Midi Health CEO on building the front door to midlife women’s health

Joanna Strober is the co-founder and CEO of Midi Health, a virtual menopause and perimenopause care company serving patients in all 50 states, covered by insurance. She spent 15 years as a venture and private equity investor, then founded and sold a digital health company called Kerbo, before her own perimenopause experience made the care gap impossible to ignore. When she finally found a clinician who understood what she was going through, that expert was an hour away and cost a fortune out of pocket. In 2021, she co-founded Midi with Sharon Mears to bring expert menopause and perimenopause care to every woman virtually, in 50 states, covered by insurance. In this episode of Product Talk, host and Planned Parenthood Direct Chief Product Officer Hannah Park sits down with Joanna to talk about what her investor background gave her as an operator, how she built a billion-dollar company to solve midlife women’s health, and what it actually looks like to scale care quality to hundreds of thousands of patients without letting it slip.

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Show Notes

1. Joanna founded Midi after her own perimenopause experience made the care gap undeniable. She saw doctor after doctor, was sent for a sleep study, and not one of them mentioned hormones. When she finally found a clinician who understood what she was going through, that expert was an hour away and cost a fortune out of pocket. Her conclusion was simple: expert menopause care should not be that hard to find.
2. Fifteen years of investing gave her a specific lens on product that she believes many pure operators lack. The founders who got funded were the ones who could hold two things simultaneously: a clear and compelling vision of where they were going, and a grounded understanding of exactly where they were right now and how to close the gap. She applies that same discipline to every product decision at Midi.
3. The tension she manages most actively as CEO is the pull toward the long term at the expense of the near term. As the vision person, she is always tempted to focus on where Midi is going rather than making sure what already exists is working and scalable. She relies on her product leaders to pull her back when the foundation is not solid enough to build on yet, and she sees that dynamic as healthy rather than frustrating.
4. Trust at Midi is not something that lives in the visit. Early on, the team optimized the visit itself heavily, trained providers carefully, and built excellent tools for them, but underinvested in everything around the visit: reminders, follow-through, notifications. They discovered that trust is built across the entire patient journey, and neglecting any piece of it creates a gap patients can feel.
5. One of the deepest trust questions Midi thinks about is whether the trust belongs to the provider or to the platform. A patient who trusts their individual nurse practitioner is vulnerable if that provider leaves. Joanna pointed to Planned Parenthood as the model she aspires to: patients come because they trust the institution, not because there is one specific person they count on.
6. Women’s health is structurally under-researched, and Joanna is direct about this with patients. Estrogen and testosterone are generic, so no drug company has the financial incentive to fund large, long-term clinical trials. When the research is thin or absent, Midi’s approach is shared decision making: here is what we know, here is what we do not know, and here is what we know is safe. The patient decides with the clinician, not for her.
7. MIDI University and Midi’s care protocols exist to solve the scaling problem: how do you take the knowledge in the heads of a small group of elite specialists and make it available to every nurse practitioner across the platform? The answer was to convene physicians across specialties to build searchable care protocols that every provider can reference. Joanna is direct that even now, it is still not fully solved.
8. Midi uses three layers to support its providers: the care protocols, AI integrated into the clinical system, and real-time specialist access via Slack, where a rotating roster of physicians hosts daily care rooms to answer complicated case questions from nurse practitioners. Any complicated patient is effectively getting input from an army of specialists, which is what gives Joanna confidence in the care they are delivering.
9. AI models are often wrong about women’s health. OpenAI and similar tools tend to deprioritize newer, smaller studies in favor of older, larger ones, which means the most current research on hormone replacement therapy and testosterone for women frequently gets surfaced incorrectly or downplayed. For Midi, this is why they cannot rely on general-purpose AI for clinical guidance and have to build their own protocols on top of it.
