Doximity, Inc. (DOCS) Q4 2026 Earnings Report, Transcript and Summary

Ladies and gentlemen, thank you for standing by. My name is Abby, and I'll be your conference operator today. At this time, I would like to welcome everyone to the Doximity Fourth Quarter 2026 Earnings Call. [Operator Instructions] And I would now like to turn the conference over to Perry Gold, Vice President of Investor Relations. You may begin.

Thank you, operator. Hello, and welcome to Doximity's Fiscal 2026 Fourth Quarter Earnings Call. With me on the call today are Jeff Tangney, Co-Founder and CEO of Doximity; and Matt Sonefeldt, our new CFO. A complete disclosure of our results can be found in our press release issued earlier today as well as in our related Form 8-K, along with a copy of our prepared remarks, all available on our website at investors.doximity.com. As a reminder, today's call is being recorded, and a replay will be available on our website. As part of our comments today, we will be making forward-looking statements. These statements are based on management's current views, expectations and assumptions and are subject to various risks and uncertainties. Actual results may differ materially, and we disclaim any obligation to update any forward-looking statements or outlook. Please refer to the risk factors in our annual report on Form 10-K, any subsequent Form 10-Qs and our other reports and filings with the SEC that may be filed from time to time, including our upcoming filing on Form 10-K. Our forward-looking statements are based on assumptions that we believe to be reasonable as of today's date, May 13, 2026. Of note, it is Doximity's policy to neither reiterate nor adjust the financial guidance provided on today's call unless it is also done through a public disclosure such as a press release or through the filing of a Form 8-K. Today, we will discuss certain non-GAAP metrics that we believe aid in the understanding of our financial results. A historical reconciliation to comparable GAAP metrics can be found in today's earnings release. Finally, during the call, we may offer incremental metrics to provide greater insights into the dynamics of our business. These details may be onetime in nature, and we may or may not provide updates on those metrics in the future. I would now like to turn the call over to our CEO and Co-Founder, Jeff Tangney. Jeff?

Thanks, Perry, and thanks, everyone, for joining our Fourth Quarter Earnings Call. Today, I'll cover our financials, our AI investment year, and a couple of key hires. First, our financials. Q4 ended above the high end of our guidance, with a record $107 million in free cash flow, our first ever 9-digit free cash flow quarter. Revenue was $145 million in Q4, up 5% year-on-year. For the full fiscal year ended March 31, revenue was $645 million, up 13% year-on-year. On the bottom line, our adjusted EBITDA margin was 45% in Q4 and 55% for the full year. Our full year free cash flow was $317 million, up 19% year-on-year. Okay. Now to our AI strategy, what we're calling our AI investment year. Let me start with the headline. Nearly half of all U.S. doctors now work at hospitals that buy our workflow or scheduling tools. And as we become more integrated into their EHRs, we're increasingly a daily use for them. Our benchmark workflow engagement reached over 800,000 unique quarterly active prescribers in Q4, up roughly 30% year-on-year, a significant acceleration from the high single-digit growth we saw a year ago. Nearly half of all these active prescribers used our AI tools in Q4. We saw record high engagement across our entire platform last quarter as doctors increasingly turn to us to be their AI assistant. In the 9 months since we acquired Pathway, our AI Search and Scribe active users have tripled. And last month, these users averaged 31 queries each, nearly double January's usage. In a side-by-side clinical search evaluation completed by 4,700 physician residents last quarter, respondents chose our AI answers over our nearest competitor by 2:1. They prefer our built-in drug reference and peer review. Hospitals are choosing us too. As of today, 140 health systems have purchased our clinical AI suite, including 7 of the top 20 hospitals. Over 250,000 prescribers now have access to our clinical AI suite in a single hospital-approved, HIPAA-compliant workflow. The race is on to build the best Scribe and Search AI for doctors. Our 380-person R&D team is all in to win this, and you'll see a slew of new physician-led features and agents from us in the coming months. I'm excited to share 2 of them today. First, we partnered with Aledade to provide value-based care AI agents for their network of thousands of primary care organizations. They'll use our Scribe and Clinical AI suite to save time and money. With them, we're bringing AI systems not just to big hospitals, but to small town family physicians, too. Second, we've added ePrescribing to our platform, so our doctors can write a prescription in a few taps after a telehealth call or while on the go. We save the doctor time and the patient money by letting the patient choose their preferred pharmacy from their phone. Over 1,000 prescribers have participated in our beta so far with strong uptake in usage. The back end is powered by our partner, Photon Health. Okay. Now to AI monetization, which is an important part of today's call. Having grown our AI search footprint so much over the last year, we're ready to monetize against our clients' large paid search budgets. We launched at our Annual Pharma Client Summit in New York last week with 40 marketing leaders from the world's largest pharma companies in attendance. The response was enthusiastic, particularly around using our AI search surface to reach prescribers in the exact moments their researching options, something traditional paid search can't do. We've already closed our first few AI search deals with top 20 pharma manufacturers, but these are early innings in a nascent and regulated market, and our financial guidance reflects that. We've forecasted minimal AI revenue contribution this fiscal year while allowing for a wider range of AI investments and related expenses meaning higher R&D, compute and marketing spend that will weigh on near-term margins. We think that's the right trade. Longer term, we believe AI search alone represents a multibillion dollar new TAM on top of the existing pharma marketing budgets we serve today. To put it plainly, we paid $63 million for Pathway AI last summer, and now we're spending against the opportunity it unlocked. This is our AI investment year. Finally, 2 management updates. As we announced last month, Anna Bryson made the difficult decision to step down as CFO after being on medical leave. We all miss her and wish her the very best. Today, we're pleased to announce Matt Sonefeldt as our new CFO. Over a 25-year career, Matt has led IR, finance and strategy at LinkedIn, Atlassian and most recently, DocuSign. He began on the buy side at Capital Research, giving him a long-term perspective across tech. Matt has advised us externally for over a year, so we know him well. He's a strong operator, a great cultural fit, and he joins us in our San Francisco office full time in early June. We're also pleased to welcome Dr. Steve Zatz, as our new President. A Cornell, Yale and Harvard-trained position, Steve spent 20 years at WebMD Medscape with the last 7 as President and CEO. We've admired Steve's work from the other side of the field for years. He's advised us over the past 5 months, and it's been great to have him on our side. He's based near New York City and brings deep long-standing relationships across the industry. To close, we've long been the largest U.S. physician network. And this year, we're becoming the largest physician AI platform. It's a multibillion-dollar opportunity, and we have the team, the tools and the trust to win. That's the company we're investing to build this year. Thank you to my Doximity teammates who continue to work incredibly hard to care for those who care for us. With that, I'll hand it over to our VP of Investor Relations, Perry Gold. Perry?

