15 ms·

At Theranos, Many Strategies and Snags

131 points by srunni 11y ago

tristanj 11y ago
>In April 2014, she got a long email from another employee. The employee alleged that Theranos had cherry-picked data when comparing Edison machines to traditional lab machines to make the Edison look more accurate, according to a copy of the email. >For one test, the device’s accuracy rate increased sharply after some information was deleted and manipulated, the employee wrote. Edison machines also allegedly failed daily quality-control checks often. >Ms. Holmes forwarded the email to Mr. Balwani. He replied to the employee, who no longer works at Theranos, denied all the claims and questioned the employee’s understanding of statistics and lab science. Oh man. If you read through Theranos' reviews on Glassdoor [1] this anecdote seems totally legitimate. Multiple reviews talk about the toxic culture and how management does anything to cover their behinds. Quite a few of these were written before the scandal broke so I think they're quite honest about what's going on. [1] https://www.glassdoor.com/Reviews/Theranos-Reviews-E248889_P6.htm?sort.sortType=OR&sort.ascending=false https://www.glassdoor.com/Reviews/Theranos-Reviews-E248889_P...
- randycupertino 11y ago
  Glassdoor actually removed a few of the more scathing negative reviews about working there. I think Theranos advertised on Glassdoor so they removed some of the even worse reviews... there used to be some even more negative ones.
  - shrewduser 11y ago
    i wonder if we can find them? or an archive of them?
  - jere 11y ago
    So I was on Glassdoor just yesterday and saw a little note "Your trust is our top concern, so companies can't alter or remove reviews." Is that just a flat out lie?
    - in_cahoots 11y ago
      It's not a lie but it's not necessarily the whole truth. Companies can't alter reviews, but Glassdoor definitely can and does. We just don't know what criteria they use.
      - randycupertino 11y ago
        Glassdoor seems like it has the same business model as yelp- "Buy our advertising and we will make your good rankings rank higher and your worse reviews be filtered or lower." Maybe not outright extortion but certainly not what they claim of being a truly independent forum.
        eli 11y ago
        That allegation against yelp has never been proven. I'd be surprised if either yelp or glass door is outright deleting reviews for money.
        rasz_pl 11y ago
        What would you consider a proof? does a a sales rep asking her friends to post fake negative reviews count? https://www.youtube.com/watch?v=C67Lh4LE5LY https://www.youtube.com/watch?v=C67Lh4LE5LY
        eli 11y ago
        The fact that they need to have friends post fake reviews suggests to me that this is not sanctioned activity or a systematic fraud. An environment where salespeople feel they can do stuff like that is a problem, but no, it is not proof that "yelp deleted bad reviews for money"
        xorcist 11y ago
        True not not, Yelp certainly wants you to believe it helps to buy from them. It's how they make money. It doesn't need to be written in the contract to work.
  - bby 11y ago
    Can someone post those reviews? I'm curious to read them. Hopefully there is a daily cache of glassdoor that we can look at.
    - randycupertino 11y ago
      The couple I remember reading that have been deleted were about how the CEO and the COO park their Ferraris/crazy racecar sports car in 2 designated spaces directly in the front entryway (like literally exactly in front foyer the building) whereas the actual handicapped spots were about 150 yards away down the parking lot away from the entry of the building compared to the CEO/COO spaces. There were also complaints about ridiculously high security to the point where people didn't even know their own exact job descriptions/workflows because of "competitive secrets" and that they couldn't talk to people working in other departments due to paranoia/culture of fear. Finally there were a couple about how they interview and act like your job will be at the fancy building on Sand Hill near Stanford but really the bulk of the employees are relegated to annexed buildings far away in EPA or in Mountain View, yet they don't tell them this until their start date - during all their onsite interviews up through the offer letter it seems like they'd be working at the HQ on Sand Hill.
- firasd 11y ago
  The kicker is right after your quote: He added: “This is product development, this is how startups are built.” The reply ended with an edict that the “only email on this topic I want to see from you going forward is an apology that I’ll pass on to other people.”
- tomasien 11y ago
  Just FYI for anyone clicking this link, this is a link that sets it to show the worst reviews on Glassdoor, not a random sampling. I wasn't that familiar with GD beforehand it and confused me.
  - devanti 11y ago
    You kind of have to. The vast majority of them are obviously fake. If you look at the wording / grammar there is a lot of similarity (uses of the word "Great", etc)
- deleted 11y ago
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- bane 11y ago
  Here's some fascinating things I came across above and beyond lousy management kvetching and nepotism complaints: - complaints about poor pay, minimal benefits, no options, no 401(k) matching, no wellness benefits, no gym - not allowed to post Theranos on your linkedin profile...that's crazy goobers - lots of acknowledgement by reviewers that many of the reviews of Theranos are fake, including a couple that say there's regular pressure to post fake positive reviews on the site. Reading the positive reviews that sound like press releases, I can believe Holmes probably wrote them herself. - long work hours, minimal work from home, regular weekend work - incredibly high turn-over rate (no surprise) - complaints about lack of domain knowledge up through the management chain, from product development to medicine - very heavy involvement by the COO in everyday employee's work, complaints about the COO's temper and lack of domain knowledge (he, Ramesh "Sunny" Balwani appears to be Stanford CS dropout who went on to get an undergrad and MBA elsewhere) - descriptions of the assay preparation not being particularly unique...which feeds my previous notion that they're main innovation is subsidizing blood tests with VC money to drive the price down - employees with experience in the regulatory environment are ignored - no protocol "if you stick yourself with a needle" (written by a current Phlebotomist)
  - akhilcacharya 11y ago
    Interesting thing about Balwani is he already had an IS/CS degree from UT Austin in '90 and a MBA from Haas in '03 - the CS degree from Stanford is from '04.
- Dr_tldr 11y ago
