply — Ivím Health was born from a personal health story, not a market opportunity. 2. Don't chase trends blindly — they almost passed on GLP-1s before understanding the cardio-metabolic benefits. 3. Keeping providers in-house costs more upfront but gives you full control over patient experience and clinical quality. 4. Organic growth beats paid ads early on — Ivím Health didn't spend a dollar on marketing for the first year. 5. Visit your compounding pharmacies in person — if you're putting it in a patient's body, you should know where it comes from. 6. Labs aren't always necessary for female HRT — symptom-based care can be more effective, but patient comfort matters too. 7. Build tech that personalizes the journey, not just the prescription — engagement is what drives outcomes. 8. Use AI to empower providers first, not replace them — the best healthcare will always be a hybrid model. 9. If one compounder is doing something no one else is, that's a red flag, not a competitive advantage. 10. When the mission is bigger than the business opportunity, patient trust becomes your moat. Chapters 00:00 — Intro: Telehealth consolidation is coming — and why Ivím Health isn't worried 01:27 — The origin story: From Crohn's remission to building a peptide platform 03:29 — How a family of four bootstrapped a telehealth company with zero investors 03:51 — The GLP-1 pivot: Why they almost said no, and what changed their mind 04:53 — From 15 patients to 150 in 30 days: The TikTok moment that changed everything 05:42 — Building for patient experience, not just growth metrics 07:22 — Why Ivím Health keeps all providers in-house — and what that costs 08:31 — The medications they offer now — and why peptides are coming back 09:18 — Female HRT beta learnings: Labs, symptom-based care, and insurance dynamics 11:24 — The peptide landscape in 2024 — what's coming back and when 16:17 — Compounding pharmacy diligence: Why visiting in person matters 17:41 — The seven-pharmacy algorithm — routing prescriptions for speed and quality 18:42 — AI for providers, not patients (yet): How Ivím Health is using automation to scale care 21:05 — Why healthcare will be the last industry to go fully AI — empathy still matters 23:01 — Doubling provider efficiency with AI — from 1:1000 to 1:2000 patient ratios 24:49 — Where telehealth is going: Consolidation, exits, and who stays standing 26:21 — Why Ivím Health isn't looking to cash out — and what kind of partners they'd actually take 28:12 — Final thoughts: Patient outcomes over everything

Why AI Should Help Doctors — Not Replace Them

“Healthcare shouldn’t feel like a black box.” – Dr. Myra Ahmad In this week’s episode, Steve sits down with Dr. Myra Ahmad (Founder & CEO of Mochi Health) to break down how telehealth is evolving—and why most healthcare systems still fail patients. Dr. Myra explains how Mochi Health is building a marketplace model that connects providers, pharmacies, and patients into one seamless system—focused on long-term care, not just prescriptions. She shares why continuity with the same doctor matters, how transparent pricing is reshaping patient behavior, and why traditional healthcare often prioritizes systems over people. The conversation dives into the GLP-1 explosion, the rise of peptides, and what’s actually coming next in weight loss and preventative medicine. They also unpack the role of AI in healthcare, where it works best (operations, workflows, efficiency) and where it still falls short (patient trust and real care). The episode closes with a grounded look at the “wild west” of online medications, how to think about safety and regulation, and what the next 3–5 years of telemedicine will really look like. TAKEAWAYS * Most healthcare systems are built around operations—not patient experience. * Continuity of care (seeing the same provider long-term) leads to better outcomes. * GLP-1 drugs triggered massive demand—but they’re just the first wave. * Future treatments will expand into more conditions beyond weight loss. * Transparency in pricing is a major reason patients are shifting to telehealth. * AI is powerful for backend tasks—but not ready to replace doctors. * Patients still want human trust when it comes to medical decisions. * The peptide market is growing fast—but lacks consistent oversight. * Many online medications operate in a regulatory “gray zone.” * Telehealth’s growth will be driven by convenience, cost clarity, and access. CHAPTERS 00:00 Intro: Why healthcare systems fail patients 00:49 What Mochi Health actually does 02:10 Dr. Myra’s background & why she built Mochi 03:30 The gap in care delivery most people don’t see 05:10 Marketplace vs. traditional telehealth models 07:20 Why continuity with one doctor matters 09:15 GLP-1 drugs: from skepticism to global demand 12:40 What’s next in weight loss & new medications 15:30 Oral vs injectable treatments: what actually works 18:20 Peptides: hype, risks, and future potential 21:10 The “wild west” of online medications 24:00 AI in healthcare: where it works vs. where it fails 27:30 How Mochi uses AI to improve provider workflows 30:10 Pharmacy partnerships & quality control 33:40 Women’s health, HRT, and telehealth expansion 36:20 Pricing transparency vs traditional healthcare 39:10 The future of telemedicine (next 3–5 years) 42:00 What’s next for Mochi Health

