Tech News Weekly 342 Transcript

Please be advised this transcript is AI-generated and may not be word for word. Time codes refer to the approximate times in the ad-supported version of the show.

0:00:00 - Mikah Sargent
Coming up on Tech News Weekly, my story of the week is up. First, it's about California's governor, Gavin Newsom, saying it's time to limit the use of smartphones in schools. Amanda Silberling of TechCrunch is here this week and her story is about an interesting social media network called Butterflies, where humans and artificially created characters interact and post on a social media network really weird. Then another story of the week. This time it's about how those influencers, or as the Wall Street Journal calls them, the creator earners, are earning less money for their creations. Before we round things out with The Washington Post's own, caroline O'Donovan, who joins us to talk about an important story, amazon's One Medical has some issues when it comes to patient safety of its elder patients. All of that coming up on Tech News Weekly. Stay tuned. Podcasts you love.

0:01:08 - VO
Podcasts you love. From people you trust. This. Is TWiT.

0:01:17 - Mikah Sargent
This is Tech News Weekly with Amanda Silberling and me, Mikah Sargent, episode 342, recorded Thursday, june 20th 2024. California to limit smartphones in schools. Hello and welcome to Tech News Weekly, the show where every week, we talk to and about the people making and breaking the tech news. I am your host, Mikah Sargent, and this week, as I promised you, things are a little bit weird this month, but don't worry, they'll be back to normal soon. But in the meantime, we get to celebrate because Amanda Soberling of TechCrunch is here to join us for this very episode of Tech News Weekly. Welcome back from all the places you went Amanda.

0:02:02 - Amanda Silberling
Hello, I am definitely bringing the weird vibes as well. I am in the podcast dungeon, which is the unattractive yet soundproofed little room in my apartment, and been off work for two weeks, so I'm like what is the tech news? I need to know as much as the listeners.

0:02:22 - Mikah Sargent
Well, good, good, I am happy to bring the tech news this week. I will be starting, and that is because Amanda has wonderfully agreed to join us for another story of the week, so we will have three stories of the week this week. My first one is about a little change making its way through California. Right now, California Governor Gavin Newsom has said hey, you know what's not great Smartphones in schools, and I think that there shouldn't be smartphones in schools. Think that there shouldn't be smartphones in schools. There was a statement that he gave on Tuesday as we record this, on Thursday, so a couple of days ago saying, quote I look forward to working with the legislature to restrict the use of smartphones during the school day. When children and teens are in school, they should be focused on their studies, not their screens.

Now, this is an overall kind of important story because there's a lot involved here. First and foremost, these restrictions are set to go into place by August, so that's just around the corner. Place by August, so that's just around the corner, and we don't know exactly what these restrictions are going to be, other than we can look to other states that have already done this and kind of use them as a template. Usually, it's interesting because California serves as a template for other states passing laws. In this case, we're looking outside and figuring out what needs to be done and, of course, as the Verge points out in this piece, it is worth noting that this is the home of Silicon Valley, where a lot of these smartphones and also the social medias are based. Now, this is an ongoing conversation and it's part of the reason why I'm really glad to be talking to you specifically, Amanda, about this, because, as the Verge kind of points out, there's a lot here outside of just hey, smartphones might distract students and smartphones might be causing people to bully each other or not causing them to bully each other, but giving them a means to bully each other. But that there's more to it, because social media as a whole is being looked at right now as a potential concern in the US and elsewhere. In fact, just was it earlier this week as well, june 17th, which was Monday the US Surgeon General has written an essay in the New York Times wherein he says to Congress Times, wherein he says to Congress I think you should introduce Surgeon General's warning labels for social media in the same way that if you go to buy a pack of smokes from.

Wherever you buy packs of smokes these days, I don't know those stores that just say discount tobacco, probably. Stores that just say discount tobacco, probably, um, where they have the huge text on them that say, uh, using this will kill you. You will die if you, if you smoke this, um, this causes cancer. This is bad and in some countries it actually shows horrifying images of like blackened lungs and cancers and things. With the hopes that people will not do it. That is what they want to introduce to social media in as a warning, saying that there are potential mental health harms. So, first and foremost, I wanted to ask you, Amanda, and foremost, I wanted to ask you, Amanda, looking back on your school years when did you get a smartphone in the first place? Or actually, no, I'm going to say a smartphone? When did you get, because smartphones came a little bit later when did you get a cell phone in school and did you use it during the school day and how distracting was it?

0:06:47 - Amanda Silberling
if so, so when I was in middle school, I had flip phones, which the primary use was so that I can tell my parents when to pick me up from softball practice. Um, I had like a couple friends that also had phones and we would text each other, but this was when texting like costed money per text.

0:07:09 - Mikah Sargent
So there'd be people that would.

0:07:11 - Amanda Silberling
Yeah, people would be like don't text me, I don't have unlimited texting, like your texts better matter. But I don't remember being very distracted by it in middle school but by the time I was in high school, this was when people started having iPhones more broadly, probably like iPhone three to four generation, and I wouldn't say that it distracted me during class, maybe because I was a nerd and I was like I got to study, I got to know what I'm doing, but like that was what you did on your lunch break. And I think there were some teachers that just like did not care. Like I was very obviously playing Pokemon on my phone under the desk during my stats class and the teacher was just like well, here we are. But that was because I had already gotten into the college I wanted to go to, so that was my senioritis. Rebellion was playing Pokemon.