  Good shout on the glassdoor reviews, it's amazing how even the most rudimentary internet searching seems to elude journalists! Also, can this be our last Theranos thread before the company officially implodes? I get no small amount of freude out of this schade, but it's becoming the new bitcoin in terms of endlessly rehashed HN topics.
asdfologist 11y ago
As the article says, "blood tests sometimes provide life-or-death answers." If these allegations of fraudulent testing are true, then the executives belong in jail.
Mithaldu 11y ago
I'm honestly getting kind of annoyed with seeing stuff about Theranos, since everyone writing about them is beating about the bush, and only ends up describing how Theranos communicates with a startling lack of earnestness. Example from the video, paraphrased: Mod: "What prick tests are you able to do, using no commercially available lab equipment?" Holmes: "[lots of waffling] We're currently only doing the Herpes test. [proceeds to not answer the question]" Mod: [accepts the non-answer and moves on] This kind of reporting is entirely useless, unless it's some kind of attempt to subtly out Theranos for being dishonest.
- oska 11y ago
  A media interview is not a police room interrogation, nor a courtroom cross-examination. The interviewer (most probably) realises the question has not been properly answered but understands that they have to keep the interview moving. Also, if they go in too hard, it can have a backfiring effect of causing the audience to start sympathising with the person being interviewed (even though that person is clearly waffling and dissembling). The interview is still effective in that hard-headed people watching the interview who need concrete answers and actual information will still draw their own (likely negative) conclusions.
  - Mithaldu 11y ago
    Yeah, i understand that interviewing follows specific rules, since it's a realtime setting. However, what i failed to make clear in my original post: The mentioned exchange is not addressed seriously in the article either.
- trevyn 11y ago
  Huh? Sounds like she did answer the question -- only Herpes.
  - eropple 11y ago
    They're currently, as I understand it, doing the herpes test commercially (sometimes, apparently). The question was what they are able to do, not just in a commercial sense.
rdlecler1 11y ago
The key questions that needs to be addressed, is how homogenous or heterogenous are blood markers at the level they want to measure at? The machines may be reporting results accurately, but a pin-prick-sized droplet may simply not be a large enough sample size for the tests they want to run.
- srunni 11y ago
  There was a recent publication on this subject in the American Journal of Clinical Pathology (http://news.rice.edu/2015/11/17/blood-test-results-vary-from-drop-to-drop-in-finger-prick-tests/ http://news.rice.edu/2015/11/17/blood-test-results-vary-from...): > Bond and Richards-Kortum found that averaging the results of the droplet tests could produce results that were on par with venous blood tests, but tests on six to nine drops blood were needed to achieve consistent results.
- onewaystreet 11y ago
  >prick-sized droplet may simply not be a large enough sample size for the tests they want to run This was always the main criticism of Theranos. Finger-stick blood tests have never been considered reliable for clinical diagnostic tests because you don't get enough blood and the blood you do get can be contaminated.
  - brandon272 11y ago
    How does the blood become contaminated?
    - paulcole 11y ago
      Stuff on your fingertips.
    - CamperBob2 11y ago
      For one thing, it's almost impossible to get your skin perfectly clean. Any test that uses a single drop of blood will be very sensitive to even the slightest amount of soil or contamination on the fingertip where the drop is extracted.
desireco42 11y ago
Is it just me or WSJ increasingly is behaving like apologist for big business? They probably always were, just now I am noticing.
ThomPete 11y ago
No matter how this story ends (whether they eventually ends up with having a fully functioning product or not) this should be a cautionary tale to anyone wanting to actually change the world in healthcare. Science speaks for itself and does not care how much you raised at what valuation. It requires a rigorous approach to testings and facts and data or it will be merciless if you aren't living up to your own claims. So hopefully next time someone has a great disruptive idea in healthcare, they will spend a little more time getting the science and tech right before they start worrying about becoming a unicorn.
- krmboya 11y ago
  "For a successful technology, reality must take precedence over public relations, for nature cannot be fooled" - Richard Feynman
  - trhway 11y ago
    how about reality distortion fields?
- Zigurd 11y ago
  Well that's all very moral, but what Theranos is doing is mostly engineering. So while "hype the fuck out of it, raise big money, and fake it 'till you make it" might feel all icky, it's not a unique plan. Will we be saying the same things about Palantir? Maybe, maybe not. There's not that much difference between Palantir and Theranos. What has Palantir got that others don't? Answer: The ability to raise money at incredible valuations. Both are living off a mythologized ("PayPal has great fraud detection" and "you don't need an incompetent phlebotomist poking holes in your arm") advantage. We'll see if they can turn all that money into a real advantage. But you can't count on science to spank these people.
  - jjoonathan 11y ago
    That's what I thought at first, but $400M and 12 years should have been enough to put together a pretty solid uTAS seeing as microfluidic integration wasn't exactly bleeding edge back then either. But they seem to have drunk their own kool-aid and created a working environment so toxic that they sabotaged their own chances to fake it till they made it. They might still get there, but even if they do there's a lesson to be had about expectation management. EDIT: to clarify, I'm not the source of downvotes. Before the recent media explosion I believed exactly as you did.
geomark 11y ago
I like how Holmes' recollection of meetings is always different than the other attendees. Only one machine had an error message, not all three. She didn't abruptly walk out of the meeting. She didn't refuse to answer a question due to "trade secrets". And so on.
- CamperBob2 11y ago
  Every article I read about this company sounds like a recap of Rashomon. No two participants ever describe the same events.
  - mlvljr 11y ago
    Must be some sort of a quantum effect. All that future tech they are working with... (actualy, would be an interesting idea for a movie)
- wpietri 11y ago
  I can't help but be impressed by the spokesperson as well. It's clear the reporter didn't buy a word of it, and I don't either. But I wish I could have seen the discussion; that was a lot of impressive tap dancing.