Thanks, Jeff, and thanks to everyone on the call today. Fourth quarter revenue grew to $145 million, up 5% year-over-year, exceeding the high end of our guidance range. Full year revenue grew to $645 million, up 13% year-over-year. Our existing customers continue to lead our growth. We finished the quarter with a net revenue retention rate of 109% on a trailing 12-month basis. Our top 20 customers remained our fastest growing, with a net revenue retention rate of 114%. We ended the quarter with 125 customers contributing at least $500,000 each in subscription-based revenue on a trailing 12-month basis. This is a roughly 6% increase from the 118 customers that we had in this cohort a year ago, and these customers accounted for 83% of our total revenue. Turning to our profitability. Non-GAAP gross margin in the fourth quarter was 89% versus 91% in the prior year period, driven by AI compute costs. For the full fiscal year, non-GAAP gross margin was 91% versus 92% last year. Adjusted EBITDA for the fourth quarter was $66 million and adjusted EBITDA margin was 45% compared to $70 million and a 50% margin in the prior year period. The primary driver for the change in EBITDA margin versus last year is our increased investment in AI compute driven by a steep ramp in AI usage which is outgrowing overall workflow engagement. We will continue this investment into fiscal 2027 and are excited about the engagement and commercial potential ahead. For the full fiscal year, adjusted EBITDA was $358 million, and adjusted EBITDA margin was 55% compared to $314 million and a 55% margin last year. We are proud to continue to run a highly profitable business with 14% year-over-year growth in our bottom line. Now turning to our balance sheet, cash flow and an update on our share repurchase program. We generated free cash flow in the fourth quarter of $107 million compared to $97 million in the prior year period, an increase of 11% year-over-year. For the full fiscal year, we generated free cash flow of $317 million compared to $267 million last year, representing growth of 19% year-on-year. In addition, free cash flow was 49% of revenue for fiscal 2026. We ended the year with $749 million of cash, cash equivalents and marketable securities. During the fourth quarter, we repurchased $91 million of our shares bringing the total value of shares bought back in fiscal 2026 to $432 million, a significant step-up versus the $116 million repurchased in fiscal 2025. As of March 31, we had $493 million remaining in our existing repurchase program. Now moving on to our outlook. For the first fiscal quarter of 2027, we expect a revenue range of $151 million to $152 million, representing 4% growth at the midpoint, and we expect adjusted EBITDA in the range of $68.5 million to $69.5 million, representing a 46% adjusted EBITDA margin. For the full fiscal year, we expect revenue in the range of $664 million to $676 million, representing 4% growth at the midpoint, and we expect adjusted EBITDA in the range of $323 million to $335 million, representing a 49% adjusted EBITDA margin. Additionally, we expect stock-based comp to increase to the low 20s as a percent of revenue in fiscal 2027 and then trend back down starting in 2028. This is primarily the result of our Pathway acquisition as well as performance-based grants issued in fiscal 2026 for our growing AI team. That said, we expect dilution from these new awards to be more than offset by our share repurchases this year. Now I'll provide more color on our outlook. We are witnessing a continuation of the trend discussed on our last call, with short-term demand in the HCP digital pharma ad market soft and visibility is still limited. This market environment is the result of policy uncertainty remaining elevated and increased macro risk. Taken together, we expect overall market growth to be modest this year, likely at or below 5%. Consistent with broader industry trends, many brands still made meaningful upfront investments, but with more modest growth and shorter planning horizons than typical. As a result, we currently have 65% of our subscription-based revenue guidance booked at this point, in line with our 3-year average, however, with more moderate growth incorporated into our guide than prior years. We're encouraged to see second half budget activity beginning to materialize from several brands that were initially more cautious during the upfront. That said, shorter-term spend commitments remain the norm across supplemental buys at a number of other brands. Within this environment, the dynamic we're seeing is relatively consistent. There isn't much incremental budget available today and when dollars do free up, brand managers are typically looking for 1 of 2 things: innovative new offerings or low-cost engagement options. In many ways, this feels very similar to what we experienced during the early days of HCP-focused programmatic advertising 3 years ago. We believe we are now well positioned to meet the demand for innovation with the recent launch of our commercial AI Search offering, which is already generating strong early interest and allows us to tap into innovation-focused budgets. We began selling the product in late April. And while we do not expect meaningful contribution in the first half of the fiscal year, we do anticipate a more notable ramp as we move into our fiscal back half. We were deliberate in how we built our AI monetization to be aligned with our physician-first commitment. This focused approach has consistently proven to be a long-term winner. Importantly, comparing our business to 3 years ago, our revenue and engagement are both up more than 50%. As a result, we believe we remain well positioned to outgrow the market over time. Stepping back, despite the near-term market pressure, our underlying fundamentals remain strong. Engagement is at record levels, product velocity remains high, and we continue to strengthen our AI differentiation through PeerCheck, our integrated platform approach and our expanding health system distribution footprint. From a profitability standpoint, we remain committed to maintaining adjusted EBITDA margins in the high 40s or better in fiscal 2027, even as we continue to invest in AI compute and PeerCheck and increase our brand marketing spend. As Jeff mentioned, workflow active provider growth accelerated to approximately 30% year-over-year with AI engagement growing even faster, reinforcing that our tools are becoming increasingly embedded in everyday clinical care. We believe we are well positioned to capture a significant share of this emerging growth vector while continuing to deliver strong profitability. As always, we remain focused on the long term by investing to expand our platform's clinical care capabilities and delivering strong and measurable ROI for our customers. We believe we're still early in a multiyear shift towards AI-driven health care workflows, and we're excited about the opportunity ahead. With that, I will turn it over to the operator for questions.