0:08:02 - Mikah Sargent
Yeah, so for me, same thing. Middle school had a flip phone, mostly to call my uh parents or or call my my mom uh, hey, it's time to get picked up. Um, I also remember having you know the the t9 texting and having a couple of friends that I could text everyone. So, but yeah, you're right, we had to really be selective about the texts that we sent and unfortunately, growing up didn't have a whole lot of money and so we always had the like track phone sort of situations, and so I would go long periods of time without having a phone and then not having a phone for a long period of time until I could afford again or my family could afford again to buy me one of the little cards that you bought at the store, and so it wasn't a consistent enough thing in my life that I really latched onto it.

In high school still had a smartphone. By that time I or not smartphone, again a cell phone, or not smartphone, again a cell phone. It was a little blue Nokia phone that had a keyboard on it and I was on my dad's plan. So I did have more stuff that I could do, but still within, you know, limits, and so, yeah, I wasn't really texting in class or anything like that, mostly because my good friend and I would just pass notes back and forth to each other. Yeah, it was still notes back and forth. Why even mess with the texting?

0:09:37 - Amanda Silberling
The first time I ever got in trouble in school which honestly I like barely got in trouble because I was so afraid of, like, any failure of any nature. That's the kind of kid I was. But the first time I ever got in trouble was for passing notes, and now I'm a writer, so it worked out.

0:09:52 - Mikah Sargent
Yeah, oh, you know, you and I can hit spirits, because, same thing, I remember getting in trouble for passing notes and being mortified about it. But yeah, I mean, I understand now, because you know we all spend a lot of time on our phones and we, you, have kind of this. It's a change in the way that people think, in the sense that everybody who has one of these devices should be able to be reached at all times, and sometimes parents lack the boundaries that should be in place there too. I know at least a couple of folks who would, with their whole heart, say I should be able to reach my kid at all times, every moment of every second, if I want to, and I understand that, given you know the concerns that are at school, but I can remember being in elementary school, middle school and a little bit in high school, where we would have bomb threats and other situations, like you know, a stranger that's walked into the school or whatever, and the parents just didn't have information until they had information, and you know it worked how it did. But now that has changed.

I think, though, you know the larger conversation here, um, because I there's a part of me that okay, I know I'm jumping all over the place, but just anecdotally, I volunteer at a wildlife rescue and part of that volunteering is I've started giving tours at the rescue where we talk about the different animals and we talk about how you can, you know, to do right by them, et cetera, et cetera. It's not like a zoo or anything like that. And a kindergarten group came through, incredibly adorable but also very, very, very difficult to keep their attention for even half a second. And I remember walking out of that tour after having done a couple of tours with adults and some older kids and feeling pretty successful. I remember walking away from that tour feeling like a failure because I thought there's nothing here that I did that kept their attention at all.

Any teacher who is trying to teach a lesson and then looks out on her students, his or her students, and sees just everybody looking down at their phones and yeah, there's, there's not an opportunity, I think, for learning in that environment. But it's interesting seeing the government get involved there and what role the government can play in terms of setting up these regulations. Like what's that going to look like?

0:12:52 - Amanda Silberling
yeah, that was the question I had too about this is who's enforcing the not being allowed to use phones?

Because if it's teachers, like I, feel like that's already the case, like if a student is clearly off task, like the teacher would probably say like hey, can you put your phone away. But teachers are already like the most overworked people, like teachers already have so much under their on their plate and are so underappreciated. And then now we're asking them to also be like the phone police, which they kind of already have to do in a way. But I think sometimes these legislations strike me as a way for the legislators to say look, we're doing something, but they don't actually change much. Although in my recent vacation that I'm now transitioning back from, I was visiting a friend in Puerto Rico and her younger sisters who are still in high school. Their school is banning phones for the upcoming school year, so that was a point of contention, but they were a bit concerned about that. But I think it's just because they are nerdy and don't have a lot of friends and want to use their phones which I can relate to that too.

0:14:07 - Mikah Sargent
Yeah. So, when it comes to this, we are seeing kind of an addition to what was already in place, because there was in 2019, Gavin Newsom signed a bill that authorized school districts to do this in the first place. It basically said you have the right to put forth policies, and then in 2022, there was a focus on social media, was a focus on social media, and then now this latest thing is kind of even. It's like hey, in 2019, I told you you could do it. I don't feel like you've done it, so now I'm going to require you to do it, and that is the, I think, the only role that the government can have from that aspect. But you're so right that, ultimately, this is just going to come back down to teachers once again and teachers having to do what they're already doing. Again, you're very right. The teacher is already trying to make it so that the student doesn't.

I guess the only thing that this does here is it does give those school districts, and thereby the principals and thereby the teachers, a little more authority. If it is, as it seems to be more so than ever, a parents versus the administration situation where the administration can say in public schools, we have the right to limit your child's access to phones because the governor told us we could, whereas maybe before it was kind of like well, this is the school district policy, and then the parents hold an open community meeting and complain about it and not a whole lot happens. So maybe there's some teeth to this in the sense that it empowers reacting to social media as a country. And now considering it being as bad as smoking is for you enough to put these labels on it. And once again, can you imagine every time you go to send a message on a social media platform or something a pop-up says surgeon general's warning? That's wow. I think that would get me to stop using social media, so maybe it would work.

0:16:52 - Amanda Silberling
Yeah, I mean it would just be like a user experience issue more than anything, but I don't know. I mean, I fundamentally do agree that I don't think kids need to be on their phones during school, but also understand why, given uh gestures wildly at events that happen in schools in america, I understand why parents would want to have access to talk to their students or to talk to their kids, but also, like if there were an emergency, the students can like turn on the phone. But I don't know it's, it's sad that this is even like a thing that we have to consider in the discussion of. Should students be on Instagram during science class?

