Dr. Jay Parkinson

Part of being an entrepreneur is knowing when to shift tactics.

Thu, 23 May 2013 17:11:00 -0400

When you’re building something new like Sherpaa, you have no real precedent to see how other companies sold the product/service. You can’t learn from others. So you have to build something, get it out there, see how people react, and experiment with what works best. Once you get a hunch that something is more effective, you build that and run with it.

We created Sherpaa to increase access to healthcare and make healthcare affordable for companies. When we launched with tumblr in February 2012, I made an assumption that companies would pay for access to a doctor for their employees. We were right. We’re now up to about 40 companies. However, when Cheryl joined Sherpaa in May 2012, she brought a whole new level of expertise to the company. I knew the medical side of things. She knew the HR/health insurance side. So we combined our expertise and continued to sell Sherpaa as 24/7 email and phone access to our group of doctors, paid for by companies looking to offer their employees an amazing perk and save money.

Although some companies were willing to pay for perks for their employees, not every company wants to or can. However, every company has a mandated, yearly, big, hairy problem— they have to purchase health insurance. It’s such a pain in the ass and it’s confusing as all hell. I don’t want to bore you, but they essentially have two very old-school and boring options— a health insurance broker (picture a sleazy insurance salesman incentivized to get you to spend as much as possible) or a Professional Employer Organization (a creepy company that “hires” your employees, groups them all together with all the other companies they’ve “hired” and goes to health insurance companies as a large group to secure lower cost health insurance). This means you may work for “super cool internet startup company” but get paid by this creepy thing called Trinet or Ambrose, or ADP. PEOs also offer payroll. But payroll is easy with plenty of super affordable options. However, PEOs charge about $150-$180 an employee per month for all of this stuff they say they can do. So any cost they save by lumping you together for health insurance is offset by their monthly fees. There are a ton of problems with PEOs which is beyond the scope of this post. But for the most part, they’re designed to put out fires when you’re small. But once you grow bigger than 20 employees are so, it’s time to be a big boy company and get off the PEO or you have a financial albatross around your company’s neck.

The other option companies have are brokers. For the most part, you reach out to them once a year, they get your company the most expensive insurance they can get you to buy, and then they go away and say your employees are on their own. They did the job they were hired to do. However, they don’t help individual employees use their health insurance wisely and they are incentivized to maximize your spending.

I think there’s a massive hole in the market between a creepy, bloated, expensive PEO and a once a year conversation with a broker who’s not financially on your side. There needs to be an entity that can procure health insurance for you and also help you and your employees use that health insurance wisely on a daily basis so you don’t waste time or money.

But for the past year we’ve been selling Sherpaa as a perk (24/7 access to doctors!), not part of the mandated equation (purchase health insurance and get this super amazing benefit, 24/7 access to doctors!). So, all of that is changing. We’re focusing equally on procuring insurance for you and giving you access to our group of doctors. We procure the most logical health insurance for your company and then we partner our doctors with you and your employees so you use that health insurance effectively so you don’t waste time or money.

And, year after year, we get better and better. In fact, the companies we’re renewing for year two saw health insurance premiums increase half as much as what they would have increased without Sherpaa. We also discovered that employees covered by Sherpaa spent half as much on healthcare expenses this past year than we expected. Why? Because when you have a doctor available to you within a few minutes to speak with you and create a plan with you, you never waste time or money. We’re doing something wonderful here. Making healthcare accessible and more affordable. It’s my dream come true.

There’s currently a measles outbreak occurring in...

Thu, 23 May 2013 14:20:00 -0400

There’s currently a measles outbreak occurring in Williamsburg and Borough Park in Brooklyn. There have been 34 cases, 8 of which were in adults.

Here’a brief history of measles in America. This is what effective vaccines do:

Measles is coming back because of a quack of a doctor in the UK who admitted to publishing blatantly false data for fame and notoriety. He falsely connected autism with the Measles, Mumps, and Rubella vaccine. He’s since admitted it and has been banned for life from practicing medicine in the UK. Rightly so. The body count is up to 1155.