[Operator Instructions] And our first question comes from the line of Brian Peterson with Raymond James.

Jeff, I wanted to start on the AI Search launch, and it's great to see a large customer win. Given that you've seen a few innovation cycles in pharma over the years, I'm just curious, how should we be thinking about the appetite for customers to invest in AI solutions? And as we're thinking about a maybe 2- to 3-year road map. Any sense for how big these AI products could be over that time frame?

Thanks, Brian. This is Jeff. Yes, having just come back from New York last week, where we were with 40 of these top pharmaceutical marketing executives. I was surprised, honestly, by the degree to which they are really all leaned in on AI. In fact, a number of the top 20 pharma reported to us that they have minimum budget percentages, 10%, 20% of their budgets that from a top-down perspective are part of their compensation plan that they should be spending on AI. So we are happy to offer them an AI product now that we've spent the first year post-Pathway acquisition here focusing on physician-first, which we always do and building a better, more accurate product with peer review, with a built-in drug reference, with over 10,000 cited authors reviewing the results and winning 2:1 and head-to-head studies with residents. But I'll tell you, the pharma interest in all of this is quite high. It provides a lot of insight to them in addition to the -- being there at the place of learning and decision-making. And they're understanding gap, frankly, in their own product marketing, which is really interesting. And again, we're excited to have a whole data spend with them talking about how we can help them with that. So in terms of the TAM, we do think it's a multibillion-dollar TAM, as we said in the prepared remarks, I mean if you look at how much U.S. Pharma spent on paid search and all, and it's hard to know because it's -- you have to piece together some e-marketer data with some Google data. But it's probably around $19 billion in overall U.S. paid search. Now a lot of that's for consumers. So that's why we're saying multibillion dollar for health care professionals. But we think it's a very large market, and it is incremental to the market we're in today. Today, we are not considered to be part of the paid search market, and so we're excited to be entering that market this last week.

Great. I appreciate the color, Jeff. And maybe just a follow-up on the budgets for calendar year '26. I appreciate that it's a fluid environment. But are you seeing significant changes in how customers are buying just the shorter-term commitments. And I'd love to understand how you guys are thinking about maybe mid-year buying and kind of end-of-the-year buying that kind of underpins that 4% growth for the year.

Brian, it's Perry. Yes, it's a great question. There's noticeable differences this year. I think the overarching theme is there's more uncertainty, policy and now macro. And I think as a result, a lot of these companies, a lot of the C-suite want to retain optionality. And so we're seeing some of these incremental buys are just shorter duration. That's kind of like a consistent theme that's come up. That's a big one. So I think that's kind of leading to less visibility for us. So that's kind of the broader theme. I think the other thing I'll call out and referenced it in my script, it feels like when there is incremental budget, they're looking for innovation, which we now have to offer where they're looking for the bargain bin. They're looking for some cheaper engagements. And that's something that's kind of a world we never really played in. We're a premium offering for physicians, native ad formats and we don't play in kind of the banner ad, cheaper by pound space. So I think we can now offer them some of what they're looking for, for that limited incremental budget they have and there's a lot of excitement around our AI Search offering. But those are kind of the key trends we're seeing right now.

And our next question comes from the line of Michael Cherny with Leerink Partners.

