Julie Yoo

1. Key Themes

The Transaction Is the Data Moat: Directories Rot, Bookings Self-Validate

The reason the "provider directory problem" persists, according to Kharraz, is that directories are static publishing exercises, while transactions continuously correct themselves. Whoever owns the booking owns the freshest truth about who is available, who takes what insurance, and who actually exists.

Oliver Kharraz: "When you put out a provider directory, frequently you're in the business of publishing the Encyclopedia Britannica, right? By the time you're able to really put it out there and present it to patients, it's already out of date." [00:03:07] He continued: "Once you have the transaction, it's much more like Wikipedia, right? Every incremental transaction actually validates the information you have. You make any mistake, you make exactly once." [00:03:45] The result: "We have the ability to schedule into the providers that are connected to that, where our data that's more than 99% accurate, which compares quite favorably with your average insurance directory." [00:03:07]

Twenty Years of Unglamorous Integration Work Is the Real Barrier to Entry

The hard part wasn't the idea, it was the long tail of workflow idiosyncrasies across EHRs, insurance plans, and specialties. Most competitors got frustrated and quit; Zocdoc was "stubborn enough to persist."

Oliver Kharraz: "There are hundreds of different EHRs. There's tens of thousands of insurance plans that need to be mapped... And it turns into this Tetris game that we needed to solve. And it took us 20 years to get to where we are today." [00:03:45] On the depth of the problem: "There were literally a 1,000.1% solutions that we had to figure out to make the EHR integration for scheduling truly accurate. And that took us several years to do. And I think many folks just got frustrated with this task, and we were stubborn enough to persist." [00:06:53] Zocdoc now has "175 different EHRs plus" integrated "out of the box." [00:05:34]

From Destination Website to "Healthcare Access Infrastructure"

Zocdoc is unbundling its marketplace into an API/infrastructure layer that payers, AI platforms, and other consumer surfaces can plug into. The strategic shift: stop needing the booking to happen on zocdoc.com.

Oliver Kharraz: "What is new now is that we take this infrastructure that we have built that enables that marketplace, and we make it available to third parties. So, whether you are a payer, you're an AI platform, you have a consumer audience, you can now give them the ability to schedule their doctors seamlessly no matter where they start their journey." [00:01:34] And: "Our role in this is really just that of healthcare access infrastructure, right? We don't need every booking to happen on zocdoc.com or our app. We just want to make sure that whatever door the patient is knocking on, that door actually opens." [00:13:06]

AI Agents Multiply the Front Doors, Creating a Distribution Problem Zocdoc Solves for Providers

AI creates demand and intent but cannot act without bookable supply. As agents proliferate, no individual practice can integrate with each one, so a single aggregation point becomes valuable.

Oliver Kharraz: "The AI can give you the information. But Zocdoc can make it actually actionable so that you can go see a provider." [00:12:33] And: "The number of, sort of front doors is really exploding, because there are lots of different agents... for a doctor, it's really inconceivable to, sort of hunt them all down and try to connect to them, one-off. And so, our promise to the providers, do a single integration with Zocdoc. We then distribute your availability to all the different platforms that are out there and sort of take that distribution worry off your hands." [00:13:06] On agents and users: "We really look at that as one thing, the patient and the agent. We don't differentiate between these two things." [00:15:23]

Healthcare Is a City, Not a Building: Open Doors Beat Walled Gardens

The industry's instinct to "own the front door" is both strategically flawed and unsupported by patient behavior. Patients shop widely, then show high loyalty once they commit.

Oliver Kharraz: "Healthcare isn't like a building where you lure the patient in and you slam the door shut behind them. It's a lot more like a city, right? And the patient walks the city." [00:08:14] And the data: "We see actually extremely high loyalty to the providers that they go to, you know, a roughly 75% to 80% rebooking rate with the same provider when a patient books in the same specialty. So, it speaks to the fact that it's not really necessary to lock them in through the systems you build. You will gain their loyalty just by being a good doctor to them." [00:11:06]

Healthcare's Capacity Is Mismanaged, Not Absent: Zocdoc as "Yield Management" for Doctors

Wait times have worsened, but there is hidden last-minute slack in the system. Kharraz frames Zocdoc as doing for doctors what online travel did for airlines.

