Women @ RopesTalk: Conversation with Lisa Mango, One Medical

In this episode of Women @ RopesTalk, Ropes & Gray health care partners Jenn Romig and Christina Bergeron interview Lisa Mango, chief legal officer and general counsel of One Medical, a human-centered, technology-powered U.S. primary care organization on a mission to make quality health care more affordable, accessible, and enjoyable through a seamless combination of in-person, digital, and virtual care services. Lisa talks about the evolution of her career, beginning at a mid-sized law firm and then moving to in-house legal roles at early dot-com and design software companies before starting at One Medical in 2016. In looking back at her career, Lisa encourages junior lawyers to embrace the unknown, reflects on an important mentor, and shares her approach to working and parenting. Finally, she talks about the exciting past few years at One Medical, including the company’s recent agreement with Amazon.

Transcript:

Jenn Romig: Welcome, and thank you for joining us on our latest installment of Women @ RopesTalk, a podcast series brought to you by the Women’s Forum at Ropes & Gray. In this podcast, we spotlight extraordinary women who have had successful careers and interesting lives, and are also making a positive impact in their workplaces and in their communities. We feature women attorneys at Ropes & Gray in conversation with prominent women clients, industry leaders, entrepreneurs, and others about their careers, and what’s led to their successes, the challenges they’ve faced, and the hard-earned wisdom they’ve acquired. I’m Jenn Romig, a health care partner at Ropes & Gray, and I’m based in Chicago. My practice focuses on digital health, privacy and security, and mergers and acquisitions in the health care space. I’m here today with my colleague, Christina Bergeron, who’s also a health care partner. Christina, would you mind providing a brief overview of your practice for our listeners?

Jenn Romig: Excellent—thanks. With that, we would like to introduce our special guest, Lisa Mango, from One Medical. Welcome, Lisa.

Christina Bergeron: Lisa, that sounds great, and we can’t wait to dig in more to your role at One Medical. Before we get there, can you tell us how your career began? We know you’ve had a fascinating career and we’d love to hear more about it.

Lisa Mango: Sure. I started, like a lot of us, at a firm. I had no plan, really—I didn’t know if I wanted to be a partner, a general counsel, public defender, I don’t know… a badminton player or whatever.

Christina Bergeron: Sky’s the limit.

Lisa Mango: Sky’s the limit. So, what really happened to me is that through my experiences, it helped hone what I wanted to do. I started out at a mid-size firm—I did litigation. I got great experience right away—did depos, was in trial. I gained great humility as well as some public speaking experience, but decided that wasn’t my jam, so I moved into more employment counseling and technology transactions. Through that, I started to develop a real keen interest and love for talking with my clients and getting to understand their businesses, and being their daily partner.

I eventually transitioned to in-house. And my first real in-house career move was during the dot-com years, working for one of the fast-growing internet consulting companies. I say this was a seminal moment because I really had no in-house experience to speak of. I had just had my first child, who was six weeks old, and a former colleague reached out to me and said, “Why don’t you come be my second lawyer?” It was her first general counsel job, and I thought she was crazy. I didn’t really know what I was doing, but she told me that I was smart and hard-working —she had worked with me, and she wanted to go on this journey together. And that was awesome. I joined and I immediately had to negotiate complex licensing and consulting agreements. I had to look at public disclosure stuff. I had to handle IP litigation and international expansion. And I think we hired a team of eight more lawyers, all in a short period of time. Like many a dot-com company, it grew really fast, and then it un-grew really fast. And I moved with some folks over to their GC for a small start-up, which I enjoyed, as well—again, a broad array of legal work.

But when that started winding down, I decided to make a little bit of a change and go to a larger legal department where I could get not just broad, but deeper experience in different areas—and so that was at Autodesk. It’s still one of the largest design software companies. It’s an amazing company, and I had such a great experience there. And even though I was only there for almost 12 years, I probably had five or six different jobs.

Christina Bergeron: That’s so interesting.

Lisa Mango: I know. I worked for different product divisions. I supported the finance team, the employment team, started the compliance group for them, privacy, and even dabbled in some legal ops. So, I did a lot in those 12 years, and it was great.

Christina Bergeron: Lisa, this is a lot of categories/areas of the law. How have you tackled that?