Measles is also coming back because of the anti-science movement (hipsters in Williamsburg?). The anti-vacciners are on par with the Christian Scientists believing that prayer will save your diabetes. If you are not vaccinating your children, you are simply rejecting science and one of the most remarkable inventions of humankind. On the same level as rejecting cars, planes, elevators, etc..

The issue of vaccinating your kids has very little to do with your kids, and everything to do with protecting the health of your community. Vaccinate your kids, and you’re doing your kid, your family, and your community a social favor. Don’t vaccinate your kids, and you are selfishly anti-social putting your kids, yourself, and your community at unnecessary risk of death.

Dr. Unk arrested for drunk driving You can’t make this...

Tue, 21 May 2013 14:44:23 -0400

Dr. Unk arrested for drunk driving

You can’t make this stuff up. As a sidenote, Dr. Jay has yet to be arrested for jaywalking.

Thank you so much, Paris, for the time and effort you put into...

Mon, 20 May 2013 17:59:00 -0400

Thank you so much, Paris, for the time and effort you put into writing this, sending this, and being so thoughtful with your words.

I struggle with email. I get so many a day from strangers, friends, and colleagues. I don’t get to answer all of them because, if I did, I would be a professional emailer and not actually getting things done. It’s also hard for me because being a quote-unquote innovative doctor in a very, very traditional and anti-creative industry, I tend to stick out. So the med students in America, undergrads in Indiana, nurses in Australia, doctors in India, etc., read something about me, get inspired, and fire off an email to me. It’s very inspiring and one of the main reasons why I truly love what I do. But, managing these communications could literally be my full time job. And don’t get me started on twitter and DM’ing…really? Making communication so easy is the biggest trick we’re playing on ourselves nowadays. At the end of the day and our lives, we’ve still got only a finite amount of time. I’d like to spend more of that time doing things, than talking about doing things. But that’s another story…

However, it is very, very rare, on the order of once or twice a year, that I get a handwritten note in the mail. And when I do, I pause. Why? Because it’s unexpected and the person understands that. It stands out. It also took a special kind of time.

I spoke at PopTech! back in 2008 and I remember Marian Bantjes say something very interesting. If people see something and the viewer has this impression that it must have taken a ton of time to make, the value of that thing skyrockets. That’s Marian’s work above.

When I see an email, it’s nice. But when I see a handwritten note, I am acutely aware of the time and effort it took someone to write and send that, and it makes me pause. This is also the reason why we here at Sherpaa don’t send out cold emails. We send handwritten cards saying something nice about the company/potential client along with a real live bonzai tree. And about a week after we do that, we send an email reminding the recipient to water the bonzai tree and that’s when we ask for a meeting to discuss Sherpaa. Time, effort, thoughtfulness, and a bit of the unexpected make people pause.

Thank you, again Paris.

“How often do you feel close to people?” As many as 30 percent...

Mon, 20 May 2013 14:27:34 -0400

“How often do you feel close to people?” As many as 30 percent of Americans don’t feel close to people at a given time…

Natural selection favored people who needed people. Humans are vastly more social than most other mammals, even most primates, and to develop what neuroscientists call our social brain, we had to be good at cooperating. To raise our children, with their slow-maturing cerebral cortexes, we needed help from the tribe. To stoke the fires that cooked the meat that gave us the protein that sustained our calorically greedy gray matter, we had to organize night watches. But compared with our predators, we were small and weak. They came after us with swift strides. We ran in a comparative waddle.

So what would happen if one of us wandered off from her little band, or got kicked out of it because she’d slacked off or been caught stealing? She’d find herself alone on the savanna, a fine treat for a bunch of lions. She’d be exposed to attacks from marauders. If her nervous system went into overdrive at perceiving her isolation, well, that would have just sent her scurrying home. Cacioppo thinks we’re hardwired to find life unpleasant outside the safety of trusted friends and family, just as we’re pre-programmed to find certain foods disgusting.

via The Lethality of Loneliness

A team of engineering students at Rice University have been...

