I’ve been seeing a lot of discussion lately about the peer sharing economy and how it applies to healthcare. Some people like to call it the Uber of healthcare, but that phrase has been applied so many ways that it’s hard to know what people mean by it anymore. For example, is it Uber bringing your doctor to your home/work or is it an Uber like system of requesting healthcare? There are many more iterations.
I’ll to consider doing a whole series of posts on the Peer Sharing Economy and how it applies to healthcare. There’s a lot to chew on. However, most recently I’ve been chewing on the idea of on demand medical services. In most cases this is basically the Skype or Facetime telemedicine visit on a mobile device. These models are starting to develop and it won’t be long until all of us can easily hop on our mobile device and be in touch with a doctor directly through our phone. In some cases it will be a telemedicine visit. In other cases it might be the doctor coming to visit you. I’m sure we’ll have a wide variety of modalities that are available to patients.
Every patient loves this idea. Every insurance company is trying to figure out the right financial model to make this work. Most doctors are scared at what this means for their business. Certainly there are reasons for them to be concerned, but I believe that this new on demand medical service could be very good for doctors.
In our current system practices do amazing scheduling acrobatics to ensure that the doctor is seeing a full schedule of patients every day. They do this mostly because of all the patient no shows that occur. This makes life stressful for everyone involved. Imagine if instead of double booking appointments which leads to all sorts of issues, a doctor replaced no show appointments with an on demand visit with a patient waiting to be seen on a telemedicine platform. Basically the doctor could fill their “free time” with on demand appointments instead of double booking appointments which then causes them to get behind when both appointments do show up.
I can already hear doctors complaining about them being “mercenaries” and shouldn’t they be allowed free time to grab a coffee. I’d argue that in the current system they are mercenaries that are trying to fill their schedule as full as possible. The current double booking scheduling approach that so many take means that some days the doctor has a full schedule of appointments and some days they have more than a full schedule of appointments. If doctors chose to back fill no-shows with on demand appointments, then their schedule would be more free than it is today. Plus, if they didn’t want to back fill a no show, they could always make that choice too. That’s not an option in the double book approach they use today.
In fact, if there was an on demand platform where doctors could go and see patients anytime they wanted to see patients, it would open up a lot more flexibility for doctors much like Uber has done for drivers. Some doctors may want to work early in the morning while others want to work late at night. Some doctors might want to take off part of the day to see their kid’s school performance, but they can work later to make up for the time they took off (if they want of course).
Think about retired doctors. I’m reminded of my pharmacist friend who was still working at the age of 83. I asked him why he was still working at such an advanced age. He told me, “John, if I stop, I die.” I imagine that many retired doctors would love to still see some patients if they could do it in a less demanding environment that worked with their new retirement schedule. If there was an on demand platform where retired doctors could sign in and see patients at their whim, this would be possible. No doubt this is just one of many examples.
Currently there isn’t an on demand platform that doctors could sign into and see a patient who’s waiting to be seen. No doubt there are many legal, financial and logistical challenges associated with creating a platform of this nature. Not the least of which is that doctors are only licensed to practice in specific states. This is a problem which needs to be solved for a lot of reasons, but I think it will. In fact, I think that legal issues, reimbursement changes, and other logistical challenges will all be solved and one day we’ll have this type of on demand platform for healthcare. Patients will benefit from such a platform, but I believe it will open up a lot more options for doctors as well.