Lisa Mango: When I was starting in a new practice area, two things: 1) find good outside counsel, but 2) sometimes even more importantly, find a peer benchmarking group, because they are invaluable. When I started the privacy group at Autodesk, I found a number of other in-house attorneys at peers, like Adobe, and they immediately helped me with templates and how to respond, and my favorite, which is when your business client tells you, “They're doing it at X company—why can’t we do it?”

Jenn Romig: Hear it all the time.

Lisa Mango: It’s so fun to pick up the phone and call the privacy attorney at X company—it’s like, “No, we're not doing that.” So anyway, I’ve always highly recommended to join benchmarking groups. Everybody, even if you’re competitors (and of course, the appropriate way), people bond and understand we’re all going through similar experiences.

Jenn Romig: And then you made a pretty big pivot over to digital health.

Lisa Mango: I did—yes. Primary care and digital health, with no health care regulatory background at all.

Jenn Romig: Just adding something else to your plate.

Lisa Mango: Exactly. But the real reason that I made that was because the woman who had recruited me to the original internet consulting company back in 1999 reached out to me again 15 years later and said, “I’m starting this legal team here, and I want you to join me.” She knew that I had dabbled in several different areas. She knew that I loved building things. Because even when I joined Autodesk, it still grew a lot—the legal department tripled in size while I was there, and the company did, so you’re building processes to support the different groups. So, she asked me to join, and I said, “Okay.” And it took off from there.

Christina Bergeron: It’s just very interesting how the common thread between some of the different jobs was this relationship you had with this woman you had worked with at the very beginning of your career, and you continued to have that trust, and she had that confidence in you, even that many more years later.

Lisa Mango: It was critical—and that’s one of the things I have attempted to share with my fellow colleagues, as well as folks on my team, is honestly, don’t ever think you can't do anything. Particularly at One Medical, I feel like I learn something new every day. There are some days I’d like to come into the office and just know everything that I’m asked—it’s rare. But just know that you can take chances. I do tell my team I’d rather they try and make a mistake than just not try at all.

Christina Bergeron: That’s good advice.

Lisa Mango: Beth had this belief in me—I knew that she was interested in a more strategic role, and that eventually she wanted me to take over as general counsel, which I did. It was terrifying because I didn’t have the health care regulatory background that was necessary. And frankly, our first couple hires at One Medical were not health care lawyers, and I know that sounds odd. I think the founder, Tom Lee, at the time, as well as Beth, had the view that some of the health care lawyers they had worked with weren’t as used to the pace, the innovation.

Jenn Romig: You have to be creative, flexible, thoughtful and practical.

Lisa Mango: You have to be creative because frankly, what were you thinking about doing didn’t really violate with the intent of the law was meant to capture. But pretty soon after hiring a couple more technology-focused attorneys, we brought in health care attorneys. And it’s been a fun mix, because it’s nice to have people that were trained with the depth of knowledge that a number of my team members have, and then it’s also nice to have folks who have been on the technology side, they can bring in some of that. One Medical is a health tech company—it’s a health care company, but it is empowered and enabled by technology. And so you find more of that in the technology world, or at least you did back then.

Jenn Romig: Yes—I think we’ve all found that oftentimes the regulations don't necessarily keep up with the technology, and that can be really difficult in an area like health care, where the technology is often trying to drive toward a greater good, but the regulations are taking a while to catch up.

Lisa Mango: Correct—and it can be frustrating.

Jenn Romig: It can be very frustrating. Christina and I hear all the time from your team about what an exceptional manager you are.

Christina Bergeron: It’s true.

Jenn Romig: It’s true. Christina went out to lunch with someone and she said, “Why are you still at One Medical?” And the person basically said, “Lisa. I’m still here because of Lisa.” And I’m sure there are more things—I have no doubt that this person loves One Medical overall—but I think it says a lot about you, and your strengths, and managing a team, and what you’ve learned, and then what you apply to your team in terms of the confidence you give them, or expectations. So, do you have a philosophy in how you build and run a legal department? It sounds like you’ve now done this at a few places, which is kind of a unique skill.

Christina Bergeron: Yes, tell us about your secret sauce. Jenn and I want to know.

Lisa Mango: Thank you for that. I have been so lucky. I have an amazing legal team, and I do hear that not just from my internal clients, but other folks who interact with them, including law firms. I think for me, the number one thing, consistent, I guess, with what I’ve been saying, is I need people who are teammates first, and are nimble, respectful, and really care about the DNA. And I know that sounds like corporate speak, but it has fostered an environment where people have been willing to jump in, particularly when our team was very small, and do things that they really didn't know a lot about, knowing that they had the support of the team, including me.

