Its founder was arrested and most of its U.S. staff have quit, but it’s still pumping out prescriptions to its American clientele.
Done’s big secret? Key operations were moved to China. Its staff there have been aggressive in making sure customers can still get easy prescriptions for Adderall, a drug prescribed for attention-deficit hyperactivity disorder that is also among the most abused drugs in the country.
After a two-year investigation, authorities arrested founder Ruthia He in June and charged her and six others in a conspiracy to distribute controlled substances.
The founder, a Chinese citizen, was jailed for three months, and a district judge cited substantial risk she would flee the country. She was released last week, on condition that she remain under house arrest with two 24-hour guards. She has pleaded not guilty.
By the end of 2022, staffers across China had sidelined U.S. corporate staff and taken more control of strategy and operations, and began directing key policies.
Done’s China operations aren’t mentioned on its website, which lists an address in San Francisco—currently an empty storefront.
The company’s clinicians, who are based in the U.S. and write the prescriptions, are mostly nonstaff contractors. They said they reported to U.S. supervisors and didn’t know that policy directives were coming down from staffers in China.
He herself looked into leaving U.S. territory during the federal investigation—she made plans to fly to Hong Kong before she was stopped by authorities. In text messages with the head of Done’s China team, Yue Wang, she discussed fleeing the U.S. to avoid arrest, opening foreign bank accounts and which countries had extradition treaties, prosecutors allege.
Wang, a college classmate of He’s, now runs the company along with four others. Three are in China, including Wang, who didn’t respond to requests for comment.
Done also has transferred $6.6 million to entities in China and Hong Kong since its founding, according to court records, including nearly $1.5 million transferred this year to a new entity named MakeBelieve Asia.
When He was arrested, a U.S. employee posted a warning to customers on the company’s Instagram account. Under police light emojis, the message said clinicians were quitting and patients were losing care, and that “The management team from China has taken over operations.” It was signed “The US/Core Team.” The post was removed within minutes.
“We look forward to vigorously defending Ms. He in court,” her lawyer said in a statement. She started Done to improve access to care for millions of Americans who don’t have it, her defense team wrote in a court filing.
Done didn’t respond to requests for comment. A statement posted on its website in June said it disagreed with the criminal charges for He and for its senior doctor, David Brody, who was also arrested in June. The company said the charges “are based on events that principally occurred between February 2020 and January 2023.” It said the company is working to make treatment accessible for patients and will continue operating.
Brody, who has pleaded not guilty, declined to comment through his lawyer.
Easing access to drugs
For law-enforcement officials, the crackdown is complicated by efforts to maintain access to medicines for many who need it, while also policing their improper use.
Five other Done employees were charged; four pleaded guilty and are cooperating with the federal investigation, while one has pleaded not guilty.
The arrests might have toppled other startups, but Done had tens of thousands of patients at the time. Hours after He’s arrest, the Centers for Disease Control and Prevention issued a public health advisory warning that if Done patients lost access they might turn to dangerous counterfeits.
Done ended May with about 67,000 patients, most of them getting prescriptions for Adderall and other stimulants, up from roughly 56,000 patients in November 2022, according to company documents. It’s still writing prescriptions and taking new clients.
This account of Done’s practices and He’s management is based on conversations with more than two dozen current and former Done employees, contractors and others familiar with the company, as well as a review of hundreds of pages of internal documents, employee communications and court filings.
Stimulants can have great benefits for people with ADHD. But Done’s clinicians didn’t spend the time that experts say is necessary to properly diagnose the condition, sometimes writing prescriptions after online appointments as short as 10 minutes, The Wall Street Journal has reported.
The U.S. government classifies stimulants such as Adderall as controlled substances in the same category as OxyContin and other opioids due to their potential for abuse.
During the pandemic, the Drug Enforcement Administration relaxed a rule that required an in-person appointment before a prescription for controlled substances. That opened the door for telehealth companies such as Done and others to offer online access to such drugs, including Adderall, ketamine and testosterone. The DEA is scheduled to reinstate the stricter prescription rule at the end of this year, although that could change.
