Although having a doctor accessible 24/7 via app or phone is a wonderful and remarkably helpful experience, truly letting people connect in a deep way with those doctors over the internet is a challenge. As a user, you can tell our doctors are experienced, knowledgeable, and exceptional doctors…but you can’t grasp their wonderful personalities via a message. So, we created these videos of our doctors to let you meet the person on the other end. I’m so proud of our team of doctors. They are all simply outstanding.

This is Dr. Ida Santana. Also, meet Dr. Susan Gonnella and Dr. Ezra Feinberg. These are the people that make Sherpaa great.

From 1988 to 2014, watch the battle to eradicate polio unfold.

Red means the country still has cases of wild polio, yellow means the country is in a region that still has cases of wild polio, and white means that the disease has been eradicated.


Not too long ago, the Robert Wood Johnson Foundation invited me to speak to their entire organization about Sherpaa, re-imagining healthcare, and designing a better way of doing things. The Robert Wood Johson Foundation is the United States largest philanthropy devoted solely to the nation’s public health and they do absolutely wonderful work. 

After I spoke, they asked me to write a piece for them. Here’s what I wrote:

Everything great comes from an elegantly designed process. Just think of all of the experiences we love and use on a daily basis. Consider the iPhone. Apple re-imagined what a phone, or rather, a tiny computer in your pocket, could be and created a revolutionary device. Steve Jobs designed not only the interface that changed computing forever, but Tim Cook designed the manufacturing and material sourcing processes that enabled them to produce a remarkably complicated device at a relatively inexpensive price. They understood that, in order to deliver an exceptional user experience, they had to design the entire process, from the interface to the factory.

Health care was never designed. It just happened, revolving mostly around doctors’ needs and wants, in a culture that strongly believed “doctor knows best.” But our culture changed with the democratization of health information and other industries quickly evolved, raising consumers’ expectations of what health care could and should be.

Comparing the Apple Genius Bar with today’s average health care experience is laughable.

So how can health care catch up? Design an elegant health care process that enables intelligent health care delivery. Don’t only design that process, but implement it. Essentially, combine the elegance and creativity of Steve Jobs with the process-driven business savvy of Tim Cook. That’s what we do every day here in my company, Sherpaa. Here’s how it works:

  • Our salaried, full-time doctors have one mission: communicate via phone or web and creatively solve our patients’ health problems, all day, every day.
  • When patients have health problems, they log in and tell us their story.
  • Our doctors then, online, ask the right questions and get a careful history, prompting them to either order lab or imaging tests, treat with a medication, watch and wait, or refer for an in-person evaluation to a doctor in the patient’s neighborhood.
  • 70% of the time, our doctors treat or solve the issue without having to refer to an in-person doctor. When we do refer, it’s always to the exact specialist the patient needs.

Does that really mean that 70% of primary care, specialist, and ER visits don’t need to happen? Does that really mean that 70% of those insurance claims should never happen? Yes, exactly. If you give patients accessible doctors at the right time to skillfully decide how best to use health care, health care is used intelligently with very little waste. In this system, everything that’s done actually needs to happen.

All of this is the result of an elegantly designed health care delivery process. But elegant processes aren’t free. So, in conjunction with this process, you must have an equally innovative business model to pay for this new process. There’s a hard fact floating around companies saddled with health care costs—health insurance premiums double every seven and a half years. Employers have a vested interest in taming those costs. And with roughly 70% of health care costs in America fronted by employers, they are the perfect innovation partner. Employers pay us to innovate their way out of rising costs through intelligent health care delivery.

This is all very interesting for the early adopters—the innovative and creative companies looking to make health care awesome for their employees. But what about the rest? What about the unions, those folks on Medicaid, and companies with minimum wage workers? Well, it’s called trickle-down technology. When the iPhone came out, few people could afford it. Over time, we now have cheaper versions of iPhones and, most importantly, Google’s Android smartphones. There’s even a $25 Android smartphone soon to be released. Now, almost everyone can afford this fancy “new” technology. This will also happen with health care. Start with the innovators who can’t stand frustrating experiences and who are dying to pay for something better. Work with those folks to refine your process and make it even more elegant, build an even bigger business, and watch competitors arise. And in the not too distant future, we’ll all wake up one day to see health care transformed by a little combination of dreamers, designers, and businesspeople who couldn’t stand seeing something broken without doing something about it.

Tumblr Founder David Karp Invests in Medical-Treatment Startup Sherpaa — WSJ

We’re thrilled to announce that David has invested in Sherpaa. I’ve known David for about six years now after meeting through the NYC grapevine. Tumblr has powered my blog since I launched my practice back in 2007. David was one of my earliest followers on tumblr and when we were talking in late 2011 about the early ideas that would eventually culminate in Sherpaa, David suggested getting Sherpaa started by partnering with tumblr. David’s early support, and now, his investment, catalyzed our success. It feels good to know that David, after working with us for two years, believes so much in what we’re doing, he’s invested. And for that, I am grateful. It’s another milestone for us in making healthcare as awesome as we can.