Christina Bergeron: Yes, for the sake of the team.

Lisa Mango: For the sake of the team. And so I’m pretty transparent.

Christina Bergeron: You don't say?

Jenn Romig: That’s one of our favorite things about you, as well.

Lisa Mango: I'll be the first to say, “I don’t know, let's figure it out.” I would tell them stories about my third day at One Medical. Fortunately, I was sharing an office with another One Medical attorney, when somebody from the marketing team had this idea about: “People love One Medical so much that they want to refer their friends. So, let’s pay them a referral bonus. Let’s give them a prize for referring a friend.” I'm like, “I came from a technology company. We did that all the time. That's great.” And then, the woman next to me said, “Actually, we can’t do that here.” And I said, “Hold on—one moment please.” So, I told him this story. I had to eat crow there.

Christina Bergeron: You made me nervous for a minute. I didn’t know where you were going with that, but you turned it back real quick.

Lisa Mango: We didn’t do it. But it was just more of an example of we’re all learning, we’re doing the best that we can. I do empower them. I have tried to share my experiences with them. I want them to work directly with the senior leaders of the company. And I think they care more about the business the more they know about it. I think to be a really effective in-house counsel, even if you’re a specialist, you really need to understand the business. Our business is complicated, health care is complicated, and One Medical has made health care even more complicated with a different business model. So, I think it’s a focus of really being together as a team—that’s the most important thing. There’s lots of smart lawyers out there. There’s not always a lot of smart lawyers who are willing to put team first, be flexible, take risks, and support their colleagues. And it’s amazing seeing some of these folks on my team grow.

Christina Bergeron: It’s like family. We also notice that the teams at One Medical are very diverse teams. And so speak to us a little bit about that: One Medical’s focus on diversity and how you feel like it helps the team.

Lisa Mango: That’s one of the things I loved about working there since the day I showed up. We were in the city, and I looked around, and I thought, “Wow, I really feel like I am in a diverse place, and have learned so much from the experiences that my diverse teammates have had.” It's really evident in our provider and our staff who work out in the fields, and we’ve made a huge connection to make sure that we have all different kinds of people because we serve a diverse group of patients, and you need to be able to relate to and understand some of the specific needs. And then that just becomes part of the company and the DNA, and you learn from them. I have several women on my team who are Asian, a couple African American, who have provided a lot of fascinating perspectives, and we spend a lot of time talking about our families and how we grew up, and it’s been interesting. One woman whom we hired recently was talking to me—she’s African American, and she said, “I know One Medical’s all about engaging in a non-formal way with their patients.” So, they don't call you “Dr. Jen,” they call you “Jen,” and they’ll call me “Lisa.” And she said, “I came from the South and grew up as an African American woman in the South, and we want to be called ‘Mrs. Mango.’” It's a respect thing, and so it was interesting. We have our patient interaction methodology, which we call CICARE, which is how we interact not just with our patients, but with everyone. But it’s focused on our patients, and it’s all about making sure that you connect—it'’ an acronym for Connect, Introduce, Communicate, Ask questions, Respond, and then Exit. And it’s a whole philosophy that we train everyone on, because we want the patient experience to be like you are going to a longtime friend’s house, as opposed to a scary medical office.

Christina Bergeron: Yes, you want people to be comfortable.

Lisa Mango: Right. And so some of the things that we’ve done: the providers don’t wear white coats, and we use first names. But you learn when you have a diverse set of employees with a diverse set of experiences how maybe you need to make adjustments.

Jenn Romig: You had a mentor who it sounds like encouraged you twice to step out of your comfort zone and into something new, including when you had a very young baby. I know you have team members with young children, as well—we’ve certainly talked to them. And Christina and I both have relatively young kids. Something I think we hear a lot about from our clients, from our female associates, is the struggle as a woman in the workforce, a mother in the workforce, this feeling of sometimes I think everything collapsing around you.

Christina Bergeron: The mental load.

Jenn Romig: Right—the mental load. And often, Christina and I will find ourselves talking to people about, “Do you step into this role? Do you step back?” Something that’s interesting that you’ve said, is that you really stepped into a new role when you had a newborn. How do you talk to other women on your team, or who you meet with—how do you encourage them? What words of wisdom, I guess, I would say, do you give them about their own careers?