Oliver Kharraz: "When we got started, there was roughly 17 days the average wait time nationwide to see a primary care doctor. Now it's 31 days. However... using Zocdoc, you can see a doctor typically within three days or less." [00:27:46] The mechanism: "Airplanes used to fly 60% full. But that was in the '70s... now airplanes have a load factor of over 90%. In the wild, doctors have load factors around 70%, just under 70%. Now, with Zocdoc, we fill that last-minute capacity." [00:28:24]

Pricing Aligned to Value Delivered: Free Software, Paid Discovery

Zocdoc moved from flat subscriptions to charging only for "discovery bookings," and made the lowest-friction part (booking your own doctor) free, which drives bottom-up supply growth.

Oliver Kharraz: "We charge a provider for a discovery booking, meaning a booking where the patient was doing a general search, and we connected them to that doctor. You know, notably, we do not charge for bookings where a patient is looking for a specific doctor... That's software. That should be free, and we make it free." [00:24:18] The proof: "97% of the providers we signed up in the last 12 months inbound to us, you know. That's word of mouth." [00:25:16]

Payer Partnerships Expand Organically Once Plugged In

Payers adopt Zocdoc's infrastructure as a drop-in layer; one use case spreads across the organization.

Oliver Kharraz: "One of our classical implementations here is with, for example, Blue Shield of California, where, on their own member directory, you can now book directly a doctor's appointment, and that's powered by Zocdoc." [00:21:56] On the expansion dynamic: "You start with one area in a payer, and then suddenly other people come and say, 'Can I use this also?'... pretty quickly, you're working with the entire organization, which is very, very exciting to us, and honestly, not something that I would have expected going into that." [00:22:45] The ROI argument: keep patients out of "the emergency room that are 10 to 12 times as expensive as ambulatory care and have worse outcomes." [00:21:56]

2. Contrarian Perspectives

The Provider Directory Problem Is "To a Large Extent, Solved"

Julie Yoo framed the directory problem as an industry constant ("death, taxes, and the provider directory problem"), and Kharraz flatly disagreed. His claim rests on reframing: the problem was never data collection but enabling the transaction.

Oliver Kharraz: "I think, actually, the problem is, to a large extent, solved... And the reason and the Gordian knot here was actually enabling the transaction." [00:03:07] Most of the industry has spent decades and billions optimizing the directory itself, while the real solution was to stop publishing and start transacting.

The Best Doctors Have the Worst Utilization, So Immediate Availability Is Not a Quality Red Flag

The cynical consumer assumption is that a doctor with open slots must be bad. Kharraz inverts it, arguing top doctors skew toward emptier calendars because their patients are busy and they refuse to double-book.

Oliver Kharraz: "The best doctors tend to have the worst utilization, because they frequently treat patients that have very busy lives and cancel on them more often, and they don't double-book." [00:30:18] His proof: a dean of an academic medical center in New York "booked out three months in the future" asked to be removed. Zocdoc asked for 30 days, and "it was something in the order of magnitude of 40 patients" that booked last-minute cancellations. [00:30:18]

Never Try to Own the Patient; Open Every Door

The prevailing health system belief is that owning the front door enables coordination. Kharraz argues the opposite is both factually wrong and strategically self-defeating, and his own willingness to cede control has become a competitive advantage as AI fragments entry points.

Oliver Kharraz: "There is a general walled garden preference in healthcare frequently, where the idea is that we own the front door to care, that we own the patient. And the reality is that that's a flawed premise." [00:08:14] On what narrowing does: "Narrowing the aperture of what you offer to them and making it hard for them to engage with you just lets you fall off their radar." [00:11:06]

Specialists and High-Acuity Care Are Already Booking Online; Patients Self-Triage Better Than Assumed

Conventional wisdom holds that specialists, especially oncology, need heavy clinical gating before releasing precious slots to patients. Kharraz says that was never a blocker.

