There are so few innovations in primary care. But it’s the entry point to all of your healthcare expenses. There have been three scalable primary care innovations:
- Retail Health clinics (Walgreens, Minute Clinic, etc.)
- Virtual Primary Care (Sherpaa)
These innovations need to be evaluated based on two questions:
- How capable are they at handling real world problems?
- How cost-effective are they?
Telehealth like Teladoc can only diagnose and treat ~30 simple, inexpensive things. Let’s call this pink eye telehealth. From a doctor’s perspective, here’s why video visits are so limited in scope. Each visit costs employees ~$49 and employers either nothing or some negligible amount like $1 PEPM.
Next are Walgreens Nurse Practitioner clinics that people call retail health. They diagnose and treat a slightly larger amount of conditions (~50) because they can examine you and do simple tests that can’t be done via a phone call or video. A nurse practitioner can diagnose more things via an in-person visit than a doctor can via a phone or video call. This makes sense. Essentially, this means a doctor is no better than a nurse diagnosing stupid simple things. Each visit typically costs $79.
Next is Virtual Primary Care (VPC), invented and pioneered by Sherpaa over 6 years ago. If you have a regular doctor who communicates with you via messaging, photos, health data, phone, and video, and can order tests and take ownership of your outcome from beginning to end, those doctors can handle ~1450 diagnoses. A month of this care costs $99 or $270 per patient per year.
Next is the traditional PCP. They can do a bit more than VPC because they can take care of the rare situations where regular physical exams are required for ongoing management of your situation (they can listen to your heartbeat and do an EKG if you have a heart rhythm disorder for example). But they charge, on average, $200 each time you visit them.
So biggest bank for your buck? By far, VPC. It’s 95% effective as traditional PCPs at less than half the cost.