Lisa Mango: It’s a great question. I think you take folks as they are. People have lots of options, and that’s one of the things I really want to tell people. You can feel like you have this new, really important job of being a mother, and particularly in the beginning—actually, most of the time—you feel clueless, but then why would you still take on something big? But you can do it if you want to, and if you have the right manager. This woman, her name is Beth Frensilli, said, “I don’t care if you have to miss work because your baby is sick or because you need to go to an appointment, or you need to be home because your nanny can’t be there.”

Christina Bergeron: She let you be a mom and have the job. She trusted you.

Lisa Mango: She said, “You’re going to get the work done—I’m not worried about that.” So, that’s where I’ve tried to say to folks, “I’m confident that you can get the work done. And so you can do it how you want to do it—it may be earlier in the morning, or later at night so you have time during the day. You may decide that you want to take a step back. And guess what? That’s okay too, because you can come roaring back. You are talented, and you can come roaring back.”

People have all different kinds of aspirations, but it’s also support groups too. Some people don’t have family nearby, or some people have a hard time finding child care. I had so much sympathy—I can’t even say empathy, because my kids were older by the time COVID came around. But when folks were with their young kids running around, attempting to go to school or not go to school, not having child care, and trying to do a very complicated job, because we were very busy during the pandemic, trying to stay in business and be as creative as possible to keep our patients safe without going out of business ourselves, I couldn't believe how folks did that. And so my philosophy was, “Take the days off. You can work on the weekends or whatever.” My only caution to parents in that situation, particularly women, is you do need to get yourself help when you can—even if you are working from home with a flexible arrangement, it’s just not relaxing to be doing that, particularly when you have a young kid, so get the help that you need. I think people have different options. You can lean in. I leaned in. I don’t remember exactly why, because this woman had faith in me, and it was great. But I’ve had friends who took a few steps back, but now they’ve leaned back in and they’re killing it. So, there’s lots of different options—it’s not just for women, it’s for men too, and I want to really support all the different options. And it really comes down to your performance in what you can do and what you’re capable of—it’s not the face time, it’s not the number of hours. It’s developing that level of trust and respect, and therefore, I want to support women and other parents when they have young kids.

Christina Bergeron: It sounds like you've done a great job doing so. It sounds like you also had a great role model in your mentor, who seems like she had some foresight as it related to that. That’s great.

Lisa Mango: I did. Yes, she actually had kids after me, and she looked at me and said, “I can't believe you did that.”

Christina Bergeron: That’s too funny.

Lisa Mango: I know, but she’s amazing, and she was able to do it all too. But again, it was all about who you were, the kind of work you did, your dedication to your job, and the trust. It's trust.

Christina Bergeron: Absolutely.

Jenn Romig: That’s great. I feel like we hear a lot of women in a moment of panic or weakness, will say, “I can't do this,” and things like that. And it is so important to have people around you who will uplift you and say, “It’s okay if you don’t want to, but you also don’t have to make that decision today. You can go home and try to get sleep, and then let’s talk tomorrow and see how you’re doing, because this isn't going to make or break it, this one moment.”

Lisa Mango: Correct—right.

Christina Bergeron: To pivot to today, I know in your past six or so years at One Medical it’s been really quiet, not a lot going on—it’s ordinary course. Jenn, do you want to highlight some of the big things?

Jenn Romig: Lisa, a few really big things: IPO in January 2020. Then of course, the pandemic. Then the Iora acquisition—huge deal: One Medical’s acquisition of Iora Health for $2.1 billion in September 2021. And now, in July 2022, Amazon agreeing to acquire One Medical for nearly $4 billion. That’s a lot of milestones in six years, and so I would love to hear from your perspective what’s been particularly interesting and challenging along the way as you’ve taken that journey?

Lisa Mango: A lot of it was new territory for myself and my management team, but it was so much fun. The IPO was a ton of work and felt like just a big milestone—and then six weeks later, we were in the pandemic. And so you have a newly public company whose primary source of revenue was generated from people coming into the office, and that wasn’t happening. We were doing our first-ever earnings call, and we didn’t know what we were going to say about guidance.

Jenn Romig: “This’ll blow over. It’ll all be done in two weeks.”