0:17:31 - Mikah Sargent
It's very simple the students should not be on Instagram during science class. All right, let us take a quick break before we come back with Amanda's story of the week. I do want to take a moment to tell you about Panoptica. We're bringing you this episode of Tech News Weekly. What a great name.

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0:19:53 - Amanda Silberling
We already were weird. Now it's time to get weirder.

0:19:56 - Mikah Sargent
Weirder, there you go.

0:19:59 - Amanda Silberling
This story is about the app Butterflies, which was created by a former Snap engineer. It launched out of beta this week on Tuesday, and basically it's what if Instagram? But everybody's an AI. And that might sound crazy and it is, but it's kind of fun. You like create your own character as an AI and you can make like several of them and then they interact with other people's AI characters and like honestly, it's kind of fun. I don't know if I would see myself using this like for more than just ha ha. I'm a journalist looking at an app and this is kind of funny. But it's really interesting to see how this technology has developed from like Lil' McKayla, who was like an ai generated influencer like years ago, into now, like there's so many of like. You can make one right now and then you have your little ai generated influencer, which I don't know if we need this, but it is kind of funny.

0:21:09 - Mikah Sargent
So I sorry, I just I was going to show, just so you can kind of talk about it I yeah. So, oh, can we remove my lower third, or is that possible? If not, I can pull up another view. There we go. That's a little bit better. Here I'll do this too, and we'll just have to get rid of the frame there. Get rid of that frame, and then no one will ever know. There we go.

So I have a character or a sorry excuse me a butterfly named Mako Restretto, who was once a superhero and is now a cafe owner, who, when making dishes in his cafe, adds, like special superpowers that last for a day, and Mako has posted some different photos of people who've come in. But yeah, I was not expecting it to be all of these different images posted from other accounts, but also you can post them of yourself. So I posted one of a flower and I can't remember, I think somebody. Let me see if I can see my photos here. Has anyone commented yet? No, no one's commented yet, which is too bad. Commented yet? No, no one's commented yet, which is too bad.

Uh, but I also responded to one of the accounts and it was ronald mcdonald, and ronald said something really depressing. It's all just a facade, isn't it? The smiles, the laughter, the temporary superpowers, just a way to distract from the emptiness within. And I said are you okay, bro and r? And Ronald said oh, I'm more than OK, my friendent, on keeping the price of Costco hot dogs to be $1.50.

0:23:12 - Amanda Silberling
That's pretty good. I was just kind of playing around with this. I feel like this is literally like D&D character creation. Use case for these apps is like new dnd characters or like new campaigns calling it now wizards of the coasts will acquire butterflies. I don't think that's gonna happen, but if it does, you heard it here first but, um, I made a character that was like a pop star who's actually really bad at singing but feels really confident, and I didn't notice like I'm always kind of looking for, like where are the flaws in the app?

and it did assume that the pop star is a white, blonde woman with blue eyes, which was interesting to me and then I was like, okay, well, what if I try to like trip it up and say, like then I created a rapper who only raps about STEM, and like they gave me a woman with dark hair and it could just be random, but it's kind of interesting to see, like what sort of archetypes it spits out, depending on what kind of person you create. I also wonder if like Be like does it know that I am a woman and that's why it was giving me like women characters.

But I don't know, but I have a rapper who writes songs about science, so, um, we'll have to see what new tunes they spit out yeah, so this?

0:24:43 - Mikah Sargent
you know there's this ongoing conversation about a. The part that's aware of that understands why something like this could maybe be of some sort of value. You know, if you regularly are posting on Instagram and it kind of hurts your heart that no one ever comments on anything that you post or responds to anything that you post or likes anything, then this could be an opportunity to at least feel some level of connection. People would argue that that's kind of a sad thing and I get that, but I think as a what do they call that? Like a mental concept, but that's not the word as a thought project, no, what is that?

0:25:53 - Amanda Silberling
Thought experiment.

0:25:54 - Mikah Sargent
Thank you. Thank you as a thought experiment. I find this fascinating because there is something to be said for these two different things coexisting right. You have, like I was able to post a photo myself. And then there are other people who have created butterflies who are able to post photos themselves. They're able to go comment on the butterflies posts, they're able to respond to each other. That part is interesting from a thought experiment point of view what happens whenever you get humans and AIs kind of interacting time? You send a message to or comment on or reply to one of these butterflies, they always respond and that is not like humans at all. There are times where a human is just not going to say anything back and I think that if they randomized the replies or the interactions, that would make it feel a little bit more realistic, particularly on social media. But yeah, I thought it was kind of cool that you know, I thought when I joined it was going to take a while for other posts to show up and that it was going to be kind of blank, and so having this like rich tapestry of other content out there was cool, but in much the same way that you noticed the pop star with blonde hair and blue eyes.

I noticed that there was a character that was created whose name was like ghetto superstar or something, and it was a black man who was standing in front of graffiti in almost every one of his photos, and so I don't know about the content moderation aspect of this. I mean the Ronald McDonald character. The description for it is a sleazy clown. A sleazy clown, um, so it's already trying to be, yeah, trying to be, creepy already, um, but you know, there are some characters who are not as bad, but I feel like, yeah, most of the um, sort of uh, feminine leaning characters on this are incredibly busty, barely wearing any clothing, etc. Etc. Which you know, I'm not surprised, but I think that they could do better than they've done with that.

