Thursday, January 8, 2009

HelloHealth: putting you back in direct touch with your doctor

Well, I just got my mind blown. I'd heard of this little company – this doctor with a completely radical idea – but until tonight I had no idea how completely upside down inside out different his approach is. Radically trashing the current way of doing business in today's doctor-patient relationship, kicking its ugly butt right down the fire escape and replacing it with what he wanted in the first place: a really good personal relationship.

Mind you: I haven't thought this through at all, to see how it plays out. Like, I don't know how his model would work when someone like me comes down with stage IV kidney cancer. But put that on hold for 20 minutes and listen to what he's talking about.

And thanks to the always richly informative Susannah Fox of the e-Patient Scholars Working Group, who highlighted this guy in her post today on that blog, Doing Our Best to Blow Your Minds. Ya think?


  1. Dave,

    First I will start with praise. He is right. The system is dysfunctional, broken, bad and overall just darn wrong. However...

    This fella presents a very very narrow view of physicians, their practice, and the needs of patients. This young physician with very little experience is catering to an audience of wealthy patients with simplistics issues. Although his product is important (communication), it is not the overarching problem of healthcare. The problem of healthcare goes deeper and wider than just communication. You know this well.

    Let's get back to his cost structure. $100 to $200 office visits. That's what he is calling affordable healthcare? Patients complain bitterly about $10 co-pays. He even attempts to sell you on the idea that now his un-insured patients now have better access to healthcare. Really? Come-on. He tries to tell us that he has made things better by offering more of his time. Well heck, I can give more of my time if I get $250 an hour for an office visit too. But we don't. Often times I get nothing. Zip. Zero. So in fact, what he has done is simply find a way to actually collect a high fee for his time. Guess what. That means that we will need more doctors. Its not so simple as to just say now that you pay me more, I can spend more time with you. If now you only see 10 patients a day instead of 40, what happens to the other 30?

    How about using the computer as your primary communication method? Tell me how my hispanic mother of 5 who earns nothing while her husband laborer is out earning 5 bucks/hr. is going to benefit from communicating with me on their non-existent computer? This is certainly the Internet age, but only for those that can afford it. Quite frankly his concept will cut out the people that need him most.

    Let's call this what it is. A nifty idea (and it isn't new by the way) for the wealthy patient with a sore-throat. This is OK. It is a fine service for many people. But let's not try to sell it for what it isn't. It is not the solution to medicine.

    He tells us about his $250K medical school debt. This is real. He tells us about his earning potential of only $75K to $110K. This is real. The solution to this problem isn't increasing his earning potential (believe me, a pediatrician doesn't necessarily deserve a whole lot more than $100K), but rather, medical school should not cost so darn much. Remove that debt burden, and $100K for 60 hr. work week for a relatively low complexity job is an acceptable starting wage (I say relatively as compared to specialty practice of something like cardiothoracic surgery or critical care medicine).

    Thank you.

  2. Hi Joe - nice to meet you. How did you find me? (I think I just dug you up on LinkedIn - very glad to make your acquaintance.)

    I don't know the Williamsburg section of Brooklyn (where he works) so I have no idea if it's wealthy or not. In any case his numbers seem to be an order of magnitude lower than the similarly structured "concierge medicine" membership plans that I've read about, though I haven't studied them in depth.

    Clearly, though, if people are paying him immediately through PayPal, he's got an online clientele, which means they're not the poorest.

    Otoh, the latest data (this week) from the Pew Internet & American Life Project shows that Internet usage is indeed spreading down the economic scale, and use of cell phones as a healthcare platform is on the rise. For instance I've heard that health applications being developed for Africa all presume the phone is the platform.

    I cited some of that in comments on Paul Levy's blog this week.

    Thanks for contributing. I'm learning as fast as I can but I freely acknowledge being new to all this, and I welcome feedback. Drop me a note at to say hi if you want.


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