# Telehealth founders keep budgeting for media before earning a position

> High CPMs are painful. Paying them before deciding exactly who the business is for is worse.

- Author: Shea Hoffman
- Published: 2026-09-14
- Topic: Telehealth positioning
- Author profile: https://sheahoffman.work/about.md
- Commercial context: Shea leads business development for telehealth and peptides at Lucyd (https://www.wearelucyd.com/).

The telehealth founders I talk to usually know customer acquisition will be expensive. What they often underestimate is how expensive it becomes when the company has no clear position.

If the offer is weight loss, hormones, longevity, and a little bit of everything for anyone who wants to feel better, every impression has to do too much work. The ad has to identify the audience, explain the problem, establish credibility, create urgency, and distinguish the company from a long list of businesses making roughly the same promise.

That is a positioning problem showing up as a media problem.

## You are probably not going to out-Hims Hims

The broad market already has very well-funded companies with familiar names, mature funnels, large creative libraries, and enormous media budgets. A new telehealth business does not need to unseat them to build something valuable. It does need a reason to exist that is more useful than another treatment menu.

"Telehealth for men" and "telehealth for women" are categories. They are rarely positions by themselves.

A stronger starting point might be telehealth for blue-collar workers, dads, women moving through a specific life stage, or a subculture the founding team understands from the inside. Those are examples, not prescriptions. The right niche is the one the company can serve with unusual specificity.

## A niche has to change the business

Putting a particular person in the hero image does not make the service specific to them.

A real position should affect:

- which conditions the company chooses to address;
- how intake and scheduling work;
- which clinicians, coaches, or other forms of support belong in the experience;
- what the company teaches before asking for a purchase;
- which objections the creative answers;
- which promises the company refuses to make; and
- what patients encounter after the first transaction.

If the niche disappears when you remove the homepage copy, it was probably a campaign theme.

## Start with an audience or budget for the cost of finding one

The strongest launch asset is often an existing group of people who already pay attention and trust the founder on a related problem. That does not guarantee they will buy telehealth. It does give the business a place to learn before it tries to purchase all of its demand in the open market.

Without that audience, the capital plan has to reflect reality. CPMs can be high, category restrictions can narrow the available playbook, and a generic message produces expensive learning. Founders should expect to fund the process of finding a repeatable acquisition model, not just the process of turning on ads.

## Media amplifies the answer

Paid acquisition is very good at revealing whether a position resonates. It is a costly place to invent that position from scratch.

Before asking how much to spend, I would want clear answers to four questions:

1. Who is this built for, specifically?
2. What can this business help that person do unusually well?
3. Which parts of the product and care experience prove that claim?
4. Why is this team equipped to understand and serve that person?

When those answers are sharp, creative gets more specific, the landing experience gets more coherent, and the media plan has a real hypothesis to test. That does not make acquisition easy. It makes the money teach you something useful.

The opportunity in telehealth is not another broad storefront. It is a business that understands one group of people well enough to build the right version of care around them.

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This essay is personal industry analysis, not medical or legal advice. Commercial calls to action lead to Lucyd.