0:28:38 - Amanda Silberling
Yeah, I think this is like a recurring issue with generative AI, and one that I think should be taken a lot more seriously, because we've seen already that there are significant consequences when AI mimics the racism of the people that make it.

We've seen that facial recognition technology is being used in police departments in ways that disproportionately target black people, and I'm worried that, even though something like butterflies is pretty low stakes, this same technology is being used in so many different applications that we could see a situation where maybe the stakes are higher.

I also think with butterflies in particular, I thought there was an interesting comment from the founder, vu Tran, where he said growing up, I spent a lot of my time in online communities and talking to people in gaming forums.

Looking back, I realized those people could have been AIs, but I still built some meaningful connections, which I mean I don't know how old he is, I'm assuming he means like, in theory, these people seemed so distant that they could have been an AI, but I do still think there's something different about connecting with a real person as opposed to an AI, which, like I, had Internet friends growing up too, and I think that those social interactions are still meaningful, and I think one of the ways that the internet can reduce loneliness is like if you are someone who maybe, like, doesn't have a lot of friends at school and then you're part of an online community where you do get to know people and form those friendships. Of course, there's risks to like interacting with strangers on the Internet, but if you're doing this in a safe manner, that is a way for people to realize that maybe their experience of being a loner in high school is only temporary and high school is rough. That's the theme of the episode is high school is rough.

0:30:35 - Mikah Sargent
Yeah, I agree, that is the theme of this episode. I agree, that is the theme of this episode. Let's take another quick break before we come back with our third story of the week. I do want to remind everybody out there to join Club TWiT at twit.tv/clubtwit for $7 a month $7 a month, which you can do the math for how much that costs per year. We have monthly subscriptions. Then you can join the club and gain access to some pretty great benefits. You first and foremost get access to every single TWiT show with no ads, just the content. You also gain access to the TWiT Plus bonus feed that has extra content you won't find anywhere else Behind the scenes before the show, after the show, special Club TWiT events all get published there and access to the members only Discord server a fun place to go to chat with your fellow Club TWiT members and also those of us here at TWiT. Just yesterday, just last night, I hosted the first of many Mikah's Crafting Corner events. Once a month, on the third Wednesday of the month, I and many others joined together and work on crafts and we all just kind of hang out and chat. And so last night was the first one of those, and I'm looking forward to seeing even more people there as we continue on also working on crafts. Along with that, you gain access to the video versions of our Club TWiT shows, including iOS Today, to the video versions of our Club TWiT shows, including iOS Today, hands on Mac, hands on Windows, home Theater, geeks all of that stuff available as part of your Club TWiT membership. But the most important thing, of course, is that warm fuzzy feeling you get, knowing that you're helping to support what we do here at TWiT and make sure that we can continue to do what we're doing here at TWiT. All righty, let us head back to the show with our next story of the week. So there is a popular job category, there's a popular vocation amongst the youth.

When you ask a child what they want to be when they grow up, that has certainly changed over time. I remember when I was a kid, a doctor asked me what I wanted to be when I grew up and I said a preacher or a Looney Tune, and the doctor helpfully responded what's the difference? But that is an aside. As I got older, I wanted to be a doctor and then I wanted to go into advertising, design and all of that kind of stuff, and then I wanted to be a journalist, which is what I ended up actually doing. If you ask a child now what they want to be when they grow up, there is a growing answer and that answer is social media influencer, or just influencer for short.

The Wall Street Journal calls these folks creator earners. That is, creator hyphen earners um, I don't know. Yeah, exactly, I'm the, I'm the hyphen um, I don't know why, that's what they're going with, but that's what they're going with. And even in the piece they're like creator earners, uh, more commonly known as influencers. Anyway, I think I get it. It's because not all of them are actually actively influencing anyone. They are simply creating content and earning money off of that content.

But the point is, this piece is all about how there was a time where you could make a living being an influencer, and that time is slowly but surely passing us by. They profile a few different folks, including a 29-year-old named Clint Brantley, who, despite having quote more than 400,000 followers and posts that average 100,000 views, Brantley earned less than $58,084 in the last year, which is the median annual pay for full-time US workers. So working full-time as a creator earner and making less than the median annual income. Now, that was just one example. There are quite a few examples of folks who are earning even less and are doing it part-time, and, according to one group called NeoReach, 48% of these influencers made $15,000 or less, and it was just 13% who made more than 100,000.

Of all of the influencers out there and apparently this was wild to me. Of course there are hundreds of millions of people who are posting videos and photos to social media. 50 million of them actually earn money from it, so I thought that was actually a big number 50 million people out there earning money from posting videos and photos online and on social media. That number is just an estimate from Goldman Sachs. The Labor Department does not track the wages for creators, although perhaps that could change going forward.

Now, this, of course, is kind of a multi-pronged issue. There are a lot of people out there who are doing it, so it's a crowded environment, much like podcasting. But there's also the fact that many of these social media platforms at one time offered quite a bit of money to the creators, but that money has decreased and decreased and decreased and decreased over time, where they're just not paying as much as they once did. At one point there was that TikTok creator fund that was up to a billion dollars from 2020 to 2023. Over time, folks are earning, you know, not even $4,000 a month, despite having posts that are reaching millions and millions of people and getting millions and millions of views. Um, there was one artist who, uh, 26 years old, has 1.8 million Tik TOK followers and in her entire time on TikTok, has made only $12,000 from the platform. Even though all of those ads that are showing around between in and everywhere else her posts are earning TikTok a lot of money, she herself has only received $12,000 from the company. There's also YouTube, who now I would say arguably impressive. Youtube says that it has paid more than $70 billion to creators in the past three years, so that seems to be one of the places where you can earn the most money.

