Ro is one of the most valuable private health technology start-ups. Its mission is to provide vertically integrated, affordable healthcare services with consumers in mind.

Although the patient-centered healthcare system is undoubtedly long overdue, Ro first has to deal with a huge challenge: it cannot meaningfully monetize outside of Roman itself, and its erectile dysfunction is vertical. The stagnant ARR and Ro's need to grow to its recent valuation of $5 billion, create an environment for employees and paint a picture of a company that is struggling to find new growth paths and acquisition integration.

Fearing retaliation or the impact on future employment, TechCrunch talked with ten current and former Ro employees about Ro's working environment on the condition of anonymity. These employees described the low morale work environment in detail, partly because the leadership developed crazy strategies and rejected basic feedback. They said that the tension caused the loss of employees on all teams.

According to LinkedIn, in the past few months, all departments have had multiple departures, including high-profile positions such as data director, partner relationship director, and product management director. Employees said that eight of Ro's 11-person customer service operations team resigned due to cultural reasons, and most of them left after only five months in the company.

After contacting Ro for comments, TechCrunch obtained a company-wide email from Ro to employees about this article, stating that it was "designed to portray Ro in a negative way." This email prompted more employees to contact TechCrunch, also requesting anonymity to confirm their experience of Ro's disturbing environment. 

"Every time I feel stressed about work, I return to the same understanding: we are selling chicken essence, we are not curing cancer, and we are not being the first call for patients," a current employee told TechCrunch. "[Erectile dysfunction] is where we make money."

Update: A few hours after this story went live, Ro CEO and co-founder Zachariah Reitano published a Medium post in response to this article.

Ro initially sold erectile dysfunction drugs to men. Zachariah Reitano founder Zachariah Reitano founded the company after firsthand dealing with the crushed and stigmatized ED patient experience. Four years later, Reitano and co-founders Saman Rahmanian and Robert Schutz quickly realized the company's ambitions.

Over the years, Ro has launched a number of different services, including Rory, a digital health clinic for women; zero, smoking cessation treatment services; Ro Pharmacy, which provides low-cost generic drugs; and more emerging products such as Ro Skincare and a health guide that beats WebMD .

Investors have noticed. So far, this health technology unicorn has raised nearly US$900 million in venture capital, attracting top venture capital firms including Dragoneer Investment Group, SignalFire, FirstMark, General Catalyst, and Initialized Capital. Ro's recent round of $500 million in Series D financing triggered an acquisition frenzy: In less than a year, the company acquired Workpath, Kit, and most recently Modern Fertility. It is even exploring a potential IPO.

Although Ro has expanded its product lineup and attracted ready investors, several former and current employees paint a different picture. They said that Ro’s vertical erectile dysfunction is at the core of Ro’s business, which puts the company in an uncomfortable position, over-relying on Viagra, a generic drug with expired patents, facing competition-from other suppliers. Bottom competition. After COVID-19, the company's overall ARR has flattened out while most of the health technologies are developing rapidly.

In a statement to TechCrunch, Ro denied this, saying that the ARR is currently higher, reaching $300 million and not stagnating, but did not give a time frame or more details. At the same time, employees said they were told that ARR's slow growth was due to Ro's investment in acquisitions and recruitment, rather than lack of success—even if other health technology companies touted revenue growth. Ro’s closest competitor, Hims & Hers, stated in its second-quarter earnings that revenue grew 69% year-on-year.

In addition to erectile dysfunction drugs, Ro has not been able to successfully make meaningful money, which accounts for a large part of Ro's income-some say up to half. No other Ro product can achieve such initial success. Ro confirmed that Rome accounted for half of its revenue, but said that non-Roman growth exceeded 130% year-on-year, without specifying. Update: In a statement issued after this story went live, Luo said that this year's non-Roman revenue will exceed 50 million U.S. dollars.

"If you look at all the marketing expenditures, everything is leaning towards Roman," said a former employee. Ro denies this, claiming that more than 20% of its marketing expenditures so far this year have been spent on non-Roman brands. In other words, it confirms that nearly 80% of marketing expenditures are spent on Roman.

This tension is gradually reflected in how Ro prioritizes new vertical business areas. Employees say that it knows the need but has not invested money at the same time.

“I noticed that this leader’s model is very focused, very vigilant at the time of the release, bringing the team together, and then never heard of the release,” the employee continued. "But I also think that Ro is engaged in telemedicine. To make the launch successful, many obstacles and obstacles need to be overcome."

