Just over eight years ago, fresh from residency, Jay Parkinson, MD, decided to combine something old and something new to create what was a novel idea in 2007 — the Uber of healthcare. Now he's here to say this idea will not work, no matter how you cut it.
Writing for KevinMD.com, Dr. Parkinson described how the advent of the iPhone and Google Calendar paved the way for his idea to reinvent housecalls. Working in New York City, Dr. Parkinson set up a website where patients could sign up for an appointment online using Google Calendar and explain their symptoms, attach photos and give him their addresses. Then Dr. Parkinson would determine if the patient could be seen with a housecall, recommend another venue if necessary and if not, pick up the necessary supplies and cab over to see the patient.
As an amateur photographer, he was well-connected in the uninsured artist community, enough to get his practice off running, until it was picked up by Gawker, Fox News, NPR, GQ, Esquire, TED, MSNBC, CBS and other national news media. At that point, he had no problem packing his Google Calendar.
Yet, he soon found out the practice was not at all sustainable, despite that it was "ridiculously fun," he wrote. Although his practice was limited to the Williamsburg, Greenpoint and Brooklyn neighborhoods, zig-zagging from appointment to appointment all day was exhausting, he wrote, and meant 50 to 60 percent of his time was spent commuting or acquiring supplies for the appointments.
This in turn meant he could only see about eight patients a day, and at $100 a visit, it meant he was only making $800 a day before costs, which was much less than his office-bound peers, who could see roughly 30 patients a day.
Though he said he does not regret his experiment, Dr. Parkinson wrote, "But primary care doctors are a dying breed. We need all of them we can get, and we need them to be safely seeing a maximum amount of patients per day. We need to optimize their realistic daily processes and make them markedly more efficient. Every second the doctor is not seeing patients is wasted time."
The inefficiencies are scalable, he wrote, and once venture capital runs out, budding Uber practices for healthcare will not be financially sustainable. He added, "Short of teleportation, the doctor house call will always be an irresponsibly massive reduction in primary care efficiency. Patients need us now more than ever."
Now Dr. Parkinson is on to his next project: an online patient consultation service called Sherpaa.
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