Why AI Should Help Doctors — Not Replace Them

“AI should power the system — not replace the doctor.” – Myra Ahmed In this episode of Compound Wisdom, Steve Sood sits down with Myra A., founder of Mochi Health, to break down where modern healthcare actually breaks — and why most solutions are solving the wrong layer of the problem. Myra’s entry into healthcare was driven by a single question: where do patients fall out of care? That question led her to build Mochi Health — not as another telehealth brand pushing prescriptions, but as a marketplace connecting providers and pharmacies under one system. Mochi’s model challenges the dominant telehealth approach. Instead of vertical integration and branding, it focuses on infrastructure — giving providers tools to operate, and patients the ability to choose, compare, and stay with the same doctor over time. Continuity, not transactions, becomes the core product. The conversation then moves into the GLP-1 surge. Myra explains how initial skepticism around injectables quickly flipped into one of the largest demand waves in healthcare. What started as a niche treatment has now triggered a broader shift toward proactive care — with more drugs and categories already in development. But with demand comes fragmentation. The discussion explores the rise of peptides and the “wild west” layer of the market — where consumers are increasingly ordering unregulated substances online. Myra highlights the gap between demand and oversight, and why testing infrastructure is still catching up. On AI, the stance is clear. Most companies are applying AI at the wrong interface. Mochi uses it to remove operational burden — documentation, scheduling, billing — while keeping the doctor-patient relationship fully human. Efficiency is the goal, not replacement. The episode closes with a broader view of where telehealth is heading — toward transparency, provider-led care, and systems that reduce friction rather than add layers. The next wave won’t be about more tools. It will be about better structure. This is a grounded conversation on healthcare infrastructure, emerging drug markets, and the role of AI in rebuilding trust at scale. Takeaways Mochi Health is built as a marketplace, not a prescription-first platform Continuity of care is a core differentiator in their model Patients can choose and stay with providers long term GLP-1 demand reshaped consumer expectations in healthcare Future drug pipelines extend beyond weight loss into broader conditions Oral alternatives currently lack strong efficacy compared to injectables Peptides represent a growing but fragmented market Unregulated demand is rising due to lack of access and transparency Testing and compliance infrastructure is still developing AI is most effective in back-office workflows Documentation, billing, and scheduling are key AI use cases Patient-facing AI still lacks trust and reliability Provider efficiency directly improves patient outcomes Telehealth growth is driven by pricing transparency gaps Insurance systems often lack clarity for patients Mochi integrates providers, pharmacies, and workflows into one system Pharmacy onboarding includes testing and compliance validation Women’s health and HRT demand is increasing on platforms Future growth includes partnerships and device integrations Healthcare is shifting toward system-level redesign, not surface fixes Chapters 00:00 – Building provider and pharmacy infrastructure 02:00 – Why Mochi Health was created 05:30 – Marketplace vs traditional telehealth models 10:00 – Continuity of care and provider relationships 15:30 – The GLP-1 demand shift 21:00 – Future of weight loss and drug pipelines 26:00 – Oral vs injectable treatment limitations 30:30 – Peptides and emerging categories 35:30 – Risks of unregulated drug markets 40:00 – AI in healthcare systems 45:00 – Back-office automation vs patient interaction 50:00 – Provider tools and workflow optimization 55:00 – Pharmacy vetting and compliance 01:00:00 – Women’s health and HRT expansion 01:05:00 – Telehealth vs traditional care models 01:10:00 – Insurance and pricing transparency 01:15:00 – Future roadmap for Mochi Health 01:20:00 – Closing insights Tags #CompoundWisdom #MyraAhmed #MochiHealth #Telehealth #GLP1 #Peptides #HealthcareInnovation #DigitalHealth #AIinHealthcare #HealthcareSystems #PharmaTrends #ProviderLedCare #PatientExperience #HealthTech #FutureOfHealthcare