As Ro tried to surpass its one-shot miracle, a former employee said that the resulting "identity crisis" created a culture of rapid launch and rapid failure of new product lines, which harmed the morale of consumers and employees .

"Everything we launched [in 2020] completely failed," a former employee said. "When they start to get these financing rounds, you will be exhausted within a month and launch it, but it can do nothing, because there is a fancy article and a complete failure."

An employee stated that due to opposition from Ro's medical team, Ro's home COVID-19 test (with a login page and still a valid waiting list) never officially started. Business Insider reported on the early efforts. Ro confirmed that no tests have been sold because they have not yet been approved by the FDA.

Employees said that the other troubled project is Ro Pharmacy, a mail-order pharmacy that provides generic drugs. Ro has been talking about the recent push to operate his own pharmacy. In a previous interview, Reitano told TechCrunch that the company will have 10 pharmacies by the end of 2021 and 15 by the end of 2022. Internally, the growth indicators of Ro pharmacy work have ceased to be reported to all employees.

Another troubled vertical is Ro Skincare, a line of prescription dermatology products that was launched in May 2020 but has barely been adopted. Ro's weight management service Plenity has not yet closed, but it is also working hard to keep customers using the product.

Ro denies these struggles, claiming that all three verticals will "achieve tens of millions of dollars in revenue in 2021," and none of them will be eliminated. The company added that Plenity's annual growth rate is 1,500%, but it is not clear which indicators or benchmarks are being used since the product was launched in 2019. Update: In a statement issued after this story went live, Luo said it was referring to revenue growth.

A current employee said that Ro's smoking cessation product Zero has been discontinued for two years and no employees have participated in the project. Ro denies this, saying that Zero can still be used on QuitWithZero.com, Roman and Rory.

In the past year, rapid acquisitions have only exacerbated the growing chaos.

A recently resigned employee interviewed by TechCrunch said: "Each acquisition feels like it came out of thin air." "We have never really integrated with any company we acquired; then what are we doing this for? Because of these acquisitions, [ The focus of the company] will change a lot, and leaders will say,'This is a growth company, that's it.'"

Some employees began to feel that these transactions were just smokescreens and were done for publicity, because the long-term products in Ro's service suite were struggling. Even before the product is integrated into the platform, the leadership feels focused on marketing the product. "Packaging is packaging, are we really providing what people want?" the employee continued.

Another employee told TechCrunch that Workpath was acquired in December 2020 to provide home care services for Ro's home vaccination services, and then was thrown aside.

Some interviewees said that considering that Ro's vertical female healthcare company Rory received almost no investment, Modern Fertility, a reproductive health company, felt like an "optical" acquisition, rather than an actual change. The acquisition was controversial at the outset, because some people pointed out the pattern of acquisitions of female-centric healthcare companies by male-dominated companies—not the other way around.

Another former employee said that Rory is always struggling; “Because, frankly, no one puts any time or energy into it, because it does not sell chicken essence.” Until recently, Rory was led by Rachel Blank. She recently left to start her own female hormone health company. Ro previously claimed that before the acquisition of Modern Fertility, Rory's annual growth rate was 300%. A current employee said that last year Roman usually added 2,000 new members every day, while Rory often added about 4 members.

"If you look at what happened to all Ro's brands, why did you want to be acquired by Ro?" said a former employee. "That's why I worry about the people at Modern Fertility, because they have built such a great product and team, and now they are surrounded by this strange culture of unrealistic expectations."

In response to a request for comment, Carly Leahy, Co-founder of Modern Fertility, said: “Team Ro welcomes Modern Fertility very much and we will continue to be full of energy for what we do together for women’s health.” She also said that Modern Fertility’s executive team has no plans. Resign.

Employees have different feelings. The acquisition feels that Ro's leadership is resorting to external dependence on production innovation, rather than investing in new or existing teams.

"What has changed is the focus shifted from business development to a clear'we hope to increase the valuation of this company as soon as possible so that we can proceed with the IPO as soon as possible'," said a former employee. "It doesn't matter what individual employees are doing or who is there; what matters is that we have developed this strategy."

An employee said that when the co-founders began to spread a new focus for the company, they knew it was time to leave Ro: to become the "Amazon of healthcare." The multinational e-commerce giant is one of the largest technology companies in the world, but it has long been accused of treating its employees mercilessly in pursuit of profit.