10. To maintain care quality at scale, Midi uses AI to scan patient charts and compare them against care protocols, flagging safety issues first. The more interesting finding came from comparing providers whose patients return for multiple visits against providers with a lot of one-and-dones. The difference was not in clinical safety but in how providers talked to patients: whether they gave a clear plan, specific next steps, and left patients feeling heard. Midi now uses those patterns to improve training across the platform.
11. The AI scribe that documents visits is what makes the quality analysis possible. Because conversations are transcribed, the team can examine the texture of a visit in a way that would be impossible with just chart notes. Joanna sees this as one of Midi’s most meaningful AI use cases: not replacing the human interaction, but learning from it in ways that improve care for everyone.
12. Midi’s scope decisions are deliberate. They will not do in-person care, pregnancy, or fertility. They focus on conditions nurse practitioners are already trained to handle, then expand into adjacent areas when patient demand and clinical capacity align. Joanna used her own experience needing an endocrinologist for bone health as the test case: after a six-month wait for a specialist appointment, she asked why Midi couldn’t handle basic bone health care, brought in an endocrinologist to train providers, and added it to the platform.
13. Insurance coverage was non-negotiable from the start, even though cash pay would have been dramatically simpler to execute. The history of menopause care is that the best clinicians go concierge because the market rewards it, which means the patients who most need expert care are the ones who cannot access it. Joanna was not interested in building another concierge practice. She wanted factory workers and executives to get the same quality of care, and insurance was the only path to that.
14. Midi’s patient base reflects that mission. Some of the most powerful women in the country are patients because the service is convenient. But equally, factory workers whose employers cover Midi’s visits are calling from their cars between shifts or slipping into a work closet for their appointments. That breadth is something Joanna is genuinely proud of, and she frames it as proof that the mission and the business model are actually aligned, not in tension.
15. On the question of whether mission and profit conflict, Joanna is unequivocal: she does not experience them as in conflict. Midi cannot offer hour-long visits if it wants to be financially sustainable, and that constraint does not compromise the mission. If they went to two-minute visits, no one would come back. The balancing act is finding the efficiency that keeps the company viable without sacrificing the quality that makes patients trust them, and she believes that balance is achievable.
16. Joanna’s AI advisory board is real and she uses it practically. She spent an eight-hour flight getting OKR feedback from AI John Doerr until he approved. When Midi’s text messages were underperforming, she asked AI Dan Ariely to rewrite them using behavioral economics principles, and it worked. She has found that prompting AI to respond in the voice of a specific expert produces surprisingly useful and differentiated output.
17. Humor is a deliberate communication strategy at Midi. They found that sounding sad or heavy when talking about menopause did not resonate with their audience. Leaning into humor, including making light of real and sometimes difficult symptoms, works better. Joanna sees it as a genuine insight about the category: women dealing with these challenges often respond better to someone who can laugh with them than someone who projects sympathy.
18. On AI replacing the human clinical interaction, Joanna is confident the answer is not yet. Women frequently forget things they put on intake forms, give different answers in conversation than in text, and communicate through tone and expression in ways that change what care they actually need. Until AI can read all of that in real time with the sensitivity a skilled clinician brings, the human conversation stays essential. But she is an AI optimist: she believes Midi’s care will keep improving because of AI, even if AI does not replace the visit.
19. Joanna’s prevention advice is direct and unglamorous. The things women do in their 30s, 40s, and 50s determine the quality of life in their 70s and 80s. Her list: mammograms, colonoscopies after 50, DEXA scans for bone health, and vaccines. She added a specific data point most women are not aware of: the shingles vaccine is one of the best available interventions for reducing Alzheimer’s risk.
20. On what the next generation of women’s health founders should build, Joanna’s answer is expansive. She mentioned at-home breast cancer detection patches that can track changes over time, better ovarian cancer testing, and the many areas of women’s health where basic science has not yet been done. Her underlying point is that the care gap in women’s health is not a niche problem; it is a massive and mostly unexplored space, and Midi is one entry point into something that will take many companies and many founders to fully address.