Lisa Mango: I know, I remember our head of IR said, “No, no—we’re supposed to record what you say in advance.” But we were basically writing it ten minutes before we got on. The reason we’ve been able to be successful is we have an incredible leader—his name is Amir Dan Rubin—and no task or no challenge is something that cannot be overcome. My team is truly flexible, has a sense of humor, and rolled with it. So, we went straight from the IPO to basically crisis meetings every morning at 8:00 a.m.: “What are we going to do? Are we going to be able to stand up testing? Are we going to be able to convert to remote telehealth visits? Can we bill for that? Can we get tests?” It was truly like being in crisis mode for a long time. And trying to keep up with all the rules—there were a number of flexibilities from a legal perspective that happened under COVID.

Christina Bergeron: Yes, the COVID waivers.

Lisa Mango: Exactly—which were great, but we never knew how long that was going to last or how much we could rely upon that. And so flexing all parts of the business to roll out a brand-new remote virtual visit model that you could bill, figure out how to distinguish it from our on-demand virtual services, and figuring out: Could we serve people in 50 states?

Christina Bergeron: Yes, that was a big one.

Lisa Mango: We do now. We were also growing. So, we started with eight markets and maybe 300,000 patients. By the time of the pandemic, we were in 20 markets, I think, and 500,000 patients. And now we’re in 28 or maybe 29 markets with 800,000 patients. In the midst of the pandemic, we started looking at opportunities, and we bought another primary care company that was so culturally aligned with us, and was a great fit, but had the opposite business model as One Medical. So, as you guys know, because you’re very familiar with them, this is Iora Health, who served mainly seniors and folks in Medicare. And for the most part, their business is a value-based model where they take risk for their patients. One Medical’s legacy model, for lack of a better word, was fee-for-service along with the membership fee. So, everyone was excited and everyone got along, but then we had to figure out really, “How are we going to merge these models to serve folks?”

Christina Bergeron: You needed to make a big impact.

Lisa Mango: It’s exciting, because we now can serve our members from when they’re born until they age into Medicare. But it has been a huge challenge trying to reconcile the different business models. Frankly, we had a smaller Medicare population, and so making sure we had, particularly from the legal and compliance side of things, that all nailed down, and getting folks together to do that. And we were still in the midst of that when the economy took an interesting turn—stock market wasn’t doing well and the cost of capital became very expensive.

One Medical is all about growth too—and it’s expensive. We build clinics. We build all of our own technology. So, surprisingly, but given the economic conditions, folks started knocking on our door and showing interest in buying us. It really was a small group of us—Amir, our CEO, Bjorn Thaler, our CFO, and myself—who were handling most of that. We eventually got into deeper discussions with Amazon, and realized how exciting the combination could be. I think what we realized are a couple of things, which we knew: Health care is hard and complicated. For us to make a real impact, we can do it more quickly with the support and backing of a company like Amazon, which will allow us to grow and stabilize the business during these uncertain times. They have a customer focus, just like One Medical. They appreciate innovation. So, there’s a lot of exciting things that can happen.

I would say one of my biggest challenges right now is managing through this state of uncertainty. What’s going to be my role? I would say, my team is a corporate function, so they’re a little nervous about that. Lawyers are also control freaks, so they want to know.

Christina Bergeron: They want the plan.

Lisa Mango: They want the plan—"What’s the plan?” But I am confident that Amir’s going to stay and lead. He wants to keep the band together, the gang together, whatever the expression is—he wants the legal team, compliance team, government affairs team, HR team, and everyone to stay together and operate under his leadership. I actually think it could be one of the most exciting, if not the most exciting place to practice health care law.

Christina Bergeron: Lisa, thank you so much for joining us today for this podcast. I feel like we covered a lot of amazing topics. I know we’re going to have a lot of listeners to this, so we can’t thank you enough.

Lisa Mango: You’re welcome. I really appreciate the honor of being asked to talk to you guys. Again, I will repeat, these guys are the best. If you need health care regulatory counsel, they have saved me many times. And they’re also fun to hang out with. So, thank you.

Jenn Romig: Christina and Lisa—thank you both so much. And as always, thanks to our listeners. For more information about Ropes & Gray’s Women’s Forum and our women attorneys, please visit www.ropesgray.com/women. You can also subscribe to this series wherever you typically listen to podcasts, including on Apple and Spotify. Thanks again for listening.

For more information or to contact Lisa Mango, please visit her bio on One Medical’s website or her LinkedIn profile.