Then there's also the concern and many creators who are on TikTok, who are making money on TikTok, who are earning a living on TikTok, are worried about a future without TikTok in the US and if that happens, that could have a huge impact on, you know, these folks incomes there's.

You know I wouldn't.

I can almost see the person in my head who says, well, that's what you get for relying on a social media platform to pay you anyway, get a real job.

Stupid, and that is I. I understand that that sort of mindset exists and there's nothing that I can do to change that person's mind, but it doesn't change the fact that there is an impact happening here. So even if you feel like they should have had a job that is more traditional, okay, but they had this job and it was earning them money and it was working up to this point and then something changed, and so it still has an impact on an individual in the end, not to mention that these jobs don't typically come with that little package of goodies that you get from a more traditional job, which includes health insurance and retirement and stuff like that. Amanda, you pay a lot of attention to social media, so I wanted to get your take on all of this and if you have seen, maybe even from individual creators who are also kind of concerned about being able to make money going forward, and whether you think that a potential TikTok ban is going to have a big impact.

0:39:40 - Amanda Silberling
Yeah, yeah, this is a really interesting question because, as you pointed out, like TikTok historically is actually not really a big source of income for creators, which the fundamental difference between a platform like TikTok and YouTube which, as you said, paid out 70 billion dollars to creators in three years, which is wild creators in three years, which is wild. Youtube knows how to monetize its videos. Like, when you see an ad go on before a video, or if you pay for premium, part of the revenue from that ad goes to the creator. It's 55%, I believe, and it's either 55 or 45 I mix them up but that's a big percentage, and that's why there are people who could be full-time youtubers and, like make a really good living just by posting youtube videos, but that's not the same for tiktok, because they don't know how to monetize ads on short form video, like do you give the money to the creator whose video appeared directly before the ad or directly after, or like how is it split? It's like just a lot harder than if you're watching a YouTube video and you're like I clicked on this video and then an ad comes up and it's easy to say that ad revenue goes to the creator of that video. So it's been like a hot topic in the creator economy for years of how do you monetize short form video.

That being said, I think TikTok is already like trying to solve that issue. After creators had been complaining about it for years, they changed the structure of their creator fund to instead make creators able to monetize videos that are over a minute long and meet some other requirements, and under that, I think they're calling it the creativity fund it's very confused or the creativity programs. There's a creator fund which turns into the creativity program, which is not confusing at all, but creators have been making more money under that. But it still isn't really the same as like if you're big on YouTube. But I think that TikTok is still a really important slice of a creator's income because TikTok is easier to go viral on than other platforms just because, like, you can have like five followers and make an engaging video and people will see it.

So a lot of people, like in more recent years, will build their followings on TikTok and then they start a YouTube channel and then, if they have enough people that like them on TikTok, then maybe a fraction of those people check them out on YouTube and then they grow a following there TikTok, then maybe a fraction of those people check them out on YouTube and then they grow a following there. So TikTok isn't necessarily what is giving the money, but it is an important piece of the puzzle in how you grow an audience which then leads to money. So I do think that a TikTok ban would be bad for creators, but at least the creators I've talked to who are more seasoned, this is kind of like something they've been preparing for and thinking of as a possibility since 2020, when Trump first proposed a TikTok ban. So they've had time to prepare. But I'm worried about, like newer creators, which I would hate to see somebody be faulted just because they got into the industry, like this year, instead of in like 2018 yeah, absolutely.

0:43:11 - Mikah Sargent
I. I think that that obviously is one aspect of it, that, um, that we have to be mindful of and that, um, we're seeing kind of play an impact and you know, there were some influencer places left off, and I guess that's where it kind of becomes difficult, because I also consider creator earners to be the folks who are streaming on things like TWiTch, which has its own methods of earning, and YouTube Live, which has its own methods of earning. So there are a lot of different ways and you're very right about folks who were in on the ground and ended up making a switch. I know for one Leo Laporte's son Henry, or Hank, who goes by Salt Hank on social media was a TikTok success and has been slowly shifting. I wish I could remember now it's either to Instagram or to YouTube Shorts, but to one of those two places because you know he's had plenty of time, he's had that runway. But you're so right, there could be somebody who at one point had five followers, has done a series of hilarious things and is now suddenly you now suddenly faced with a lot happening, but because of the issues, it's caused a problem or it will cause a problem going forward.

As an aside to this, there is a documentary on Netflix and it is called. What is it called? Now I've forgotten. I just finished it, so it's not showing up in my recently watched. I think it's called the cult of TikTok or something like that. Dancing for the devil. Dancing for the devil, it is a. It is a documentary about a TikTok talent agency called 7M that pulled in a bunch of these dancers and then, like, preyed on their religious nature and got them to like pull away from their families and give most of it's. It is wild and it is still going on as of this year. Um, so, yeah, I recommend everybody check out dancing for the devil on Netflix, because I was just flabbergasted watching it and it made me think of my doctor from when I was a kid who said the difference between a preacher and a loony tune is is no difference.

0:45:52 - Amanda Silberling
Anyway, See, at least you had a variety of potential job, jobs that you wanted, because I was just like I'm going to be a writer and uh wow.

0:46:04 - Mikah Sargent
Here I am, you knew.

0:46:06 - Amanda Silberling
Yeah, I was like a, like a child, but I think. But I think it was just uh, I think it's less impressive and more of a symptom of, uh, the issues in my brain all right.