Maybe if I can jump in on the AI thought process a bit. You mentioned in the script, you talked about the dynamics of offering innovation, and I appreciate all the components you have in place. That being said, obviously, it's a competitive market. There's a lot of investment being made for doctor eyeballs as you see it. As you think about the incremental investment being on compute spend or other R&D spend or people, how are you best measuring yourself to make sure that this amount of spend you have this year is the right amount to further kick off and expand your AI journey?

This is Jeff. I can take that. Thanks, Michael. It's a good question. And the reality is the amount we're spending on compute is going up dramatically, and that's a good thing. Honestly, we're helping more doctors answer more questions, take more notes than ever before. And that's probably the #1 metric we have for ourselves and we'll have for ourselves this year is continuing to grow our AI usage among doctors. We want to be the physician's private AI assistant. I think we are well positioned to be that today. And I'm really proud. We grew 30% year-on-year in our workflow usage, the biggest jump we've ever had from 720,000 to 800,000 quarterly active prescribers. And to put that in perspective, 3 years ago, fiscal '24, I mean, we've grown our engagement 50% since fiscal '24, so from fiscal '24 to fiscal '26, we've grown our revenue 50% or more in that same period. We've grown our free cash flow per share more than 2x during that period. And I think the AI opportunity that lies in front of us now is similar to what we've had this last few years. So we're excited to lean in and invest here. A lot of it is compute, but a lot of it is also getting out with doctors, having them do the peer review, making sure that we continue to put the most accurate product out there in the market. Because if you ask doctors what they like about AI, there's a lot of things they'll tell you, and we're delivering on those. But the #1 concern they have, 71% of physicians who've used AI, 3,000 physician survey that we ran a few months ago, the biggest concern is the accuracy of the AI. And the reality is if you just hit the refresh button, you'll get a different answer. And that's not very comforting for someone who's putting their license on the line and making a very high-stakes decision for a patient. And so that's where our investment in having cited authors and physicians, who are experts in the field, do peer reviews, add practice pearls, make sure that the answers are correct, we think, is a big, great long-term investment alongside the AI investments.

And our next question comes from the line of Glen Santangelo with Barclays.

Just 2 quick ones for me. Jeff, I want to talk about the HCP marketing business for a second. I mean, you highlighted the continued regulatory concerns. Could you elaborate on what those concerns are and how much you think that's impacting the market? Is it coming from IRA price reductions? Like what do you think is really causing the hesitation there? And then secondly, with respect to sort of this new AI, the paid search offering, I'm just kind of curious, could you give us a sense for maybe how the competitive landscape maybe is different here than your traditional HCP marketing business? And maybe what the margin structure might be on that incremental revenue stream.

Great. Thanks, Glen. I'll answer part of this and I think Perry will jump in here with a bit more. So first, I had the word regulatory in my script, in my prepared remarks here. That was referring to our new AI product. And what it really boils down to is they're buying keywords, but they're also buying suppression words and there's a lot that you have to figure out to make sure that the targeting around keywords is done correctly and in a way that we're always proud of the way it appears in front of a physician. Again, we thought long and hard about this. We've tested it with our 160 doctors at our AI Summit we had here in San Francisco in March. And again, I'm very proud that our commercial offering with AI does not slow down the doctor at all. Others do. Others make you wait and watch an ad. We do not do that. We get you the answer you're looking for as fast as we can and our pharma clients are on board with doing it that way with us, but that does require some regulatory review and testing. And so it's really just why we think the AI revenue will really be significant until later this fiscal year because, again, of the regulatory needs and reviews. Beyond that, the regulatory environment hasn't changed a whole lot. I mean, obviously, we have FDA changes and lots of things happening. It's a more turbulent environment just generally. And that does lead to a bit of macro, I'd say, concern malaise. I mean, keep in mind, most of our clients are European companies, right? If you look at the top 20 pharma, this is a European-based group. But we continue to do very well, again, in working with them in their regulatory teams and continuing to show them ROI, which, in the end, is really the most important thing.

Glen, I'll just add a little to what Jeff said. I think in terms of how this is different than some of our other sales. So what we're selling, it's a little different for the first time rather than advertisers looking to target certain HCPs, we're selling them conditions, which is a basket of keywords. The product itself is more than just a native ad unit. It's a package. It also delivers insights, it delivers some retargeting capabilities, which makes our other products, the value of those products go up. There's better signal that's being brought in, better intent, being brought in. So it is a bit of a different sale. And to Jeff's point, it is a little bit of a different regulatory approval process. So it will take a little longer to get these things up and running for the first time. But I think it's incredibly additive and accretive to the entire product portfolio, and we're really excited to be out selling this new product.

And our next question comes from the line of Elizabeth Anderson with Evercore ISI.

Thanks so much for the question. I was wondering if you could talk a little bit more, it's a 2-parter, just about how you envision the gross -- sorry, the margin structure for fiscal '27. Should it be given some of those AI investments and the AI computing costs sort of similar to what we saw in the fourth quarter? Is that the right way to think about it? Or just help us sort of parse apart maybe some of those gross margin versus OpEx investment. And then secondarily, can you go into a little bit more detail about the new CFO sort of what obviously you saw his experience, but just any other sort of traits that you thought would be helpful for the business as you enter into this new era.