Oliver Kharraz: "We have 250 different specialties on the platform, and all of them are being booked... we have literally tens of thousands of oncology bookings going through Zocdoc in New York City alone." [00:16:49] And on triage: "Providers have also gotten increasingly confident, because they actually realize that the vast majority of patients have pretty good judgment on their own whether they should see this provider." [00:18:20]

3. Companies Identified

Zocdoc

Online healthcare marketplace and now "healthcare access infrastructure" that lets patients find in-network doctors and book appointments. Mentioned as the subject of the conversation and as one of the few health tech companies to become a household name. Julie Yoo: "Arguably Zocdoc is one of the few companies in health tech that has truly built like a household iconic name for itself." [00:00:51] Oliver Kharraz: "We have 250 different specialties on the platform, and all of them are being booked." [00:16:49]

Gemini (Google)

Google's AI platform, partnered with Zocdoc so users can book appointments agentically. Mentioned as the flagship example of Zocdoc plugging into an AI front door. Oliver Kharraz: "We partner with Gemini. You know, we're certainly here to partner with anyone who wants to have that immediate bookability." [00:13:06]

Blue Shield of California

Health insurer using Zocdoc to power direct booking from its member directory. Mentioned as the model payer integration. Oliver Kharraz: "On their own member directory, you can now book directly a doctor's appointment, and that's powered by Zocdoc, ultimately." [00:21:56]

Kyruus

Provider search and scheduling company, which Julie Yoo ran, that took a B2B approach with health systems. Mentioned as the contrasting approach and by way of shared history. Julie Yoo: "When I think back to the way that we approached this problem at Kyruus... we used to joke that 3M was our biggest competitor because of Post-it Notes." [00:04:33]

3M

Maker of Post-it Notes, jokingly named by Yoo as Kyruus's "biggest competitor" because office managers tracked doctor availability on sticky notes rather than in the EHR. Julie Yoo: "We used to joke that 3M was our biggest competitor because of Post-it Notes. Glad you guys cracked the nut." [00:07:27]

EHR Vendors (175+ integrated)

The hundreds of electronic health record systems Zocdoc integrates with; these are the "source of truth" for availability. Oliver Kharraz: "We have them out of the box for 175 different EHRs plus." [00:05:34] (No individual vendor is named.)

Airline and Online Travel Industry (Kayak, Expedia, Booking.com)

Used as the analogy for what online marketplaces did for capacity utilization. Oliver Kharraz: "We had, you know, the Kayaks and the Expedias and the bookings.com, and now airplanes have a load factor of over 90%." [00:28:24]

Instinct and Muse (as transcribed; consumer AI agent products)

Julie Yoo referred to a recent wave of consumer agents people use to book travel, restaurants, and healthcare. The names are uncertain in the transcript. Julie Yoo: "We're a few weeks into the sort of like the era of Instinct and Muse and all of these consumer agents that people are now using to do exactly that, booking appointments, travel, restaurants, and of course, inevitably, their healthcare experiences." [00:11:42]

a16z

Investment firm of Julie Yoo, host of the podcast; named as the venue and source of the AI-native EHR/practice management thesis. Julie Yoo: "Who will build the sort of next-generation AI-native practice management and EHR platform." [00:19:26]

4. People Identified

Oliver Kharraz

Founder and CEO of Zocdoc, who has spent roughly two decades solving healthcare access. Mentioned for his persistence, unconventional diagnostic methods, and strategic repositioning of Zocdoc as open infrastructure. Julie Yoo: "You and I are kindred spirits in both having tried to solve a lot of similar problems in healthcare over the years." [00:00:51] Illustrating his hands-on style: "I sat next to the office manager. And what I realized is that sometimes the doctor would walk out and say, 'Hey, I'm out next Friday.' And the office manager would actually take a Post-it Note and attach that to their monitor." [00:06:08]

a16z General Partner and former founder of Kyruus, who co-hosted the conversation. Mentioned for her parallel experience building in the same space. Julie Yoo: "Nothing is certain in life except death, taxes, and the provider directory problem." [00:02:16]

Unnamed Academic Medical Center Dean (New York)

A dean who asked to be removed from Zocdoc because he was booked three months out, then received about 40 patients from last-minute cancellations in 30 days. Mentioned as proof that top doctors benefit from last-minute slotting. Oliver Kharraz: "He had last-minute cancellations that would have gone to waste. But we were able to connect a patient with them who were obviously keen to see him last minute." [00:30:18]

Unnamed Practice Office Manager

The office manager whose Post-it Note system revealed the hidden gap between EHR calendars and reality. Mentioned as the source of an insight that unlocked accuracy at scale. Oliver Kharraz: "We brought all the smartest people at Zocdoc in a room. I brought them pizza. I walked their dogs. They couldn't figure it out." [00:06:08]

5. Operating Insights

Go Sit Next to the Customer: The Post-it Note Lesson

When a data discrepancy defied a room of smart people, the CEO resolved it by physically shadowing a frontline user. The deeper insight is that "ground truth" in legacy industries often lives outside the system of record, and software teams will not find it from the dashboard.