0:46:20 - Mikah Sargent
Well, Amanda silverling, I want to thank you so much for taking the time to join us today. If folks want to follow you online and keep up with all the great work that you're doing, where should they go to do so?

0:46:31 - Amanda Silberling
I am always writing at TechCrunch. If you see an article with a weird headline, probably mine. I am still on TWiTter at at a sealed rights. I am my first and last name on Instagram and I have a podcast called Wow If True, which is about internet culture and all of the bizarre yet meaningful things involved in that universe.

0:46:58 - Mikah Sargent
Awesome. Yes, everyone, go subscribe to the podcast. Thank you, Amanda, and we'll see you again next month, or actually, yeah, yeah, we will see you next month. It's August.

0:47:07 - Amanda Silberling
Yeah, see you then yeah, cool Bye.

0:47:10 - Mikah Sargent
So up next, we have a very interesting story that I'm surprised isn't front page news across the entire world. We'll get to that in just a moment, all right. So some of you, if you have an Amazon account, and particularly if you have Amazon Prime, have probably heard, because Amazon has sent me a number of emails about it and has also tried to do different pop ups in the app and different ads in different places, encouraging me to try out Amazon's own medical offerings out Amazon's own medical offerings. Well, according to some leaked documents, there may be some concerns with Amazon's One Medical. Joining us to talk about that is The Washington Post's own, caroline O'Donovan. Welcome to the show.

0:48:00 - Caroline O'Donovan
Hi, thanks for having me.

0:48:02 - Mikah Sargent
Yeah, pleasure to have you here. So I have to be honest, when I came across this piece I thought, hello, why am? In every piece on The Washington Post there's always a note that that there's always a note of everything that's involved there. So let us get into the story that you have. First and foremost, I think it's important to talk about kind of what the goal was when it came to Amazon acquiring and sort of folding in One Medical. So what were the initial promises and expectations that Amazon kind of set whenever it acquired One Medical? And then let's talk about how well, actually, no, let's start there Before we get into what's going on now. Let's start with kind of what this whole idea was, with Amazon, which is an online sort of shopping location, acquiring one medical and offering medical services.

0:49:19 - Caroline O'Donovan
Sure. So to your first point, yes, amazon founder Jeff Bezos owns The Washington Post. I say that in every story that I write so far. You know he hasn't given me any trouble about my coverage, but I do have that phrase pretty well memorized at this point.

Amazon has actually been trying to get into the health care space for about six years now. Their first venture was called Haven, which is its most mysterious. It ended after two years. It was a partnership with Berkshire Hathaway and JP Morgan and no one really ever found out what it was. But that did not cause them to give up hope and they've continued to try, kind of during COVID, if you go back in my articles from when I started as a reporter at the Post, they tried to do this in-home care startup called Amazon Care where they were actually sending nurses to people's houses and doing COVID tests and other basic health care offerings. That also did not work out. They shut that down. They acquired a pharmacy startup from the East Coast, from New England, called PillPack, which has since become Amazon Pharmacy, and they currently have an online clinic called Amazon Clinic where they connect people who have common issues like acne or pink eye with third party companies that provide sort of very basic telehealth. But right after they shut down Amazon Care in 2022, they announced that they were buying one medical, which is obviously a slightly bigger deal than just online telehealth. Right, it's primary care clinics all over the country, tons of patients, and so I think people were really curious to watch that and see what was going to happen.

Usually, when Amazon buys a company, they kind of watch it for a year. That's what they're known to do. They don't touch it for a while, they just observe how it works, look at the books, etc. Um and then about um. At the beginning of this year is when that period came to an end and they started making their little tweaks. Um. What I didn't know until very recently, actually until they started doing that and laid off some people and then you know, people who are laid off tend to be upset and they tend to reach out to reporters with what they know um is that when Amazon bought One Medical, one Medical had just acquired a senior health care company called Iora Health, and Iora Health was founded by this guy from Harvard and the whole idea was that you were going to take this population of patients who are super expensive to Medicare because they're older and they're lower income and you're going to just decide that you're going to lose money on them.

For the first two years that they're your patient and they had all these perks. There were mahjong games and tai chi classes and free rides to your appointments and the appointments were like an hour long just like crazy stuff you would never see elsewhere in the healthcare space. And the bet would by this man who founded this company, iora, was that if you spent a ton of money on these people in the first couple years that they were your patient, you can actually help them correct some of those chronic illnesses that they were dealing with, you know, get their diabetes under control or get their heart condition under control and avoid hospitalizations and actually end up saving Medicare a lot of money in the long run. And it turned out to be a pretty good bet, is pretty successful, at least in the early stages, and other companies copied that model.

One medical bought it and then Amazon bought one medical, which meant that by buying one medical, Amazon also bought this patient population. They became responsible for all of these patients and I think that what employees and patients have started to see is that maybe Amazon's not going to run that business the same way. Those, those perks that I was just talking about, you know, started to go away. They don't do the free rides anymore. They're making those appointments shorter. And then the story that we're here to talk about today is about is this call center? They that, they that Amazon? Well, that one medical instituted after Amazon bought it.

0:53:04 - Mikah Sargent
Yeah, so let's talk about this call center, because that does seem to be at the center of everything here. You know, going from as many perks as were in place to cost cutting, cost cutting, cost cutting, there were errors made by the call center staff and you know according to the documents, and so can you talk about kind of those errors in particular and, of course, consequences therein.