MathsOX 11y ago
Many in SV find it hard to grapple with traditional startups not penetrating health care to a greater degree; in Rise of the Robots (one of the Financial Times and The Economist books of the year) it's lamented for an entire chapter. Traditionally the level of fundamental research and development displayed by Theranos - in areas of health or national defence - are done for years behind closed doors and then slowly rolled out to the public to mitigate any questioning of the underlying tech since the standards are understandably higher (i.e - it has to work from the start). This stands in contrast to the "move fast, break things" attitude pervasive in start-up culture. I don't think there's anything necessarily fraudulent about Theranos, from what I've read, which seems to be the not-so-subtle undercurrent in much of the commentary. Rather they flipped the model startups should use in health, which is establish a business model that works and then work on preparatory tech in the background until it's ready to be rolled out. This seems to be largely what Theranos has done, but not what it's purposely chosen to articulate to the public and investors as it surely would have garnered less attention/funding. At this point Theranos seems to be playing the waiting game; waiting for their technology to reach a point where they can make a more transparent case for their business model and change the narrative once they've reached a point that's more aligned with the aspirations that have been articulated by Holmes for the past decade. Once again, Peter Thiel's approach with Palantir looks to be extremely well executed and one that perhaps Theranos should have emulated.
- apalmer 11y ago
  Thing is, the approach your describing is fundamental dishonest... Leading investors to believe that you have technology that will be ready in 2011 when in reality you expect it to be ready in 2016 is not flipping a start up business model... It's just lying to get investor money
  - MathsOX 11y ago
    The latter half of that paragraph is articulating what I think Theranos is currently doing, not what I think they should have done. What I said they should have done is described to their investors the business model that would act as a stop gap measure (gain market share and revenues by using existing technology) while allowing them to develop their proprietary technology to a point where it can get regulatory approval and can replace the already existing tech they're currently using. > Leading investors to believe that you have technology that will be ready in 2011 when in reality you expect it to be ready in 2016 is not flipping a start up business model... It's just lying to get investor money I've not seen any indication that rounds were predicated on certain delivery dates of the tech (what tech? what is the "success" percent? can the tech be augmented with more traditional tools?). If terms did get that specific, then there would be grounds for potential fraud.
timrpeterson 11y ago
Theranos = Pets.com of this decade's bubble, which will once again be defined by founders, often young ones, having no clue what they are doing. Investors can you please get better at realizing that sometimes experience and know-how can help?
- wpietri 11y ago
  Should they get better at that? I mean, I'd like them to. But they're after return, not virtue or value. I can certainly say I don't like what they're doing, but I'm not sure I can say that they won't make money on this.
GabrielF00 11y ago
Does the composition of Theranos' board strike anyone else as very weird? It seems much more like the board of a foreign policy think thank than a biotech start up. There are three former cabinet secretaries (state and defense), two former very senior military officers, two former senators (one regarded as a foreign policy expert), a bigshot DC lawyer, and the former CEOs of Bechtel and Wells Fargo. The only physicians are former Senator Frist and a very credentialed epidemiologist, but it's not clear to me that either would have much knowledge about laboratory testing. I'm really curious what the rationale for this board composition is. [Edit: I'm curious if this is connected to Holmes' father's experience in the foreign policy establishment]
- michaelhoffman 11y ago
  If you were trying to get military contracts that might be pretty helpful. The military has a huge healthcare system. So does the Department of Veterans Affairs.
- hackaflocka 11y ago
  I suspect that Holmes is the "front" for someone connected to her father (who is a "civil servant" -- dunno why the article isn't more specific). Probably someone connected to military, government, etc.
  - GabrielF00 11y ago
    Her father has a high-level job at USAID. https://www.usaid.gov/who-we-are/organization/christian-holmes https://www.usaid.gov/who-we-are/organization/christian-holm...
    - bookbok 11y ago
      > Holmes worked in the field with USAID missions in Pakistan, Bangladesh, Indonesia, Egypt, Yemen, Ghana, Haiti, Liberia, Kenya, and Ethiopia > Holmes served in the U.S. Army, Second Lieutenant, Civil Affairs, receiving the U.S. Army Soldier’s Medal for Heroism. Want to guess who he really works for?
blakeross 11y ago
I wrote a parody of Theranos as a TV pilot that is increasingly becoming true: http://www.pricks.com/ http://www.pricks.com/ (I'm sharing this here because the Hacker News community seemed to enjoy my Season 3 premiere of Silicon Valley [https://news.ycombinator.com/item?id=10179894 https://news.ycombinator.com/item?id=10179894], but apologies if others feel it detracts from the discussion.)
- Cyberdog 11y ago
  Well, if nothing else, congrats on acquiring that domain name.
  - danso 11y ago
    It definitely wins my award for Most Esoteric, Timely Use of a Six-Letter .com Domain Name that Can Be Found in an English Dictionary.
- nikcub 11y ago
  Great stuff Blake. I can imagine an entire episode dedicated to trying to get Pricks onto Product Hunt. The double entendre's and puns write themselves.
- randycupertino 11y ago
  I was just thinking that someone needs to write a novelization of this Theranos nonsense & turn it into a screenplay and voilà:- Silicon Valley's "Wolf of Wall Street" or the next "The Social Network" ... I'm sure someone is already writing it up.
  - interesting_att 11y ago
    I thought Arrested Development has been parodying the tech scene well. Seasons 1-3, which aired during the Bush era, showed the lives of incompetent and corrupt property developers + military contractors. Now the main running gag is a BS non-existent app.
Animats 11y ago
How can I short Theranos?
- nradov 11y ago
  I suppose you could go long LH and DGX. They might outperform if a potential major competitor fails to make an impact.
- shoyer 11y ago