Elizabeth. Yes, I can take the margin question first. So I think the key things to look out for in fiscal '27 for gross margin, I think the big step-up will be AI compute. That's largely driven by kind of a big jump in engagement. The other piece to a lesser extent, there's a little bit of licensing cost for journals for docs. So that's a much lower piece of it. For the rest of kind of OpEx, you now have a team that just got leveled. So there's kind of the expense base went up a little bit. We have a few more AI engineers. So you've got a full run rate of that spend this year. We've got some PeerCheck investments that hit selling and marketing. And this year, I think for the first time, we're really leaning into brand marketing. I think our product velocity is so high. There's so many new incredible AI features we're rolling out. We really want to go out and make some noise around that and educate our physicians about it. And so I think that's an online presence, that's a kind of a conference presence. We have a team internally that's kind of very focused on this now. And so I think that's kind of an intentional investment that it's a little different than what you've seen for us in the past. We think it's a really good use of funds right now. I will pass the next question to Jeff. I'll just say I've known Matt for many years from my time covering LinkedIn on the sell side. Matt's fantastic. I'm thrilled to have him here. But I'll let Jeff take the rest of that.

Yes. I'm excited to introduce Matt, he's sitting right next to me here. So I'll just say that we worked with Matt for over a year as a consultant, and he has just really been super helpful. And I feel like a lot of the team already knew them and when we started talking about who we would like and the types of attributes we'd like in a CFO leadership role here. Matt has checked all the boxes. In particular, his experience is very relevant for us. I think the way that LinkedIn has, I think, been very professional, but also high growth and built a marketing solutions business, in particular, using a portal. He helped inform a lot of that portal strategy for us a couple of years ago, and that continues to do well. If we don't get a chance to say later, we have doubled the number of portal users that we have year-on-year. And the portal is a perfect place to deploy more AI insights and more of the sort of search bidding and other things that Perry just talked about a moment ago. So Matt's been not only, I think, a great leader here, but also someone who brought a lot of industry expertise. So with that, Matt?

Thank you, Elizabeth for the question. I'm incredibly excited to be here. I think for a lot of different reasons. I think when I look at Doximity, I see it as a company that has just incredible platform potential along the ways of other companies that have been privileged to be a part of like LinkedIn, like Atlassian, incredible brand like DocuSign for us, some of our assets are the largest medical professional digital network with 800,000 workflow users, just to say that again, with engagement that's accelerating behind a lot of the AI innovation that we're doing right now, an incredible monetization machine that's grown over multiple cycles, building on that strong engagement and relationship with medical professionals as well as kind of underpinned by the relationship we have across health systems. I think when you look at, I think the innovation at Doximity is investing in and creating right now, our pharma ad business, in particular, can really evolve from here into that search ad market. And that's something that LinkedIn did an incredible job over multiple years with evolving its ad business. And I think for me, it's really important to be part of a special culture. Doximity is special culture. It thinks about physicians and medical professionals first. It make investments and big choices focused on the long term. All of that makes it just an incredibly exciting place to be. And I can't tell you how pumped I am to get started for this next several years.

I'll just chime in quick and say, sorry, that Matt Blog was named a culture for breakfast, which I love because, of course, culture does eat strategy for breakfast. And the culture here is something that he yes, be a very strong fit for.

And our next question comes from the line of Ryan MacDonald with Needham & Company.

Jeff, as we think about the back half of the year and sort of the mid-year upsells and sort of year-end budget flush, are you viewing the market opportunity in the demand environment as such that the new AI Search product is really the only opportunity to unlock incremental budget from current levels? And then on the pricing side, I know you mentioned that you obviously don't sort of play down market in sort of banner ads and sort of lower-priced options. But have you looked at or contemplating any sort of pricing changes this year to try to unlock maybe more demand as we go through into the back half?

Thanks, Ryan. This is Jeff, and Perry might help me a bit with this. I'll just say as we get to this year-end, we're excited to have an AI product. We did not have an AI product last year, year-end and the bigger part of the budget season, and we're excited to this year. In terms of do we expect growth from our non-AI products? Absolutely. The growth that we've seen in our telehealth business, I mean we had 1 day this last quarter, where we served 720,000 patients. This was during the big snowstorms in the East Coast. No one else is at that scale. Again, as we've shared, nearly half of all U.S. physicians have an enterprise license to our telehealth service. And that is a great opportunity for our clients to have reach because they're waiting millions of minutes during those visits with patients for the patients to fill out their consent forms and do other things. That's a great learning opportunity, right? It's a magic moment. Doctors there at their desk at home, doing their telehealth today, and they're wearing their white lab coat, and it's a great moment to learn. So I don't know if this analogy will fly, but I think this is, in a way, like Google, where they have both search and really interesting insights and intent, but then also YouTube, where you get a lot of time and a lot of attention. And I think we brought those 2 together here. I actually think the AI product will help us sell more of our existing products because we have a lot of time and attention and now we know how better to be more relevant.

