Today in Tedium: Generally, bureaucrats don’t tend to transcend their titles. Often, they leave public service as quick as they entered, or stay behind the scenes over a long career. Dr. C. Everett Koop, a public health official who was the very definition of old school, somehow became the exception. Serving for nearly eight years as the U.S. Surgeon General, he’s perhaps the only person who’s served in that role that could be reasonably called a household name. Case in point: You many not even know who the current one is. (His name is Dr. Jerome Adams, who came to his role after serving a similar position under Mike Pence when he was Indiana’s governor. Here’s something cool Adams did earlier this year.) Koop became a trustworthy icon of public health during a period when public health was in crisis. He was important. But the reason I want to talk about him today comes down to his unlikely career riding the waves of the dot-com bubble. Yes, Dr. Koop was once an internet entrepreneur, and today’s Tedium is all about what might be the strangest tech IPO of all time, DrKoop.com. Here’s why it failed. — Ernie @ Tedium
“This website is not associated with C. Everett Koop, M.D., former Surgeon General of the United States.”
— The message at the bottom of the current DrKoop.com, which appears to be a generic blog with the kind of anonymous, unbylined health-related content that you might expect to find some random piece of search engine bait attached to. The only differentiator is this message at the bottom of the website, which highlights the way that websites become anonymous over time. An analysis of the website over at the Internet Archive highlights the sad status of the domain, which for years redirected to HealthCentral.com, and when DrKoop.com was still active before that (around 2009 or so), it had this note back then, too. The truly fascinating story about this domain dates to the bubble years.
C. Everett Koop, as shown during his days as Surgeon General. (National Institutes of Health)
Why C. Everett Koop was the perfect choice for a namesake website in 1998
These days, if you’re a public figure, it’s considered table stakes to have a website of some kind.
But for figures higher up the food chain, like Martha Stewart or Bob Vila, they can get away with having a whole website, banked on their name, that’s largely built around content produced by people who are simply making stuff that leverages the topic that the public figure is known for.
With DrKoop.com, C. Everett Koop was perhaps one of the first public figures to try for a digital content play like this. It was a perfect role for Koop, who had improbably withstood the tough headwinds that surrounded his Surgeon General nomination to become the most widely respected voice in public health of his era.
Koop earned the role despite early signs suggesting he would be a divisive figure. In 1981, The New York Times published an editorial titled “Dr. Unqualified,” which implied that the Reagan administration was trying to bring him on board in an effort to support an anti-abortion crusade. The editorial noted that Koop was already of advanced age when he took the role—he was 65 at the time of his nomination, older than most who had taken the role in the past—and wasn’t afraid of making his socially conservative views known.
“Dr. Koop is, of course, entitled to his opinions, but opinions should not be construed as qualifications,” the Times editorial board wrote.
But Koop surprised everyone by not only being good at his job, but by taking stances on public health that at times seemed to conflict with his own personal beliefs.
At the height of the AIDS crisis, he publicly promoted the use of condoms and the need for sex education. In a public service announcement about AIDS he recorded in 1988, he avoided using language designed to prey upon stereotypes. “Let’s stop the rumors and misinformation about AIDS,” he stated.
He helped further the anti-smoking cause, aiming at bold goals at a time when the tide was starting to turn against Big Tobacco. And when Reagan called on Koop to produce a report highlighting the health effects of abortion on women, he didn’t let his personal beliefs get in the way of data that failed to support the conclusion that many abortion critics anticipated.
By May of 1989, as Koop was planning his exit from public office, the same Times editorial page admitted it was happily eating crow regarding its early assessment of Koop:
The skeptics and cynics, this page included, were wrong to fear that Surgeon General C. Everett Koop would use his office only as a pulpit for his anti-abortion views. Throughout his seven years of service—he has now announced his retirement as of July—he has put medical integrity above personal value judgments and has been, indeed, the nation's First Doctor.