  This is yet another downside of unicorns ;). Though I doubt investors need much help at this point to realize how overvalued it is. Theranos will never raise at anything close to a $9B valuation again.
ekianjo 11y ago
Interesting, Theranos' funder's behavior is what you would expect from someone who knows nothing about Science: - make bold claims - avoid going into details ("trade secrets", sheesh) - make investors believe in your "vision" - give talks about successful entrepreneurship to polish one's image And still nothing reliably demonstrated. What amazes me the most is how clueless investors are. If they don't care about Science, what do they care about when it comes to providing new Healthcare solutions? What's next, a new take on homeopathy ?
- epistasis 11y ago
  > What's next, a new take on homeopathy ? Not too far off, actually: http://blogs.sciencemag.org/pipeline/archives/2015/12/04/andreessen-horowitzs-first-move-in-biopharma http://blogs.sciencemag.org/pipeline/archives/2015/12/04/and...
  - ekianjo 11y ago
    Hehe, I really like Derek's sense of humor: > A few billion years of blind evolutionary tinkering gives you a mass of insane, irrational, tangled interwoven systems with no documentation in sight. Crazy new things keep getting uncovered all the time (siRNA! Who knew!), and the number and scope of the crucial things we have no clue about is just another one of the things that we have no clue about. If your worldview has been formed by using human tools to make human-designed applications for humans, you are in for quite a shock.
6d0debc071 11y ago
It's a long shot gamble funded by some people who maybe should and maybe shouldn't know better - I don't pretend to be in a position to judge the science in this case. So, who cares? I don't mean that in a derogatory sense, I mean it in the sense that you might set yourself a limit of a few hundred pounds for a game of poker one night. If it pays off, great. If it doesn't, no biggy. If they're committing fraud, then there are regulatory mechanisms in place around that - how far you trust those is an issue, but it's a much larger issue than one company. The big sin that you mustn't commit, and that many do anyway, is to trust a private company's data where a potential conflict of interest like this exists. Run your own trials.
ekianjo 11y ago
> Sunny Balwani is an entrepreneur and a computer scientist. Sunny joined Theranos after dropping out of the Computer Science program at Stanford University. He received his MBA at UC Berkeley and undergraduate degree from UT Austin. Honest question, can you claim to be a Computer Scientist if you drop out from a computer Science program ? To me it sounds like calling yourself a Doctor after dropping out following the first year of Medicine Studies. Needless to say, this smells of arrogance more than anything else.
- chetanahuja 11y ago
  Sounds like he dropped out of a graduate degree from Stanford. If his undergrad degree from UT Austin he might have a plausible fig leaf to go around calling himself "a computer scientist". Though I certainly wouldn't call somebody who with just an undergraduate degree a "scientist" in any field unless they've proven themselves by practicing such science in a credible manner for a reasonable period of time.
  - isolate 11y ago
    I prefer an operational definition: a scientist is somebody who does research using the scientific method. But then again, this eliminates a bunch of CS people, since they're mostly doing math and engineering.
    - chetanahuja 11y ago
      Me too. Hence the "practicing such science" part in my comment. University degrees such as Master of Science/Doctor of Philosophy etc. are meant to provide validation from universities that the holder of such degrees has had some training in the discipline but it's by no means a requirement to be a scientist (Leonardo da Vinci certainly didn't have a PhD).
      - ekianjo 11y ago
        In theory, yes. But when it comes to highly specialized topics, there are a number of things that are very hard to learn on your own (at least for now) without going through an academic path. Chemistry, Biology, pretty much require hands-on experience as part of your education - and you can't do that kind of things from home or simply by reading books.
ekianjo 11y ago
> He replied to the employee, who no longer works at Theranos, denied all the claims and questioned the employee’s understanding of statistics and lab science. > Quality-control failures were due to the “newness of some of our processes, which we are improving every day,” Mr. Balwani wrote. > He added: “This is product development, this is how startups are built.” The reply ended with an edict that the “only email on this topic I want to see from you going forward is an apology that I’ll pass on to other people.” I would rather question Balwani's understanding of Lab Science and Statistics as someone who has never had a remote experience of lab science in the first place. And about his understanding of Statistics, I have no idea where he thinks he has any authority either. MBAs are not particularly known to be very good at grasping probabilities.
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devanti 11y ago
though not yet proven, I believe we may have found the Enron of our decade
FussyZeus 11y ago
Holmes' backstory is getting so redundantly covered. It's like how every Superman movie has to walk us through how he was sent to Earth when Krypton was destroyed. I suppose if the author didn't talk about Holmes' history, though, they wouldn't have half the damn article. Certainly nothing interesting to talk about with that company by itself, were it not for the headline grabbing founder. That said if I read about how this "inspiring" person dropped out of Stanford when she were only 19 one more time I might lose my mind.
aceperry 11y ago
For awhile, I kept seeing job posts at Theranos, which is how I know the name. I didn't know whether they were expanding or just had high employee turnover. The WSJ articles and the strange Glassdoor reviews (either totally love the company and CEO or extremely negative about the company and its ethics) leads me to believe that the WSJ is correct. The latest article with the video interview of the CEO, makes me think that she is incredibly smooth at spouting the BS, to the point of being a pathological liar. This company will be VERY interesting to watch during the coming year.
- draker 11y ago
  I'd be interested to be the results from a bot monitoring/archiving the Glassdoor page. I'm sure Glassdoor has some ability to audit or approve the review statements before they posted publicly which would provide some degree of damage control, but given the negative reviews it seems some would get through.
melted 11y ago
The company's name sounds vaguely like "tear anus". What did they expect?