Ryan, it's Perry. I'll just jump in on the pricing question. So I'd say high level, we're not changing our pricing model or positioning to compete on costs. The brands that know our ROI best are generally not searching for discounts. I can say, looking back 3 years ago, to kind of the last cycle, these low-cost experiments usually underperform on engagement. And eventually, there's a flight back to quality cycle that plays out over the next sometimes 1 year or 1.5 years. And a lot of times, you'll see kind of that money come back our way pretty aggressively when some of those kind of lower cost experiments to really work out quite as well. I will say on the AI Search front, it's a bit of a different pricing paradigm. It looks a little different. And I think even versus who we compete within that space, I think we're attractively priced out of the gate. So I think there's some opportunity there for folks to say, "Hey, this, there's good value here." But I think we're not the banner ad company. We're not a cheaper by the pound company. So I think our overall strategy doesn't really change on the pricing front.

And our next question comes from the line of Craig Hettenbach with Morgan Stanley.

Jeff, on the time line to monetize DocsGPT, you talked about kind of different medical review. Any parallels to -- if I think back to the point-of-care modules, video modules a couple of years ago in terms of what you went through there and what you may expect this go around?

All right. I appreciate the long-term memory, Craig. And yes, certainly, we did think hard and long about that as we thought about our forecast and it's why we haven't put much in the AI bucket because even if we sell or contract for a lot of business, we are worried that reviews may take a little while. I'll say as I look at this product, it's actually less new for our pharma clients than the vertical video was. It's hard to make vertical videos, especially 3, 4 years ago before we had a lot of AI tools to do it. And the reality, they just didn't have the content, so you have to go literally hire an agency and make a video and do a video shoot and clip it together. I mean that took a fair bit of time and review. I think this time around, it's not about needing new assets as they call it, new content. It's really just the reviews around the target keywords and the suppression words. So I think it will be faster this time, but we are taking a conservative approach.

Understood. And then just as my follow-up, you talked about kind of putting the doctors first. You have PeerCheck and doing a lot of things to kind of get this product situated. What else beyond that and maybe is that just relative to some of the other newer entrants in this space? Like what do you think is distinguishing Doximity the most today? And then what are you looking to kind of build on to create some separation from new entrants?

Yes. Thanks, Craig. The number one thing I'll highlight is hospitals. At the end of the day, hospitals have a very difficult decision here. They do have some liability with the tools that their doctors use. And what we have seen from our data and usage, it's about half of all of the queries, half of all the queries that doctors ask that have some amount of patients protected information in it. And of course, that is a huge concern for the security departments of these hospitals, and we've seen a number of them start to lock down and block access to the Wild West of AI that's out there. So we're really proud that we've doubled our queries in a couple of months, but I'd say I'm most proud. It took us 2 full years with our telehealth product, Dialer. And this was during COVID, when things were moving very fast. It took us 2 full years to get to 140 hospital enterprise clients, and we've done that in 2 quarters with our AI product which is pretty impressive. And now we have over 250,000 doctors in the U.S. a lot, more than anyone else, who have the full HIPAA-permission, HIPAA-compliance to put patient data in to our tools to help them provide better care, ask questions, get answers. And I think that's a pretty sizable note.

And our next question comes from the line of Richard Close with Canaccord Genuity.

Maybe, Jeff, a follow-up on that 140 health systems, hospitals that you just mentioned. Are these generally speaking, upsells, they were existing Doximity clients?

Yes, Richard. They mostly are folks who were existing clients. I think we've had a couple of new clients who worked previously clients who came in. But we have 7 of the top 20 hospitals in the U.S. And again, we'll have more next quarter to talk about. They all have AI steering committees and reviews. So I will say that the process to get going here isn't just us adding a paragraph to a contract that already exists. It actually is a fairly exhaustive review process because let's face it. People should be worried about their AI security and AI chaos, especially, again, when you're dealing with a lot of patient information. So each of these has been a full process. But again, we're at 140 now. We continue to grow. And we're proud now to also move beyond just working with the biggest health systems, but Aledade, as we called out in our upfront script. They are the largest network of independent primary care practices in the country. We're excited to work with Farzad and his team to make agentic AI for their teams using our Scribe and other tools. So I think we've got a nice win here where our AI is helping us win in the small practice in addition to the big health systems.

Okay. That's helpful. And then, Perry, maybe on the shorter duration comments, it seems that's a theme with some others that have reported. But what do you think has to happen or occur for pharma to move beyond the uncertainty? What are they waiting for to get more comfortable with either the pricing or policy environments?

Richard, it's a great question. I think the reality is it's coming from the C-suite down and the risk appetite is not terribly high right now. And I think for better or worse, the policy and macro environment have to get a little bit better for there maybe to be a little more willingness to commit more money upfront for longer. I think eventually, some of these folks realize they're missing out on better economics by not doing that. So I do think that's going to take a little time for macro and policy to get better. Hopefully, we'll have some kind of settlement to this war in Iran at some point. I don't know if after the midterm elections, there's a little bit less noise around pharma policy. It's not -- our specialty is calling these things. But I really think that's what has to happen. The other piece, maybe it's showing -- getting people comfortable with our new product, AI Search and eventually the nice thing about what we have now in the early days -- and it's still very early. There's a ton of competition we're seeing amongst brands and amongst sales reps, which is really nice to see. And there is some level of selling these categories and competitive blunting. And so there are some brands that want to kind of own a certain category and a lot of times for the entire year, I think it's actually is what they're going to want to go for. So I think the ability to block out some competition, specifically through this product and selling through share of voice, is one of those things that we think will get some folks to commit to longer than -- sorry, 3-month contracts. That may not happen until the next upfront cycle. But I do think there's a component of big competitive blunting that folks may want to leverage for longer-term contracts.