Oliver Kharraz: "We brought all the smartest people at Zocdoc in a room. I brought them pizza. I walked their dogs. They couldn't figure it out. So, I sat next to the office manager." [00:06:08] Once you find the real behavior, "math is your friend." [00:06:53]

Price at the Moment of Created Value, and Make the Rest Free to Collapse Sales Friction

Zocdoc's shift from flat subscriptions to per-discovery-booking pricing aligned revenue with value and removed adoption barriers, creating word-of-mouth supply growth (97% inbound). The insight for any marketplace: the commodity workflow (booking your existing relationship) should be free, while the scarce service (new customer acquisition) is monetized.

Oliver Kharraz: "We started out as a subscription business, where we charged every doctor the same amount of money... ultimately, it was maybe too expensive for some and too cheap for others." [00:24:18] And: "All we do is facilitate the booking. That's software. That should be free." [00:25:16]

Manage Supply to the Customer Experience Metric, Not to Internal Volume Metrics

Zocdoc dynamically recruits providers in specific "specialty, zip code, insurance quadrants" when capacity thins, tying supply operations directly to the patient promise (an appointment within days).

Oliver Kharraz: "We manage our network to being for a patient to be able to have that experience. So, when we see that there's low capacity in one of our specialty, zip code, insurance quadrants, then we will add providers there. And we're really much more driven by the patient experience and patient metrics than we are by any other metric." [00:28:59]

Treat Fragmented Downstream Distribution as a Product: One Integration, Many Surfaces

Instead of forcing every customer to integrate with every channel, offer a single integration and handle the distribution. This is a repeatable playbook as agents, directories, and search surfaces multiply.

Oliver Kharraz: "Do a single integration with Zocdoc. We then distribute your availability to all the different platforms that are out there and sort of take that distribution worry off your hands." [00:13:06] Zocdoc has also extended products to "live on the provider's own homepage" and "in their call center." [00:20:19]

Start With One Team in a Large Enterprise Customer and Let Internal Demand Pull the Expansion

In payer deployments, a drop-in integration with minimal change cost let adoption spread through the organization without a top-down sales motion.

Oliver Kharraz: "The amount of change on the payer side is relatively minimal, right? They can now plug into our healthcare access infrastructure, and it just works out of the box." [00:22:45]

6. Overlooked Insights

Regulatory Permission Was a Structural Part of the Moat (Stark and Anti-Kickback)

Buried in a single answer is the disclosure that Zocdoc "got permission" from regulators to run its performance-based discovery-booking model, after presenting the issue and laying out the benefits. In a space where Stark and anti-kickback rules constrain who can pay for patient referrals, a marketplace that has regulatory clearance for its pricing structure has a durable, hard-to-replicate advantage that competitors, especially new AI entrants who might copy the front-end, cannot simply clone.

Oliver Kharraz: "We were very blessed by getting... presenting this issue to the regulator, and also laying out why a system like Zocdoc is really beneficial for the patient, for the provider, for the payers. And we ultimately got permission to operate the model that we operate today." [00:24:18] Julie Yoo flagged the legal work as "pushing the envelope" but neither discussed its implications for AI-native entrants.

The Rise of AI Agents May Make Zocdoc's Supply-Side Integration More Valuable, Not Less, and Free Doctor-Side Onboarding Is the Lever

A throwaway framing, "the patient and the agent are one thing," implies Zocdoc is positioning to be the neutral, agent-agnostic supply layer. Combined with the 97% inbound provider signups and free self-serve onboarding, Zocdoc is building a supply base that every AI front end needs but none can easily replicate. The bottleneck for AI-driven healthcare access is not model quality but bookable, insurance-verified, real-time inventory, which is exactly the "Tetris" Zocdoc spent 20 years solving.

Oliver Kharraz: "The AI can give you the information. But Zocdoc can make it actually actionable." [00:12:33] And: "Our goal is to connect every single provider and make sure that every single front door in healthcare opens." [00:32:22] The signal for investors and founders: startups building on healthcare access can get API access through Zocdoc's website, a sign that the company expects third-party builders to become distribution partners rather than threats. [00:33:34]