Mon, 20 May 2013 13:01:00 -0400

A team of engineering students at Rice University have been tasked with developing a new device that can harvest the body’s motion to produce useful electric power. In the process of researching where it’s best to gather the energy they settled on the heel of the shoe, which is normally designed to absorb the shock and finally transfer the energy into heat that is lost forever. They instead developed a mechanical heel that spins a small motor, that in turn generates electric power.

Considering that the iPhone costs 41 cents a year to power, this is a super interesting, and potentially useful way to harness our natural energy to power our external brains.

I just received this in my inbox from one of my most talented...

Fri, 17 May 2013 16:43:00 -0400

I just received this in my inbox from one of my most talented friends:

“My oldest brother was diagnosed with severe ADD in his early teens. He took Ritalin, Adderal, and a few other drugs through high school. He struggled through much of it. I have two other brothers, and both of them, myself, and my Dad all exhibit behaviors that resemble what doctors would consider symptoms of a disorder. We think we’re all a bit ADD.

That oldest brother eventually found art school, went off medication, and has had an amazing life as an artist and educator. Another brother and myself ended up in design school. My dad is a voice actor. My youngest brother is still figuring it out (but is interested in film and move makeup).

ADD is shorthand for a lot of different things to a lot of different people. For us, we associate it with a different learning/cognitive style. I like calling it a “style”. We do things a little bit differently, process a little bit differently. And sometimes that can cause some difficulty in a rigid system that is optimized for the majority learning style (that’s why I did pretty terribly in High School but killed it in college).

I think my youngest brother has been told over and over about his limitations and he can’t help but believe some of it. It pains me. He’s a guy with a different learning style bumping up against a rigid system.

We are a family of creative people. We may not be the best at remembering that the gas stove is still on, but we all create things that we are proud of. I’d much rather be that than the guy who can keep everything safe and in order.

Anyways, thanks for sharing. It’s something that I’ve thought about through my adult life and wish I could shake some of these kids into realizing that there are opportunities built for them, for their style.”

image via (h/t nevver)

"ADHD is a fictitious disease"

Fri, 17 May 2013 12:16:00 -0400

“ADHD is a fictitious disease”

- Remember, there are two ways drug companies can make money:

Invent new drugs

Invent new diseases already invented drugs can treat

In the past decade or so, Big Pharma has created less than 10 new novel drugs per year.

As an example of Big Pharma inventing diseases is “short, normal” children. We can treat “short, normal” kids with human growth hormone and make them “normal.” For parents who want tall or “normal-sized” children, they can inject their kids with growth hormone on a regular basis. When I worked with Nader at his group, Public Citizen, in 2006, I wrote a petition to the FDA to ban human growth hormone on the newly approved disease, “short, normal” children because we identified about 10 reported cases of “short, normal” children who had died from complications of receiving human growth hormone.

Leon Eisenberg, “The Father/Inventor Of ADHD”, on his deathbed

Too many people tell me that they suffer from ADHD when, to me, they suffer from the consequence of bad design. Are you familiar with the Social construct theory of ADHD?:

ADHD as a social construct [edit]

Psychiatrists Peter Breggin and Sami Timimi oppose pathologizing the symptoms of ADHD. Sami Timimi, who is an NHS child and adolescent psychiatrist, explains ADHD as a social construct rather than an objective ‘disorder’.^[5] Timimi argues that western society creates stress on families which in turn suggests environmental causes for children expressing the symptoms of ADHD.^[6] They also believe that parents who feel they have failed in their parenting responsibilities can use the ADHD label to absolve guilt and self-blame. A common argument against the medical model of ADHD asserts that while the traits that define ADHD exist and may be measurable, they lie within the spectrum of normal healthy human behaviour and are not dysfunctional. However, by definition, in order to diagnose with a mental disorder, symptoms must be interpreted as causing a person distress / espec. maladaptive. In America, the Diagnostic and Statistical Manual (DSM-IV) requires that “some impairment from the symptoms is present in two or more settings” and that “there must be clear evidence of significant impairment in social, school, or work functioning” for a diagnosis of ADHD to be made.

(via kenyatta)

plannedparenthood: It’s National Women’s Health Week. Make your...

Tue, 14 May 2013 15:48:58 -0400

plannedparenthood:

It’s National Women’s Health Week. Make your health a priority and schedule a well-woman checkup today.