Our next question comes from the line of Ryan Halsted with RBC Capital Markets.

Maybe just to dig into the bookings disclosures. Last quarter, you mentioned starting the year off at record bookings pace. Just curious to hear how that translated into billable revenue? And then obviously, you're guiding to a much slower pace of bookings growth. So just curious kind of how all that has transpired.

Ryan, yes, it's a great question. I think what I'll come back to is January was record bookings growth for January, but January is, I think, the smallest month bookings-wise the entire year. And some of that was simply delayed bookings, things that should have signed by 12/31 that got pushed a little bit. So I think as we went on to the future months, the market has remained soft. That's the reality. I think there's a lot of uncertainty, a lot of want for optionality. And so we haven't -- it's been, I think, a little bit incrementally worse than 90 days ago. That's the reality. We didn't have a war in Iran 90 days ago. So I think that's maybe the disconnect between strength in January, which some of it was bookings from the prior year and not seeing that flow through so far this year. That's kind of the biggest factor.

Okay. That's helpful. And then my follow-up question, just on the upsell and the commentary around the shorter-term spend commitments, just looking for some clarification. So typically, my understanding of the upsell period is you're talking about the reallocation of dollars over the remainder of the budget calendar year or fiscal year. So how should we think about kind of that shorter-term spend commitment impacting that portion of those upsell dollars? Does that mean like some of that upsell dollars could be allocated beyond the budget year?

Sure. This is Jeff, I'll take this. So listen, if we go back 5 years, I think most of what we sold were annual programs that they would layer on more to in the midyear, right? That's how things work. We're in an environment right now where there's just a lot of change. The AI news cycle, everything, it's moving at a very rapid pace. So the bad news is that, that does hurt our visibility when clients prefer to sign 3 and 6 months sort of commitments. The good news is we do it at higher prices. And actually, we're quite explicit about that. So the year-long contracts I mean they get decent discounts for those upfront commitments and clients understand that if they make shorter commitments, they pay higher prices. So in the long run, it could work out to be better for us that we're getting better prices. Again, still with a great ROI for our clients. They're making shorter commitments, but we're getting better pricing. So I do think there is a larger shift here, as Perry has mentioned. Folks are just a little more tepid, and the world is changing pretty quickly. And so there is a few of the top 20 clients who have preferred to move away from the traditional annual commitment for their whole budget and for shorter commitments. But again, in the long run, that could turn out to be good for us. from an overall revenue and profit perspective. It does mean, however, though, we have less visibility, and that comes out, obviously, in the guidance that we're providing.

And our next question comes from the line of Steven Valiquette with Mizuho Securities.

I guess also for us, continuing on this dialogue around the revenue outlook for digital marketing spend over the next year or so. Just curious if you're able to maybe give a little more color as to whether or not certain therapeutic categories are worth calling out where you may see incremental or continued softness in marketing spend. And I ask because another public company talked about softness related to marketing spend and vaccines and also like GLP-1s related to weight loss and/or in diabetes. I'm just curious if you're seeing those same trends or maybe it's just more broad-based, but just a little bit more color.

Sure. This is Jeff. Yes, we don't talk about individual clients. I'll say that, I mean, our GLP-1 business is growing very nicely, as you'd expect, right? That overall business is very competitive. Certainly, a world where there's increased marketing spend, and it's growing very nicely. In terms of number of new FDA approvals and whatnot. It's a good year, not a great year, but it's been a good year, and we think it will continue to be a good year in other classes as well. And again, that's where we see a high percentage of the spend going towards health care professionals as opposed to DTC. And so I think we'll continue to do well there. But yes, I will say there is, clearly, a few companies that are doing very well, and we're doing very well with those companies. So it's funny, the overall iShares Pharma ETF, it's basically flat year-to-date, calendar year-to-date, but you are seeing, I think, more divergence, if you will, in which companies are doing well and which are not. And that's always been the case. But I think a little more so now than perhaps it has been in a while. But again, on our book of business, we're seeing ourselves growing with the ones we were doing well and growing a little less with the ones who are. So I think you can just index us to the overall pharma growth.

And our next question comes from the line of David Roman with Goldman Sachs.

I wanted to just start on just some of the market dynamics here. I think you've historically talked about the digital HCP for advertising market being in the $2.5 billion to $3 billion range and you've offered some perspective on the growth outlook here. But on the paid AI Search side, appreciating it's a huge TAM you're going after. But is there any frame of reference you can give us on sort of size of that category today? What you think the serviceable addressable market is? And how much of the outlook is dependent on market creation versus shifting dollars over to this type of spend?