Done connects patients to clinicians via its website. It drew patients in with social-media advertisements promising a quick ADHD diagnosis and easy access to medication. Done charged $199 for evaluations—a charge raised to $399 last week. Patients fill prescriptions at pharmacies, and must get them renewed each month, for which Done charges a $79 monthly fee.
Beginning in March 2022, the Journal reported in multiple articles about the company’s practices, including how some clinicians at Done felt pressured to prescribe stimulants. Many clinicians quit.
Done has said that clinicians decide independently whether to prescribe stimulants.
The Justice Department opened an investigation that fall, following the Journal’s articles.
Done’s founder He, who owns nearly 100% of the company’s shares outstanding, according to prosecutors, didn’t dial back Done’s ambitions. She told worried staffers and clinicians that the government was bluffing and that the company would likely just face a fine.
Weeks after the company received a subpoena, she was in Washington, D.C., lobbying for Done’s clinicians to be able to continue prescribing stimulants online. And Done kept growing as He poured millions more into online ads. She commissioned edgy ones that showed people taking pills and feeling immediate effects. Others touted a 1-minute ADHD assessment that former clinicians said was easily gamed by people who wanted stimulants.
Meanwhile, He was moving more of her organization to China.
She spent a year in China beginning in the fall of 2021, where she ran the company remotely. She returned to the U.S. just before her green card lapsed. While in China and after returning, she added staff in Beijing, Shanghai, Hangzhou, Chengdu and other cities, according to employee lists filed in court.
This team took more control over recruiting, engineering, advertising, legal, strategy and even clinical policies. More of Done’s operations disappeared from U.S. workers’ view because Chinese workers conducted business via Chinese messaging service WeChat, instead of Slack, which was used by the whole company.
He wanted what she called a “frictionless” experience for customers seeking Adderall. U.S. executives often slowed things down by encouraging more conservative policies, so He turned more to the China team to execute her plans, according to former Done staffers.
Pushing the envelope
He had always pushed the envelope at Done, running it like a disruptive tech company. She had previously worked as a product designer at Meta, at one point sitting a few desks away from Mark Zuckerberg, and launched Done in 2019 when she was 28. He, who has no medical background, told her staff to operate aggressively and break rules, and joked that she would reward the first person to be arrested for the company with a Tesla.
U.S. executives flagged problems early on. As far back as July 2021, Done’s then head of operations, T.J. Williams, wrote a memo, reviewed by the Journal, warning that some patients were lying to get Adderall. Examples of fraud, the executive wrote, included “multiple names, multiple emails, blurry photos of their IDs, photoshopped IDs, different names for the same credit card number, and more!” Williams said the company should develop tools to identify customers.
The founder, He, fired Williams three months later, telling employees the executive wasn’t a culture fit. It’s not known if any of his proposed solutions were adopted. Williams declined to comment.
Instead, Done promoted aggressive policies to attract and retain customers. The company paid its clinicians to quickly renew patients’ prescriptions but didn’t pay them to hold follow-up video visits with them. Many clinicians simply responded to auto-refill requests that patients made via Done’s app, earning about $9 per patient a month. Experts recommend that patients on stimulants be seen every few months.
Some Done clinicians manage thousands of patients and approve prescription refills in as little as 45 seconds, according to Done clinicians and documents reviewed by the Journal. Many have made more than $10,000 a month. Done’s top earner in May, a California nurse practitioner named Elizabeth Shapard, had over 3,000 patients and earned $43,000. She didn’t respond to requests for comment.
The China team amped up the founder’s efforts to get stimulants to patients quickly. They rolled out a system in which Done clinicians could renew prescriptions for other clinicians’ patients—without ever seeing the patient and without the knowledge of the patient’s original clinician.
In the new protocol, a prescription was marked “urgent” if it wasn’t renewed within 48 hours, and would go into a pool where other clinicians were paid to renew it.