He was put into power under the belief he would turn medicine into a front for the culture wars, but he did the opposite. Koop’s legacy was so strong that it likely led the Surgeon Generals that followed him to face a hard time in the years after. Case in point: Clinton appointee Dr. Jocelyn Elders, the first African American in the Surgeon General role, wasn’t afraid to be frank about the issues like sex education and drug legalization. She was on the job for just over a year before she was pushed out as her views caused backlash.
For a time, at least, Koop managed to take what threatened to be a deeply political role and gave it a voice that transcended its politics. Few can say that.
It made Koop the perfect choice for his own digital empire at a time when many were willing to throw money at the internet.
“As I came to the end of my Surgeon General years, I felt that I had gained the public's trust and that I should do something with it. First, I wanted to make sure that I did not use that trust only for private gain.”
— C. Everett Koop, writing in his memoir about his decision to remain in public life after his exit from the Surgeon General role. Koop noted that he faced a lot of commercial pressures soon after he left public office, and wanted to avoid accusations of impropriety. “Like many Americans, I was disgusted with the way retired politicians—even presidents—cashed in on their celebrity status,” he continued. “There was no shortage of companies that wanted to make a quick and big buck off me.” Koop’s words on the topic would come back to haunt him amid the ups and downs of his web platform.
DrKoop.com: The early Internet startup with a founder that was in his 80s
The decision by Koop to put his knowledge into a branded website was a brilliant play in 1998, keeping him fresh in the minds of millions nearly a decade after he left the job that made him famous.
Even with all that time away, he hadn’t lost his luster—something highlighted by the fact that DrKoop.com managed to draw 2 million visitors in its first month, according to a New York Times article.
“I’ve gone commercial,” he told the newspaper of the effort, which cost a princely $450,000 to build.
At the time of the site’s launch, Koop was 82 years old, most assuredly making him one of the oldest tech startup founders of all time. He, of course, had help—in part because the company’s original name was not DrKoop.com. The company first came to life in 1997 as Personal Health Records, Inc., and according to Texas Monthly, the firm’s founder, Donald W. Hackett, spent months trying to win over Koop, who finally relented, opening up a new stage of his life in the public eye.
Koop’s name, beyond bringing in lots of quick visitors, allowed the site to draw major sponsorships in short order, as well as big-name partnerships.
In an SEC filing ahead of its initial public offering, the company noted it had just entered an agreement with Disney to become the exclusive provider of health content to many of the sites in its Go.com portfolio, along with a major contributor to ABCnews.com. (The deal wasn’t cheap; the company had planned to pay a princely sum of $57.9 million for the access to those platforms, meaning that it needed the IPO to be a success.)
The company’s early success—having served 6 million visitors in less than a year, DrKoop.com saw a 39 percent “pop” in its first day of trading on the NASDAQ, leading other tech-minded health companies to follow in its footsteps—also, of course, opened it up to criticism.
Look at all those ads.
The issue was twofold. Koop had spent much of his two decades in the public eye standing for a particular image of unbiased public health, but the website carried many of the awkward conflicts of interest that many health content websites suffer from today, but during a period before the rules were set. The term native advertising wasn’t in the lexicon just yet, and DrKoop.com wasn’t properly disclosing what was paid and what wasn’t—a major ethical no-no. (Koop himself was reportedly getting commissions from products sold on the site.)
On top of that, the information on the website was heavily scrutinized, much in the way that other well-known online health-content plays, such as WebMD (which both predated and outlived DrKoop.com) and Livestrong.com have often been. It was, simply put, a content farm before content was put in terms of farming. (This makes sense, considering that Demand Media co-founder Richard Rosenblatt once served as DrKoop.com’s CEO; Demand Media, the owner of Livestrong.com, changed its name to Leaf Group in 2016, in part because of the name’s reputation.)
Understandably, considering it had access to a resource with a track record of high public trust, DrKoop.com used Dr. Koop to defend itself and reframe the conversation. On his website, Koop emphasized that the criticisms the site received were warranted; he maintained the platform would be part of the solution.