131 points by srunni 11y ago

>In April 2014, she got a long email from another employee. The employee alleged that Theranos had cherry-picked data when comparing Edison machines to traditional lab machines to make the Edison look more accurate, according to a copy of the email. >For one test, the device’s accuracy rate increased sharply after some information was deleted and manipulated, the employee wrote. Edison machines also allegedly failed daily quality-control checks often. >Ms. Holmes forwarded the email to Mr. Balwani. He replied to the employee, who no longer works at Theranos, denied all the claims and questioned the employee’s understanding of statistics and lab science. Oh man. If you read through Theranos' reviews on Glassdoor [1] this anecdote seems totally legitimate. Multiple reviews talk about the toxic culture and how management does anything to cover their behinds. Quite a few of these were written before the scandal broke so I think they're quite honest about what's going on. [1] https://www.glassdoor.com/Reviews/Theranos-Reviews-E248889_P6.htm?sort.sortType=OR&sort.ascending=false https://www.glassdoor.com/Reviews/Theranos-Reviews-E248889_P...

randycupertino 11y ago
Glassdoor actually removed a few of the more scathing negative reviews about working there. I think Theranos advertised on Glassdoor so they removed some of the even worse reviews... there used to be some even more negative ones.
- shrewduser 11y ago
  i wonder if we can find them? or an archive of them?
- jere 11y ago
  So I was on Glassdoor just yesterday and saw a little note "Your trust is our top concern, so companies can't alter or remove reviews." Is that just a flat out lie?
  - in_cahoots 11y ago
    It's not a lie but it's not necessarily the whole truth. Companies can't alter reviews, but Glassdoor definitely can and does. We just don't know what criteria they use.
    - randycupertino 11y ago
      Glassdoor seems like it has the same business model as yelp- "Buy our advertising and we will make your good rankings rank higher and your worse reviews be filtered or lower." Maybe not outright extortion but certainly not what they claim of being a truly independent forum.
      - eli 11y ago
        That allegation against yelp has never been proven. I'd be surprised if either yelp or glass door is outright deleting reviews for money.
        rasz_pl 11y ago
        What would you consider a proof? does a a sales rep asking her friends to post fake negative reviews count? https://www.youtube.com/watch?v=C67Lh4LE5LY https://www.youtube.com/watch?v=C67Lh4LE5LY
        eli 11y ago
        The fact that they need to have friends post fake reviews suggests to me that this is not sanctioned activity or a systematic fraud. An environment where salespeople feel they can do stuff like that is a problem, but no, it is not proof that "yelp deleted bad reviews for money"
        xorcist 11y ago
        True not not, Yelp certainly wants you to believe it helps to buy from them. It's how they make money. It doesn't need to be written in the contract to work.
- bby 11y ago
  Can someone post those reviews? I'm curious to read them. Hopefully there is a daily cache of glassdoor that we can look at.
  - randycupertino 11y ago
    The couple I remember reading that have been deleted were about how the CEO and the COO park their Ferraris/crazy racecar sports car in 2 designated spaces directly in the front entryway (like literally exactly in front foyer the building) whereas the actual handicapped spots were about 150 yards away down the parking lot away from the entry of the building compared to the CEO/COO spaces. There were also complaints about ridiculously high security to the point where people didn't even know their own exact job descriptions/workflows because of "competitive secrets" and that they couldn't talk to people working in other departments due to paranoia/culture of fear. Finally there were a couple about how they interview and act like your job will be at the fancy building on Sand Hill near Stanford but really the bulk of the employees are relegated to annexed buildings far away in EPA or in Mountain View, yet they don't tell them this until their start date - during all their onsite interviews up through the offer letter it seems like they'd be working at the HQ on Sand Hill.
firasd 11y ago
The kicker is right after your quote: He added: “This is product development, this is how startups are built.” The reply ended with an edict that the “only email on this topic I want to see from you going forward is an apology that I’ll pass on to other people.”
tomasien 11y ago
Just FYI for anyone clicking this link, this is a link that sets it to show the worst reviews on Glassdoor, not a random sampling. I wasn't that familiar with GD beforehand it and confused me.
- devanti 11y ago
  You kind of have to. The vast majority of them are obviously fake. If you look at the wording / grammar there is a lot of similarity (uses of the word "Great", etc)
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bane 11y ago
Here's some fascinating things I came across above and beyond lousy management kvetching and nepotism complaints: - complaints about poor pay, minimal benefits, no options, no 401(k) matching, no wellness benefits, no gym - not allowed to post Theranos on your linkedin profile...that's crazy goobers - lots of acknowledgement by reviewers that many of the reviews of Theranos are fake, including a couple that say there's regular pressure to post fake positive reviews on the site. Reading the positive reviews that sound like press releases, I can believe Holmes probably wrote them herself. - long work hours, minimal work from home, regular weekend work - incredibly high turn-over rate (no surprise) - complaints about lack of domain knowledge up through the management chain, from product development to medicine - very heavy involvement by the COO in everyday employee's work, complaints about the COO's temper and lack of domain knowledge (he, Ramesh "Sunny" Balwani appears to be Stanford CS dropout who went on to get an undergrad and MBA elsewhere) - descriptions of the assay preparation not being particularly unique...which feeds my previous notion that they're main innovation is subsidizing blood tests with VC money to drive the price down - employees with experience in the regulatory environment are ignored - no protocol "if you stick yourself with a needle" (written by a current Phlebotomist)
- akhilcacharya 11y ago
  Interesting thing about Balwani is he already had an IS/CS degree from UT Austin in '90 and a MBA from Haas in '03 - the CS degree from Stanford is from '04.
Dr_tldr 11y ago
Good shout on the glassdoor reviews, it's amazing how even the most rudimentary internet searching seems to elude journalists! Also, can this be our last Theranos thread before the company officially implodes? I get no small amount of freude out of this schade, but it's becoming the new bitcoin in terms of endlessly rehashed HN topics.

asdfologist 11y ago

As the article says, "blood tests sometimes provide life-or-death answers." If these allegations of fraudulent testing are true, then the executives belong in jail.