Back in 2007, I had a patient who was uninsured with a strong...

Tue, 14 May 2013 15:33:00 -0400

Back in 2007, I had a patient who was uninsured with a strong family history of breast cancer. At the time, the only place you could get tested for the gene mutations strongly associated with breast cancer, BRCA1 and BRCA2, was this company called Myriad. They had a monopoly on the test. I thought the patient really needed to know her risk (which could be as high as 87% likelihood of getting breast or ovarian cancer). I called up Myriad and asked how much their test would cost a cash-paying patient. They said $4000. I asked if they had some sort of financial assistance programs. They said nope. Of course this made me angry.

And now it’s 2013. Back in January I joined 23andMe, spit in a cup, sent it off to them, and found that I have none of the three most popular BRCA mutations. And this only cost me $99 cash. So…in 5 years or so, the cost of understanding your risk went from $4000 for testing two genes to $99 for sequencing much of your DNA. And that’s a beautiful thing.

I applaud Angelina Jolie for being open and honest about her decision to have a double mastectomy to prevent breast cancer. Celebrities can shed a vital light on important and difficult issues to popularize. And she’s done a remarkable job, unlike Jenny McCarthy. By being science and data-driven, you can save lives. By being emotional and scientifically ignorant, you can take lives.

photo by Martin Schoeller

I got myself a vintage Omega watch from the 40’s....

Wed, 08 May 2013 18:07:00 -0400

I got myself a vintage Omega watch from the 40’s. I’ve got to wind it every morning. It’s becoming a nice little ritual for me. Sit on the bed and wind a gorgeous watch and think about just slowing down.

ilovecharts: via cakostopoulos This chart has one misleading...

Tue, 07 May 2013 12:30:52 -0400

ilovecharts:

via cakostopoulos

This chart has one misleading bit. You don’t really overdose from cocaine. The vast majority of deaths from cocaine occur from an impossible-to-predict fatal heart rhythm. You snort some coke and your heart stops beating normally and you die. Cocaine is an interesting drug in that this rhythm can occur in anyone at any time and it’s not associated with the dose. It can happen the first time you do coke or the 1,000th. It can happen with just a small amount or it can happen after your 4th hit that night. It’s just sheer bad luck. Note that cocaine kills more people than heroin every year.

Back when I was a medical student in probably 1998, I saw the...

Thu, 02 May 2013 18:42:00 -0400

Back when I was a medical student in probably 1998, I saw the first surgical procedure of many on a little boy who was born without an ear to surgically create an ear for him. During this first component of the procedure, the plastic surgeon made an incision in the boy’s chest and removed a rib. For the next few hours, the surgeon whittled the rib into a few pieces, bent the rib, and stitched the rib pieces together in such a way to mimic the appearance of the cartilage inside your ear. He then made an incision in the boy’s skin where his ear should have been and put the “ear” under the skin and sewed it up. The next probably 6 surgeries were to gradually stitch the skin in such a way that makes the “rib-bone ear” look like a normal ear. I was floored. It was one of the few moments in my life where I wanted to be a surgeon. This guy was a sculptor. A true artist. And this little boy would have a new “ear.” Super, super inspiring.

And now we have 3D printers to replace the archaic, but artistic rib bone to ear procedure. Amazing. Progress.

thisistheverge:

3D printed ‘bionic’ ear combines cartilage with an antenna

I’ve always loved Jezebel… Jezebel: Say Goodbye to...

Thu, 02 May 2013 18:18:00 -0400

I’ve always loved Jezebel…

Jezebel: Say Goodbye to Dr. Google Paranoia With Sherpaa:

One recent Sherpaa patient contacted Santana after she switched insurance providers and could no longer get a specific brand of oral contraception covered. The new generic version she was taking was giving her terrible migranes, but she didn’t want to pay for the brand she knew worked. Santana investigated: turns out her doctor’s office didn’t have her full medical history and therefore denied her coverage.

“If you write the wrong thing on a form, you’re denied,” Santana said. “It’s disempowering. You have to know how the system works, and the system isn’t set up so it’s easy for the patient to figure out.”