Kelly Gordon, a nurse practitioner in Florida, quit working for Done in May, bothered by the new system. Gordon said her pay was docked for not writing prescriptions for patients she wanted to follow up with first. “I was being written up for not doing automatic refills,” she said. “Their policy is: prescribe controlled substances or get off our platform, we don’t want you.”
The China team also started a program to coach or terminate clinicians who miss targets for client sign-ups, cancellations and patient feedback scores. The team sent low performer lists to senior U.S. clinicians so they would intervene.
Current and former clinicians said the system pressured them to prescribe Adderall because when they didn’t, customers complained or canceled their service, and the clinicians received warnings that they could be fired if they didn’t improve their metrics. Clinicians said they are more likely to be rated 1-star if they don’t prescribe stimulants.
Some U.S. team members said they objected to another initiative by the China team to have customer-care staff in the Philippines monitor clinicians by joining patient Zoom appointments. The China team said it was for quality assurance, but U.S. staff felt it violated privacy rules.
The Filipino monitors appeared in the Zoom calls anyway, according to people familiar with the initiative. Clinicians objected, said these people, so the China team switched to reviewing recordings of the patient appointments. It’s not clear if they first obtained permission from clinicians or patients to do so.
For Google search advertisements, the China team suggested targeting keywords such as “adderall for sale” and “online adderall delivery.” The government alleges that Done used keyword ads to target drug-seeking patients.
Done documents show it spent around $2 million a month for online ads, primarily with Google, TikTok and Meta. The platforms continued to run the ads even after a third-party certification they required for Done was revoked in November 2022. The platforms banned the ads in June, after a Journal inquiry.
When CVS and Walmart began refusing to fill Done’s prescriptions, the China team helped recruit other pharmacies that would fill them.
Done’s China team also began recruiting customers on U.S. college campuses, and contacted Chinese student associations to help, company documents show. Adderall is commonly abused as a study drug by young people.
The China team proposed a program to use text messages to lure back patients who had canceled their prescription service. If the former patient responded “Y” to the query, Done would charge their credit card and reactivate their service.
A second proposal would permit nearly 35,000 users to retake Done’s initial online screening questionnaire after they checked a box noting a history of severe mental illness including schizophrenia or suicide attempts. Such patients require a greater degree of care than Done can provide, and the screen was meant to disqualify them. A member of Done’s China team wrote in a memo, reviewed by the Journal, that such users should get a “second chance.”
It’s unclear if either proposal was implemented.
Money transfers
In February 2023, He had a one-way flight booked to Hong Kong. When federal investigators learned of her travel plan, they stopped her on the street in San Francisco, an encounter she broadcast via Facebook. “Ruthia, we have a search warrant for your phone,” said one of the agents. She appeared to flip through a copy of the document while agents repeatedly asked her to call her lawyer.
She walked away from them and then one agent walked up from behind and grabbed her phone. “What are you doing!?” she is heard shouting as the agent leaves with her device.
She got a new device in another person’s name the next day that she used to contact co-conspirators, prosecutors allege. She didn’t get on the flight to Hong Kong.
Money transfers to China accelerated a week after He’s June arrest. Done’s finance chief, M.J. Chey, the founder’s friend from Peking University, was assigned the task to transfer $250,000 from U.S. accounts to the MakeBelieve Asia entity in Hong Kong for what was listed as expenses, company documents show. Chey didn’t respond to requests for comment. Her father is billionaire Korean businessman Chey Tae-Won, and her grandfather was a president of South Korea.
One of the documents required the electronic signature of the China team leader, Wang. Two transfers for a total of $500,000 went to MakeBelieve over a three-day period in late June, court records show, which list monthly transfers to MakeBelieve from January through late July.
Another $1 million was transferred to He’s defense team in the U.S.
He is staying at a rented house in Fremont, Calif., after being released. She isn’t allowed internet access but has a landline phone. The judge said he didn’t want to prevent her contacting workers at Done. “This is her business,” the judge said.
Write to Rolfe Winkler at [email protected]
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