“I welcome the debate on the value of the Internet as a viable tool for educating the public, as well as the discussion over the creation of standards for editorial representation,” Koop wrote on the site in 2000. “In short, I support any productive activity designed to better the environment where people gain access to accurate healthcare information.”
(Koop’s call, as messy as the situation was, did some good, eventually leading to new ethics standards for medical content websites.)
Koop, as shown in a magazine ad from the era of DrKoop.com. (via NIH)
There was also another, more subtle criticism of the platform from some corners: DrKoop.com, the website, didn’t feel like Dr. Koop, the person. It felt like an excuse to put thousands of pages of medical content online, and observers were quick to point it out.
“Besides lending his ubiquitous name and face, there is little of the famous Dr. Koop voice at the site—that of the Reagan era's self-important, scolding Mennonite elder, though Koop is a Presbyterian,” The Weekly Standard correspondent Matt Labash wrote in 1999, a few weeks after the stock price peaked. “Sure, he happens by once in a while (three or four times, so far), most recently for a chatroom appearance with supermodel-supermom-fitness-expert Kathy Ireland. But that's not that important for an Internet business.”
Labash implied that, even despite that weakness, Koop was setting himself up for a mascot-style play with the website, with an eye on living forever through his message. (There were, of course, comparisons to other celebrities with distinctive looks, such as Colonel Sanders.)
Of course, it didn’t quite happen that way. For one thing, when it comes down to it, DrKoop.com was ultimately a big content site, the kind of content site that we now know can be useful in small doses but isn’t by any means a unique beast. And while Koop’s name was an effective branding strategy at first, it ultimately didn’t prove strong enough to corner the market on health content. WebMD, strengthened by a merger, was ultimately able to usurp the brand value that DrKoop.com had tried to bank on from the start.
By the middle of 2000, the company was cutting its staff left and right, and was running on fumes—spending far more money than it was bringing in. Its stock price evoked the popped bubble pretty effectively, falling from nearly $20 just before the year 2000 to 65.6 cents in August of that year.
Even if his value on paper floated in the tens of millions in the middle of 1999, Koop the entrepreneur simply wouldn’t be as successful as Koop the Surgeon General.
DrKoop.com is a zombie site in 2018, unloved by its owner (whoever that is), and far away from being the platform that was meant to turn C. Everett Koop from the most important voice in public medicine to a man whose name carried credibility in perpetuity.
Perhaps it still does. After all, you probably didn’t know who the current Surgeon General was. But DrKoop.com was a big play at a time when a play like that could have really worked out well, and everyone working with that company knew it.
Koop’s 2000 comments on his website seem to evoke a desire to set in motion a future in which his credibility would live on forever:
I am often asked, “Dr. Koop, you are 82 years old. Why did you start an Internet company and not just enjoy your retirement?” My answer: “Because I am here to make a difference. Providing information to the world is expensive, and we have to have a company able to raise the money to make sure that consumers have the information they need to take care of their health.”
Koop wouldn’t get his wish. The site failed to raise the money it needed to stick around, fell into bankruptcy, and was sold in 2002—for $186,000, to a company called Vitacost.com, a vitamin retailer. Koop tried (and failed) to stop the sale, which makes sense, because his name was on it, and the founder of Vitacost, Dr. Joseph Allens, emphasized that the goal of buying DrKoop.com was to sell a whole lot of vitamins.
“It has 900,000 valid email addresses of people who signed up on the site,” Allens said, according to the Los Angeles Times. “We think a lot of those people will buy vitamins, and it takes our weekly newsletter distribution—now at 650,000—to more than 1.5 million. For $186,000, that's a bargain.”
(The consolation prize for Koop was that message at the bottom at every page telling folks he’s no longer associated with the URL.)
C. Everett Koop didn’t get his mascot status, but he did get a nice nest egg out of the deal, even if it wasn’t what it could have been. Koop cashed out before the bottom completely fell out, selling $850,000 in stock in 2000.
When he died in 2013 at the grand old age of 96, his internet adventure—as fascinating as it is to consider in retrospect—was but a footnote in the obits.
Perhaps that’s how it was always meant to be.