Yes, David, this is Jeff. I got to be honest, this is a hard question to answer because this is genuinely a brand-new market. And I'll highlight that with the stat. The average Google search is 2.5 words. Our average Doximity AI Search is 23 words. It's just a lot more context. It's really a very different approach. So even if you were able to identify who has an HCP on a paid search side, which, frankly, you mostly can't. The amount of specificity around the question and the amount of insight really is at a whole new level. So it's -- it is a new TAM, and I think it may end up being like what Google did to the yellow pages, right? The yellow pages wasn't that big a business or at least it was a few billion and then very quickly Google 10X'd that business. I think that as we look at AI Search for medicine, we could end up creating a much bigger TAM than what currently exists in HCP paid search, even if we could clearly identify what percent is HCP paid search. So hard question to answer, but I'll say this, the level of engagement from top pharmaceutical companies kind of off the charts. The reality is this is something that's very exciting to see and understand what are the real gaps, what are the real issues that frontline clinicians are encountering with my product. And that, I think, will be good for health care overall because I think we'll start to see better drug development and better education and really start to I think get through all the layers to understand what the key issues and questions are, hard to put a number on that right now.

Understood. And maybe just a follow-up. As you think about appreciating your comments on the macro environment and some of the political and other uncertainty that have faced pharma companies. But coming out of Q1, most companies were raising the revenue outlook for the year. You're seeing your net revenue retention come down a little sequentially and quarter-over-quarter. At what point do you ask yourselves or how do you reassure investors that pharma companies aren't figuring out how to do more with less and the businesses are doing fine without deploying a lot of resources toward HCP advertising? So this is going to be constrained for a longer period of time until they figure out the next area in which to invest.

Yes. Thanks, David. This is Jeff. I'll take that. So I think pharma companies will do more with less, but we're the more. Today, they spend a lot of the mechanics and analytics and data warehouses. In 1 KOL interviews that one of the analysts did a couple of years ago, asked what the fastest-growing area in digital HCP was? And the answer was spending on consulting firms, right, because of all of the consulting that needed to be done to measure the ROI of the programs. And so this allows them to really put money where it works for them, which is where the ROI is. And again, I think we have always won on that front, and we continue to grow there. So I think there will be efficiency gains and that will accrue to us because, again, we're the ones who are delivering the ROI.

And our next question comes from the line of Scott Schoenhaus with KeyBanc.

Perry, this one is for you. You cited market share growth at 5% or below and sort of same expectations for your own growth. I mean maybe what's the delta between your historic 2x market share versus in line market share? Is it more heavily weighted towards maybe a loss of market share on the AI side and the catch-up there? Or this downshift in temporary lower cost spend from your clients?

Scott, it's a great question. And yes, I think historically, we've always outgrown the market some years more so than others. This year, if you look at our guide, we are looking like, at least at this point, we'll be more in line with the market, maybe slight outperformance. I think the reality is, and you're talking about this earlier, there is a lot of incremental budget, and we saw this 3 years ago. We didn't have really something very innovative in the AI Search kind of commercial department to offer folks until 2 weeks ago. We weren't there in the upfront cycle to provide this. Now we have something. We're playing a little bit of catch-up on the commercial front. We're really excited about what we have to offer. So that I think will help us. But the reality is and to Jeff's point earlier, because of the Med legal review time line, right, you lose the summer for most of these programs going live. And so you have real revenue coming from them in the third quarter, the fiscal third quarter, so October through December, maybe a little bit before. But so you're losing out of most of the calendar year of having kind of this innovative product in market when you're recognizing revenue, right? So that's part of why it's a little hard to outgrow this year. The other piece, to your point on the kind of the want for maybe some discounts, some lower-cost engagements or impressions. That's just not where we play. And I think 3 years ago, we went through something similar. I think there were some legacy publishers offering discounts at that time. Maybe we lost a little bit of share of the margin. But longer term, we're in a way better position by sticking to kind of what we do best, premium physician first offering. That's the strategy that has paid off over the long term. We've been around for 16 years. We've been through multiple technology cycles. We might be a little late initially on the commercial front, but in the long run, we have the much better product, the much better physician uptake, the premium offering, and we've actually kind of have the better share gains. I think longer term, we are very well positioned to continue to outgrow the market. Our engagement has never grown faster we -- I think, over time, the revenue eventually follows that engagement growth, that engagement trajectory. And I think when folks are ready to come back to the premium high ROI channels, we will be there in force. I'll also just add, I think it was Allen put out a survey. He's been doing for a few years. And when folks were asked, pharma brands were asked who is the platform where you're going to give your money when -- if and when you have incremental budget. And we were by far the leader there. We had the biggest jump I think we've ever had. So clearly, when people get money, they want to spend with us, so I think we're well positioned if and when some budget unlocks hopefully, a little bit more this year.

Scott, I'll just jump in really quickly too. And this is from a total newcomers perspective, and I'm not here full time quite yet. But the -- I think by being an operator and platform companies by having invested in platform companies like I've been really impressed with how the team has been super disciplined on focusing on the physician's first kind of engagement side of the market and creating that because that ultimately is what will create the longer-term growth opportunity. And I think now it's time to invest as well in the pharma client experience around that much stronger engagement. But you don't really see your base of users, all that often go through dramatic acceleration points. And Doximity is saying that right now, really driven by the AI engagement. So I think that's just a really exciting kind of longer-term framing opportunity to think about how AI monetization really starts to play into the model.

And ladies and gentlemen, that concludes our question-and-answer session. I will now turn the conference back over to Mr. Jeff Tangney for closing remarks.

I'd like to just thank the entire Doximity team for their hard work in serving more doctors every day than ever before. So thank you, everyone, for joining.

Ladies and gentlemen, this concludes today's call, and we thank you for your participation. You may now disconnect.