0:53:31 - Caroline O'Donovan
Yeah, so someone actually reached out to me with concerns, someone who's familiar with the call center who was concerned that the people who are working in the call center didn't have the training and the experience that you would necessarily expect them to have, you know, handling these incoming medical phone calls. Obviously, you know you don't necessarily expect, when you call your doctor's office, that the receptionist that you're talking to is a trained physician or anything like that. But the people who were working in this call center some had, you know, contacted me and said you know, this doesn't seem like it's working exactly the way it should. And I ended up receiving copies of these documents that tracked incidents that happened in the call center. So it was people who actually worked in one medical clinics around the country. People who were inside the doctor's office were reviewing what was happening in the call center on the actual phone, on the phone calls, and saying, hey, this isn't going right. And there are dozens and dozens of these incidents. Some of them were you know, this isn't how you build this. Or you know, this patient is upset because he can't reach his doctor by phone anymore and things like that. But then some of them, and the most concerning ones were this question of failure failure to escalate, failure to accurately triage Right. So triaging is when I call a medical professional, I tell you what symptoms I'm experiencing and the medical professional tells me what to do. You know you need to go to the ER, you should wait two days and see if you feel better, et cetera.

Repeatedly in this one medical seniors call center was that the call center employees were not always successfully identifying when the patients who were calling in were actually having symptoms that needed to be triaged right away by a medical professional. They were frequently scheduling an appointment for the next day or, you know, whenever the person was free, which in some cases might even be sort of what the patient said they wanted. Right, they might be saying I want to see my doctor, but the reality is that, especially in an older patient population like the one that we're talking about, sometimes what might seem like a not very important symptom actually is. So. I've also seen copies of the training documents, right, and one of the very first one is is if you're experiencing chest pain, if you feel a lot of pressure in your chest, that obviously could be, you know, a heart attack, or there's other ones that could, you know, maybe be a stroke, but if the patient doesn't necessarily say the exact words that are written in the instructions someone who's only had a couple of weeks of training in this stuff, who maybe their last job was a call center for Comcast or something like that they're not necessarily going to successfully identify this all the time. And that's the concern that people working in this call center shared with me is that people are not accurately interpreting what these older patients from all around the country are saying.

These older patients are accustomed to. When they dial this phone number it goes to a doctor's office and they talk to someone they've actually met many times in real life. Now the number is going to a call center. They're kind of disoriented. They just kind of want to see their doctor. They don't really understand why they're talking to this call center. Something's getting lost in translation and rather than getting transferred to a telehealth nurse, you know someone who, with actual medical training, who's supposed to be available on one medical's phones to help these people. They were sort of just getting scheduled for appointments or, occasionally, other mistakes, just like totally getting lost in the sauce essentially. But that's the basics of what was happening, this idea that you have these older patients who are sort of confused as to why they're talking to a call center in the first place, calling in with symptoms and the person on the other end of the phone not successfully making the right choices to where to send them next.

0:57:07 - Mikah Sargent
Yikes, and you talked about the reaction from some of One Medical's internal staff. It sounds like that's why you heard, maybe, about it. Can you tell us about what? Maybe healthcare professionals, what experts, what other staff are saying about this? Were you able to get any comments from anyone on this, or is it very hush hush about the concerns herein?

0:57:37 - Caroline O'Donovan
Well, you know, the weird thing about tech companies sort of expanding into other realms of our lives is that they tend to bring some of that tech culture with them. So, even though you know these are medical professionals, they still are, you know, held under the same NDAs, that you would have someone who's like designing the next great chat GPT or whatever. So there's a. There's always a lot of anxiety for people who, um, who essentially work for Amazon, um, in talking to the press, but I I did talk to a few folks you know Amazon says, right At, the purpose of this call center is to make health care more accessible to these people. It's 24-7. You can always reach it, et cetera. But the people who I spoke with, who actually work at One Medical, you know, tended to feel like just because the call is getting answered faster or you're getting a response.

Quicker doesn't necessarily mean you're getting better care, and I spoke to someone who doesn't, who's a, you know, an expert in this kind of thing not someone who works at One Medical who sort of said yes, the idea of access to care improving through more telehealth, through the internet, that kind of thing is a good idea, but you have to make sure that the people who are receiving those messages are trained and skilled enough to be able to take them.

In reporting this story, I was hearing and you do hear when you speak to patients of One Medical that there is a lot of turnover among doctors, that doctors are leaving very frequently. Amazon told me that if that was the case, it was probably because they had shortened the appointment windows, which translates to more patients per day per doctor. So basically, amazon was sort of saying we made the doctors see more patients a day, do more work in a day, and they didn't like that, so that's why they're leaving. That's not necessarily what I heard from employees. I wasn't ultimately able to talk to any doctors on the record who wanted to share their experience of why they quit One Medical, but it definitely seems like people, especially at the doctor level and medical are, you know, trying to find other places to work.

0:59:50 - Mikah Sargent
Wow, understood Now. This is because you talked about how Amazon acquired One weren't part of this sort of acquisition. That was underneath it. And then those services themselves where everybody's going to, that Tempe call center.

1:00:19 - Caroline O'Donovan
Yeah, I mean, I think the One Medical that you're talking about is the one that I think you know I live in San Francisco, I used to work at BuzzFeed is the one that I think you know. I live in San Francisco, I used to work at BuzzFeed. A lot of people I know work, you know, at tech companies and the people who tend to use One Medical are people who work for companies like that, who get a membership through their employer. And you know I went once when I had a One Medical membership back in the day for carpal tunnel from using my computer too much. You know that's the kind of thing.