Gitmo is having a hunger strike problem: As of Tuesday morning,...

Tue, 30 Apr 2013 16:47:00 -0400

Gitmo is having a hunger strike problem:

As of Tuesday morning, 100 of the 166 prisoners at Guantánamo were officially deemed by the military to be participating in the hunger strike, with 21 “approved” to be fed the nutritional supplement Ensure through tubes inserted through their noses.

“We will not allow a detainee to starve themselves to death, and we will continue to treat each person humanely,” said Lt. Col. Samuel House, the prison spokesman.

The military’s response to the hunger strike has revived complaints by medical ethics groups that contend that doctors — and nurses under their direction — should not force-feed prisoners who are mentally competent to decide not to eat.

Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”

“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.

He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”

"Every dollar spent at a locally owned business generates two-to-four times the economic development..."

Mon, 29 Apr 2013 12:02:00 -0400

“Every dollar spent at a locally owned business generates two-to-four times the economic development impacts as a dollar spent on an equivalent non-local business.”

- Forbes piece on the amazing power of spending locally. (via poptech)

It’s not only healthy for you to eat fresh and local food, it’s healthy for your neighborhood’s economy.

And speaking of a healthy community, I’m speaking tonight at an event in Williamsburg that’s raising awareness about asbestos removal at the Domino Sugar Factory. It looks like there are some very shady removal tactics happening at the site putting the community at risk of breathing more asbestos fibers than we should be. The local issues in your immediate neighborhood where you work and play are by far the most important issues to get involved in.

We took buddy upstate yesterday for a little swim in Pine Meadow...

Mon, 29 Apr 2013 11:19:09 -0400

We took buddy upstate yesterday for a little swim in Pine Meadow Lake. He needed a bath. He’ll swim for hours if we let him.

“Ok for Al Jazeera to come tomorrow to the office?” Cheryl, the co-founder of Sherpaa,...

Mon, 29 Apr 2013 11:09:00 -0400

“Ok for Al Jazeera to come tomorrow to the office?”

Cheryl, the co-founder of Sherpaa, just hit me up on Skype to ask me this question. I’ll chalk this up to “things I never thought would ever happen when I finished my residency nearly 6 years ago.”

Photo

Wed, 24 Apr 2013 17:09:50 -0400

sherpaa: Meet Dr. Ezra Feinberg. Ezra is our clinical...

Mon, 22 Apr 2013 17:17:00 -0400

sherpaa:

Meet Dr. Ezra Feinberg. Ezra is our clinical psychologist. We’ve come to re-think the standard $250, 50-minute weekly therapy session. Sometimes you only need a 15 minute chat to feel safe and comforted. Sometimes you may need visits over the next month with a therapist to help you get through a breakup, or you may need intensive therapy with a psychiatrist for longer to help you overcome a serious issue. All our clients are different, so we’re envisioning ways to make mental healthcare work best and most affordably for you. Ezra will guide you to exactly who and what you need.

What’s your favorite thing about being a psychologist?

Working one-on-one with patients is definitely my favorite thing about being a psychologist. The therapeutic process is intense and challenging, but helping people to improve their lives is the reason I got into it in the first place.

What makes NYC special to you?

It’s the energy. There’s no other city with this kind of energy, and it brings out the character in everyone. It’s also a pain in the ass, but I’ll never leave New York.

Besides being a psychologist, how do you spend your time?

Time with friends and family of course, and lots of time reading, seeing films, listening to music, playing music, exercise, and eating delicious meals prepared by the various culinary geniuses in my life.

Tell us about your decision to become a psychologist.

It hit me shortly after I graduated from college. I thought “that is something I could do” which was immediately followed by the thought “but not right now.” It would be another five years before I entered my doctoral program. I knew it was a big decision and I wanted to be ready.

We all know healthcare is broken. What is it about Sherpaa that makes
you feel like you’re part of the solution?

The “care” part of our current healthcare system has gone unaccounted for. By providing access to doctors and specialists right away Sherpaa makes people feel cared for, and feeling cared for is a crucial step in becoming healthy, no matter what the ailment.