Tumblr Founder David Karp Invests in Medical-Treatment Startup Sherpaa — WSJ


W. Eugene Smith – Dr. Ceriani, 1948

Smack out of the golden age of the photojournalistic essay, Dr. Ceriani manages to maintain its power even removed from the framing of the magazine it was published in, the words around it gone. I want to think that what makes this photograph so poignant is that it essentially is a self portrait. Not in the absolutely literal way – Smith obviously was not a medical doctor, but in a somewhat metaphorical one. The concern on the doctor’s face mirrors the concern the photographer brought to his subjects, as does the closeness to the subject matter (for the doctor the injured child, for the photographer the doctor taking care of the injured child).

As a doctor you cannot help but be that immersed if you want to treat, possibly rescue, your patient. As a photographer, you could step back, but if you can’t help yourself you get close (Robert Capa’s dictum about picture quality corresponding to closeness to subject matter is mere machismo, though: Capa’s photographs always have a whiff of having been taken for effect in them, something Smith deftly managed to avoid almost all the time).

And if you want to be this close, you have go to be this good. The framing around the doctor is perfect (or expertly cropped – we have no way of knowing from the print alone), following the rules of the thirds closely. The helping hands at the bottom right corner of the frame are there, but they’re slightly out of focus. It’s all about the doctor and what he is doing.

Another one of the reasons why I think of this photograph as a self portrait is because the doctor’s attention is not on the child, at least not as far as his gaze is concerned. It’s not quite so clear what the doctor is focusing on, but whatever it is, it’s outside of the frame. We don’t know. We’re not shown. In much the same way, Smith’s photographs are as much about what they show as what they imply, what they don’t show, what’s outside those frames. There always is a balance going on (just like here): The photographic facts in the frames work with – hint at – all those facts, assertions, and ideas outside of the frame, often implicating the viewer in something: If you, dear viewer, could just get as engaged in this, we wouldn’t be in this situation, and the world would be a better place.

W. Eugene Smith was a true believer in what you could do with photographs and what it took to do that well. For that alone, he’s still missed (especially in a day and age where so much photojournalism is done for style and/or effect).

(this is one of the 100 pieces I wrote about each of the pictures in John Szarkowski’s Looking at Photographs)

Well written Jörg. Here’s the rest of the 40 or so photographs included in this photographic essay from 1948, Country Doctor. 

The last project I ever did at my previous company, The Future Well, was ideate and design the most popular iPad app for physicians, Omnio. When I was pitching the client the concept, I used this essay in our pitch deck as an emotional hook to argue that doctors no longer need a physical doctor bag, they need a virtual doctor bag in the form of an app. The clients bought into the idea, we got the job, designed the app, and now it’s a wild success. Amazing how a photograph can tell a story in so many different contexts.

Prices for tests and procedures in healthcare are literally all over the map, as told so wonderfully by Time in their groundbreaking article, The Bitter Pill. For example, if you get a brain MRI at one institution versus another, this may be the difference between you paying $500 vs. $2500 out of your deductible. That’s the difference between you going on vacation to Rio, buying that new MacBook Pro, or doing whatever your little heart desires with a cool extra $2,000 in your pocket. The obvious next question is, “Well I can only assume that if I get the test done at the $2500 place, it’s going to be $2,000 worth of higher quality and value, right?” Wrong. Healthcare costs are in no way correlated with quality and value. The same goes for procedures too. If you need an inguinal hernia repair, you’re going to quickly blow through your $10,000 deductible if you get it at one institution vs. another. But what if you can negotiate with a general surgeon for a better price? Instead of spending $10,000 of your deductible in a hospital center, you could spend $4,000 to have the procedure done in a beautiful outpatient surgical center. Now that’s $6,000 of real money you just saved.

That’s why I’m ridiculously happy to announce that Sherpaa just released a new feature in our app to help you save a potentially ridiculous amount of money when you need an expensive test or procedure. You can now tell us your story and what you need, and our doctors and insurance guides will collaborate and find you the highest quality place to get these at the best price.

I’m so damn proud of this. A resource that can save you literally thousands of dollars can make a huge difference in your life. So if you’re a Sherpaa client, give it a try and instead of throwing money blindly at an opaque, unfair system, go on that much needed vacation. You deserve it.

Sharing a lovely meal with friends and family— it’s one of life’s most beautiful experiences. For healthy people, it’s just so simple. You meet up, eat, drink, laugh, and call it a night. For people who have Parkinson’s Disease, or some other tremor, sharing a meal can not only be embarrassing, it can be impossible. Some tremors are so severe, they can’t even feed themselves. 

Liftware solves this problem. Watch the video. Such an emotional product is extremely rare. I spoke at the same conference with these guys about a year ago and their video floored me. It’s finally out. Really, really nice work.