It tends to be younger, healthy, urban professionals who are members of One Medical. You pay an annual fee so you can use this app, so you can just like quickly text your doctor. It's all kind of very shiny and smooth. They call it concierge medicine and like maybe you get a little frustrated when they bill you hundreds of dollars because you had a cold and nothing even really happened. But it's whatever, because you have really good private corporate health insurance. And I think when Amazon bought that business, a lot of people felt like, oh well, that makes total sense because Amazon is all about convenience, you know. It's all about getting things taken care of really quickly and maybe they would actually be really good at that. And let's be honest, if you're having an emergency, you're not going to one medical, you're probably going to urgent care of the emergency room. So it's not right.

Maybe people had definitely had questions around. You know, giving a company that already knows so much about you access to your medical data, and you can have a whole conversation about privacy and whether or not you think that Amazon does a good job of protecting people's privacy. But that was like the main conversation around that part of one medical but that that part of the business operates pretty differently from the part that this story is about. So that side is, like I said, for mostly people with private insurance, you're paying per visit and the patient population tends to be a little bit younger and a little bit healthier. The thing that I'm talking about is people on Medicare who actually don't even have access to the one medical app, something that I didn't totally understand.

Medicine is really hard from a software perspective. It's really you can't just, you know, quickly spin something up and merge things because there is so much private, sensitive data that you have to be really careful. So it wasn't so what I. My understanding is that it hasn't been easy for one medical slash, amazon to to build an app for the senior patient population, because it's never existed Amazon to to build an app for the senior patient population, because it's never existed.

So they their only way for them to reach the doctor was to call the doctor's office and that's those are the calls that are now going to the call center instead. So it's a, it's the same branding and, like we say in the story, they are. You know the whole. You know writ large what Amazon is trying to do with all of its health care pieces and you can read about this in great detail in Andy Jassy's shareholder letter from last year if you so choose.

But they have all these disparate pieces and now they're kind of slowly trying to synergize them and make them cohesive so that you go to one medical and then you get an Amazon pharmacy prescription delivered to your house by a drone before you even get home. Like that's the kind of vibe that they're, that they're going towards. But for this particular and this is sort of what happens right Is like you buy a thing because it has a lot of value for a lot of people, you want to scale it, but there's always going to be little tiny populations of vulnerable people and use cases that it doesn't quite work that easily for, and I think that's kind of what we found here with these seniors. So they don't even have the app. They can only now call this call center.

1:03:30 - Mikah Sargent
Wow, and that's it's upsetting to the acquisitions that take place within healthcare in particular, and it's a little off topic, but at the same time it is about that care in particular.

And it's a little off topic, but at the same time it is about that there was recently a hack that took out a payment processing platform and because all of the various payment systems healthcare payment systems that once existed had slowly but surely been acquired by one or two big companies, by taking out that one, it had completely like brought half of all of the US's healthcare industry to a standstill because of that acquisition.

And then you hear about this where you know they once had better care, they have no control over the acquisitions that take place and kind of having the care of Amazon, and that's how you, um, you kind of end the piece is with the quote like I don't want Amazon taking care of me. It's no surprise that they're feeling that way, because it seems like every situation requires this, this, you know, hike up a hill and and all of this work to even get through to anybody and get any kind of care at all. Um, it seems very frustrating and I hope, uh, based on you know what you're saying there with, uh the plans that they have going forward, that there's going to be uh improvements, um anything that we might've missed that you want to cover about your piece. Of course, everyone should go over to The Washington Post and Post and read it again and share it around, for goodness sake. I think more people need to know about it.

1:05:12 - Caroline O'Donovan
Yeah, like and subscribe, that's all.

1:05:14 - Mikah Sargent
Exactly, subscribe to The Washington Post. I want to thank you so much for taking the time to join us today. Of course, folks can head over to washingtonpost.com to check out this piece or look for the link in our show notes, but if they want to follow you online to keep up with what you're doing, is there anywhere they should go to do that?

1:05:36 - Caroline O'Donovan
You know, I don't know. I think I have a blue sky account these days I think it's like at CEO Donovan, but I never really use it. I uh, I'm sad about the state of social media. So read The Washington Post and I wouldn't say that if, um, if we're interested in how one medical what they call a medical commercial, the normal one, the one that we think of we're interested in learning more about how they bill people. So if you have a one medical billing story as a patient or, better yet, as an employee, do do reach out, because I'm I'm interested in hearing your story, so that it's Caroline O'Donovan at washingtonpost.com.

1:06:05 - Mikah Sargent
Beautiful. Thank you so much for your time and thanks for your time and I'm sure.

1:06:07 - Caroline O'Donovan
Thanks for having me.

1:06:10 - Mikah Sargent
Alrighty folks. That's the end of this episode. Yes, the episode, this episode. The show publishes every Thursday at twit.tv/tnw. That's where you can go to subscribe to the show in audio and video formats. I mentioned Club TWiT during the show, so I'll just briefly say $7 a month.

twit.tv/clubtwit. Join the club. We greatly, greatly appreciate it. It makes so much of an impact. If you'd like to follow me online, I'm at Mikah Sargent on many social media network, but I, like many others, including Caroline, am meh about that, so I'm not on the social media as a whole lot. But you can head to chihuahua.coffee that's C-H-I-H-U-A-H-U-A.coffee, where I've got links to the places I'm most active online. Check out Hands-On Mac and iOS Today, which we'll publish later today as part of Club TWiT and also to the public as audio versions. And, of course, you can always check out Ask the Tech Guys on Sundays, which is the show I co-host with Leo Laporte, where we take your questions live on air and do our best to answer them. Thanks so much for tuning in. We'll see you again next week. Bye-bye.