Mithaldu 11y ago

I'm honestly getting kind of annoyed with seeing stuff about Theranos, since everyone writing about them is beating about the bush, and only ends up describing how Theranos communicates with a startling lack of earnestness. Example from the video, paraphrased: Mod: "What prick tests are you able to do, using no commercially available lab equipment?" Holmes: "[lots of waffling] We're currently only doing the Herpes test. [proceeds to not answer the question]" Mod: [accepts the non-answer and moves on] This kind of reporting is entirely useless, unless it's some kind of attempt to subtly out Theranos for being dishonest.

oska 11y ago
A media interview is not a police room interrogation, nor a courtroom cross-examination. The interviewer (most probably) realises the question has not been properly answered but understands that they have to keep the interview moving. Also, if they go in too hard, it can have a backfiring effect of causing the audience to start sympathising with the person being interviewed (even though that person is clearly waffling and dissembling). The interview is still effective in that hard-headed people watching the interview who need concrete answers and actual information will still draw their own (likely negative) conclusions.
- Mithaldu 11y ago
  Yeah, i understand that interviewing follows specific rules, since it's a realtime setting. However, what i failed to make clear in my original post: The mentioned exchange is not addressed seriously in the article either.
trevyn 11y ago
Huh? Sounds like she did answer the question -- only Herpes.
- eropple 11y ago
  They're currently, as I understand it, doing the herpes test commercially (sometimes, apparently). The question was what they are able to do, not just in a commercial sense.

rdlecler1 11y ago

The key questions that needs to be addressed, is how homogenous or heterogenous are blood markers at the level they want to measure at? The machines may be reporting results accurately, but a pin-prick-sized droplet may simply not be a large enough sample size for the tests they want to run.

srunni 11y ago
There was a recent publication on this subject in the American Journal of Clinical Pathology (http://news.rice.edu/2015/11/17/blood-test-results-vary-from-drop-to-drop-in-finger-prick-tests/ http://news.rice.edu/2015/11/17/blood-test-results-vary-from...): > Bond and Richards-Kortum found that averaging the results of the droplet tests could produce results that were on par with venous blood tests, but tests on six to nine drops blood were needed to achieve consistent results.
onewaystreet 11y ago
>prick-sized droplet may simply not be a large enough sample size for the tests they want to run This was always the main criticism of Theranos. Finger-stick blood tests have never been considered reliable for clinical diagnostic tests because you don't get enough blood and the blood you do get can be contaminated.
- brandon272 11y ago
  How does the blood become contaminated?
  - paulcole 11y ago
    Stuff on your fingertips.
  - CamperBob2 11y ago
    For one thing, it's almost impossible to get your skin perfectly clean. Any test that uses a single drop of blood will be very sensitive to even the slightest amount of soil or contamination on the fingertip where the drop is extracted.

desireco42 11y ago

Is it just me or WSJ increasingly is behaving like apologist for big business? They probably always were, just now I am noticing.

ThomPete 11y ago

No matter how this story ends (whether they eventually ends up with having a fully functioning product or not) this should be a cautionary tale to anyone wanting to actually change the world in healthcare. Science speaks for itself and does not care how much you raised at what valuation. It requires a rigorous approach to testings and facts and data or it will be merciless if you aren't living up to your own claims. So hopefully next time someone has a great disruptive idea in healthcare, they will spend a little more time getting the science and tech right before they start worrying about becoming a unicorn.

krmboya 11y ago
"For a successful technology, reality must take precedence over public relations, for nature cannot be fooled" - Richard Feynman
- trhway 11y ago
  how about reality distortion fields?
Zigurd 11y ago
Well that's all very moral, but what Theranos is doing is mostly engineering. So while "hype the fuck out of it, raise big money, and fake it 'till you make it" might feel all icky, it's not a unique plan. Will we be saying the same things about Palantir? Maybe, maybe not. There's not that much difference between Palantir and Theranos. What has Palantir got that others don't? Answer: The ability to raise money at incredible valuations. Both are living off a mythologized ("PayPal has great fraud detection" and "you don't need an incompetent phlebotomist poking holes in your arm") advantage. We'll see if they can turn all that money into a real advantage. But you can't count on science to spank these people.
- jjoonathan 11y ago
  That's what I thought at first, but $400M and 12 years should have been enough to put together a pretty solid uTAS seeing as microfluidic integration wasn't exactly bleeding edge back then either. But they seem to have drunk their own kool-aid and created a working environment so toxic that they sabotaged their own chances to fake it till they made it. They might still get there, but even if they do there's a lesson to be had about expectation management. EDIT: to clarify, I'm not the source of downvotes. Before the recent media explosion I believed exactly as you did.

geomark 11y ago

I like how Holmes' recollection of meetings is always different than the other attendees. Only one machine had an error message, not all three. She didn't abruptly walk out of the meeting. She didn't refuse to answer a question due to "trade secrets". And so on.

CamperBob2 11y ago
Every article I read about this company sounds like a recap of Rashomon. No two participants ever describe the same events.
- mlvljr 11y ago
  Must be some sort of a quantum effect. All that future tech they are working with... (actualy, would be an interesting idea for a movie)
wpietri 11y ago
I can't help but be impressed by the spokesperson as well. It's clear the reporter didn't buy a word of it, and I don't either. But I wish I could have seen the discussion; that was a lot of impressive tap dancing.