This comparison is not just a theoretical hope: senior leaders bought a book written by two former Amazon executives, "Working Backwards", with the goal of copying Amazon’s culture and leadership strategy.

Several employees described in detail micro-management events that did not allow employees to express their opinions, from questioning the efficacy of the new product line to being told to never ask to move their seats. An employee stated that he cannot meet with other managers without his consent. They say that if employees disagree with the leadership's vision for a certain sub-brand, they will be told that they are not "Ro-first." This is not uncommon.

Failures in integration and other vertical businesses have not been resolved, and many employees say this has caused them and their colleagues to burn out.

"I think that is the part that really frustrates employees," a former employee told TechCrunch. "I know that if I complain in the Culture Amp [Employee Satisfaction] survey, my department will get a'talk'-not about how to solve this problem, but about how to ensure that there are no negative stories talking about it in the media ."

To illustrate his culture, Ro spokesperson pointed out that last fall's internal Culture Amp survey had "extremely high scores for participation." They also noticed the following: Ro is recognized as one of Inc.'s best places to work in 2020 and 2021, Forbes' list of America’s best employers for entrepreneurship, as well as “Fortune” magazine’s best healthcare workplaces, and New York’s best jobs Places, Best Places to Work Millennials, and 2021 Best Mid-Sized Workplaces List.

The spokesperson wrote in a statement: "We are proud of the culture, team and company we have established and our impact on the lives of patients." "We are extremely excited about the future development, including our recent fertility and mental health And investment in home care, which will enable us to help more people meet more healthcare needs."

In a statement issued after the story went live, Retano directly commented on the culture.

"Ro has a rhythm," he wrote. "One of the most common things we hear from people who are new to Ro is that performance standards are very high at potentially demanding speeds. This is not something we would avoid. I and many Ro'ers believe, What makes Ro very special is that we pride ourselves on being a rare combination that is both ambitious and very kind. People who have too much one but not enough may not be suitable here."

Employees say that the environment created by leaders has created a culture of large-scale departures and a low morale, although Luo blamed it on “big resignations” that took place across industries. The company said that so far this year, its voluntary turnover rate is 8%, which means that fewer than 30 employees have left since the beginning of the year — well below the macro trend. Analysis using LinkedIn and confirmation from former and current employees indicate that dozens of people have left the company. In addition, a current employee expressed doubts about this ratio, saying that more people inside the company feel that they are leaving. Last week, HR sent an email about the "great resignation" to managers across the country and urged leaders to be more supportive of their direct reports.

"Every time you turn around, there is always a feeling that someone is saying,'Monday is my last day'," they said. "It's like we hired one person and the other two left."

Reitano was not asked to comment further. In an email to Ro employees about this article, Reitano wrote: "We want Ro's standards to be very high" and "Ro is not for everyone." He also urged employees if they have feedback or need extra Resources, please submit a ticket to the staff team.

Among the employees who recently left, many explained how contradictory it is to leave a company with a great mission but poor execution.

A former employee told TechCrunch: “Everyone there has the right intention to save the world and want to improve access to healthcare.” “Then you realize that once you get there, it’s really just To make sure that you are the first to bring a cheap drug to the market, this drug can be sent to people. It feels disgusting."

An employee who left a few years ago worked at the company before it became a well-known unicorn. The micromanagement of the leadership and the "secrets of paranoia" finally let them go. "I always thought it wasn't Luo. I was the problem. It might be that I was impatient, or didn't know how it worked, or I wasn't used to it," they said.

Ro does not claim to invent breakthrough technologies—most of its business is to make generic drugs and services more accessible to consumers—so some of its active focus on marketing makes sense. However, in the final analysis, Ro's problem is that it cannot replicate Roman's success in other verticals, which has caused losses to the employees who work among its employees.

"In my first year there, I was like the happiest person on earth," said an employee who recently resigned. "The part that needs to be recalibrated is what is the final vision? When you say a vertically integrated, patient-centric health system, what do you mean? Do these actions move you in that direction? This is what I leave. The ultimate reason for this is because I think what the outside world said did not actually happen internally."

Current and former Ro employees can contact Natasha Mascarenhas via email natasha.m@techcrunch.com or Signal (a secure encrypted messaging application) at 925 609 4188.