MathsOX 11y ago

Many in SV find it hard to grapple with traditional startups not penetrating health care to a greater degree; in Rise of the Robots (one of the Financial Times and The Economist books of the year) it's lamented for an entire chapter. Traditionally the level of fundamental research and development displayed by Theranos - in areas of health or national defence - are done for years behind closed doors and then slowly rolled out to the public to mitigate any questioning of the underlying tech since the standards are understandably higher (i.e - it has to work from the start). This stands in contrast to the "move fast, break things" attitude pervasive in start-up culture. I don't think there's anything necessarily fraudulent about Theranos, from what I've read, which seems to be the not-so-subtle undercurrent in much of the commentary. Rather they flipped the model startups should use in health, which is establish a business model that works and then work on preparatory tech in the background until it's ready to be rolled out. This seems to be largely what Theranos has done, but not what it's purposely chosen to articulate to the public and investors as it surely would have garnered less attention/funding. At this point Theranos seems to be playing the waiting game; waiting for their technology to reach a point where they can make a more transparent case for their business model and change the narrative once they've reached a point that's more aligned with the aspirations that have been articulated by Holmes for the past decade. Once again, Peter Thiel's approach with Palantir looks to be extremely well executed and one that perhaps Theranos should have emulated.

apalmer 11y ago
Thing is, the approach your describing is fundamental dishonest... Leading investors to believe that you have technology that will be ready in 2011 when in reality you expect it to be ready in 2016 is not flipping a start up business model... It's just lying to get investor money
- MathsOX 11y ago
  The latter half of that paragraph is articulating what I think Theranos is currently doing, not what I think they should have done. What I said they should have done is described to their investors the business model that would act as a stop gap measure (gain market share and revenues by using existing technology) while allowing them to develop their proprietary technology to a point where it can get regulatory approval and can replace the already existing tech they're currently using. > Leading investors to believe that you have technology that will be ready in 2011 when in reality you expect it to be ready in 2016 is not flipping a start up business model... It's just lying to get investor money I've not seen any indication that rounds were predicated on certain delivery dates of the tech (what tech? what is the "success" percent? can the tech be augmented with more traditional tools?). If terms did get that specific, then there would be grounds for potential fraud.

timrpeterson 11y ago

Theranos = Pets.com of this decade's bubble, which will once again be defined by founders, often young ones, having no clue what they are doing. Investors can you please get better at realizing that sometimes experience and know-how can help?

wpietri 11y ago
Should they get better at that? I mean, I'd like them to. But they're after return, not virtue or value. I can certainly say I don't like what they're doing, but I'm not sure I can say that they won't make money on this.

GabrielF00 11y ago

Does the composition of Theranos' board strike anyone else as very weird? It seems much more like the board of a foreign policy think thank than a biotech start up. There are three former cabinet secretaries (state and defense), two former very senior military officers, two former senators (one regarded as a foreign policy expert), a bigshot DC lawyer, and the former CEOs of Bechtel and Wells Fargo. The only physicians are former Senator Frist and a very credentialed epidemiologist, but it's not clear to me that either would have much knowledge about laboratory testing. I'm really curious what the rationale for this board composition is. [Edit: I'm curious if this is connected to Holmes' father's experience in the foreign policy establishment]

michaelhoffman 11y ago
If you were trying to get military contracts that might be pretty helpful. The military has a huge healthcare system. So does the Department of Veterans Affairs.
hackaflocka 11y ago
I suspect that Holmes is the "front" for someone connected to her father (who is a "civil servant" -- dunno why the article isn't more specific). Probably someone connected to military, government, etc.
- GabrielF00 11y ago
  Her father has a high-level job at USAID. https://www.usaid.gov/who-we-are/organization/christian-holmes https://www.usaid.gov/who-we-are/organization/christian-holm...
  - bookbok 11y ago
    > Holmes worked in the field with USAID missions in Pakistan, Bangladesh, Indonesia, Egypt, Yemen, Ghana, Haiti, Liberia, Kenya, and Ethiopia > Holmes served in the U.S. Army, Second Lieutenant, Civil Affairs, receiving the U.S. Army Soldier’s Medal for Heroism. Want to guess who he really works for?

blakeross 11y ago

I wrote a parody of Theranos as a TV pilot that is increasingly becoming true: http://www.pricks.com/ http://www.pricks.com/ (I'm sharing this here because the Hacker News community seemed to enjoy my Season 3 premiere of Silicon Valley [https://news.ycombinator.com/item?id=10179894 https://news.ycombinator.com/item?id=10179894], but apologies if others feel it detracts from the discussion.)

Cyberdog 11y ago
Well, if nothing else, congrats on acquiring that domain name.
- danso 11y ago
  It definitely wins my award for Most Esoteric, Timely Use of a Six-Letter .com Domain Name that Can Be Found in an English Dictionary.
nikcub 11y ago
Great stuff Blake. I can imagine an entire episode dedicated to trying to get Pricks onto Product Hunt. The double entendre's and puns write themselves.
randycupertino 11y ago
I was just thinking that someone needs to write a novelization of this Theranos nonsense & turn it into a screenplay and voilà:- Silicon Valley's "Wolf of Wall Street" or the next "The Social Network" ... I'm sure someone is already writing it up.
- interesting_att 11y ago
  I thought Arrested Development has been parodying the tech scene well. Seasons 1-3, which aired during the Bush era, showed the lives of incompetent and corrupt property developers + military contractors. Now the main running gag is a BS non-existent app.

Animats 11y ago

How can I short Theranos?

nradov 11y ago
I suppose you could go long LH and DGX. They might outperform if a potential major competitor fails to make an impact.
shoyer 11y ago
This is yet another downside of unicorns ;). Though I doubt investors need much help at this point to realize how overvalued it is. Theranos will never raise at anything close to a $9B valuation again.

ekianjo 11y ago

Interesting, Theranos' funder's behavior is what you would expect from someone who knows nothing about Science: - make bold claims - avoid going into details ("trade secrets", sheesh) - make investors believe in your "vision" - give talks about successful entrepreneurship to polish one's image And still nothing reliably demonstrated. What amazes me the most is how clueless investors are. If they don't care about Science, what do they care about when it comes to providing new Healthcare solutions? What's next, a new take on homeopathy ?

epistasis 11y ago
> What's next, a new take on homeopathy ? Not too far off, actually: http://blogs.sciencemag.org/pipeline/archives/2015/12/04/andreessen-horowitzs-first-move-in-biopharma http://blogs.sciencemag.org/pipeline/archives/2015/12/04/and...
- ekianjo 11y ago
  Hehe, I really like Derek's sense of humor: > A few billion years of blind evolutionary tinkering gives you a mass of insane, irrational, tangled interwoven systems with no documentation in sight. Crazy new things keep getting uncovered all the time (siRNA! Who knew!), and the number and scope of the crucial things we have no clue about is just another one of the things that we have no clue about. If your worldview has been formed by using human tools to make human-designed applications for humans, you are in for quite a shock.

6d0debc071 11y ago

It's a long shot gamble funded by some people who maybe should and maybe shouldn't know better - I don't pretend to be in a position to judge the science in this case. So, who cares? I don't mean that in a derogatory sense, I mean it in the sense that you might set yourself a limit of a few hundred pounds for a game of poker one night. If it pays off, great. If it doesn't, no biggy. If they're committing fraud, then there are regulatory mechanisms in place around that - how far you trust those is an issue, but it's a much larger issue than one company. The big sin that you mustn't commit, and that many do anyway, is to trust a private company's data where a potential conflict of interest like this exists. Run your own trials.

ekianjo 11y ago

> Sunny Balwani is an entrepreneur and a computer scientist. Sunny joined Theranos after dropping out of the Computer Science program at Stanford University. He received his MBA at UC Berkeley and undergraduate degree from UT Austin. Honest question, can you claim to be a Computer Scientist if you drop out from a computer Science program ? To me it sounds like calling yourself a Doctor after dropping out following the first year of Medicine Studies. Needless to say, this smells of arrogance more than anything else.

chetanahuja 11y ago
Sounds like he dropped out of a graduate degree from Stanford. If his undergrad degree from UT Austin he might have a plausible fig leaf to go around calling himself "a computer scientist". Though I certainly wouldn't call somebody who with just an undergraduate degree a "scientist" in any field unless they've proven themselves by practicing such science in a credible manner for a reasonable period of time.
- isolate 11y ago
  I prefer an operational definition: a scientist is somebody who does research using the scientific method. But then again, this eliminates a bunch of CS people, since they're mostly doing math and engineering.
  - chetanahuja 11y ago
    Me too. Hence the "practicing such science" part in my comment. University degrees such as Master of Science/Doctor of Philosophy etc. are meant to provide validation from universities that the holder of such degrees has had some training in the discipline but it's by no means a requirement to be a scientist (Leonardo da Vinci certainly didn't have a PhD).
    - ekianjo 11y ago
      In theory, yes. But when it comes to highly specialized topics, there are a number of things that are very hard to learn on your own (at least for now) without going through an academic path. Chemistry, Biology, pretty much require hands-on experience as part of your education - and you can't do that kind of things from home or simply by reading books.

ekianjo 11y ago

> He replied to the employee, who no longer works at Theranos, denied all the claims and questioned the employee’s understanding of statistics and lab science. > Quality-control failures were due to the “newness of some of our processes, which we are improving every day,” Mr. Balwani wrote. > He added: “This is product development, this is how startups are built.” The reply ended with an edict that the “only email on this topic I want to see from you going forward is an apology that I’ll pass on to other people.” I would rather question Balwani's understanding of Lab Science and Statistics as someone who has never had a remote experience of lab science in the first place. And about his understanding of Statistics, I have no idea where he thinks he has any authority either. MBAs are not particularly known to be very good at grasping probabilities.

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devanti 11y ago

though not yet proven, I believe we may have found the Enron of our decade

FussyZeus 11y ago

Holmes' backstory is getting so redundantly covered. It's like how every Superman movie has to walk us through how he was sent to Earth when Krypton was destroyed. I suppose if the author didn't talk about Holmes' history, though, they wouldn't have half the damn article. Certainly nothing interesting to talk about with that company by itself, were it not for the headline grabbing founder. That said if I read about how this "inspiring" person dropped out of Stanford when she were only 19 one more time I might lose my mind.

aceperry 11y ago

For awhile, I kept seeing job posts at Theranos, which is how I know the name. I didn't know whether they were expanding or just had high employee turnover. The WSJ articles and the strange Glassdoor reviews (either totally love the company and CEO or extremely negative about the company and its ethics) leads me to believe that the WSJ is correct. The latest article with the video interview of the CEO, makes me think that she is incredibly smooth at spouting the BS, to the point of being a pathological liar. This company will be VERY interesting to watch during the coming year.

draker 11y ago
I'd be interested to be the results from a bot monitoring/archiving the Glassdoor page. I'm sure Glassdoor has some ability to audit or approve the review statements before they posted publicly which would provide some degree of damage control, but given the negative reviews it seems some would get through.

melted 11y ago

The company's name sounds vaguely like "tear anus". What did they expect?