Author: Jay Parkinson, MD, MPH

Comparing the operational costs of traditional primary care, Direct Primary Care, and Virtual Primary Care

The easiest way to understand the costs of primary care is to simply consider the most expensive part of delivering primary care— the salaries and benefits of physicians, NPs/PAs, nurses, and staff. To keep things simple, we’ll ignore the other costs like facilities and operations. For this exercise, we’ll consider a 10,000 patient primary care practice and we’ll compare three kinds of practices: A traditional … Continue reading Comparing the operational costs of traditional primary care, Direct Primary Care, and Virtual Primary Care

Jay Parkinson, MD, MPH

How to deal with evidence and skepticism in healthcare startups

I’ve been a startup guy for 11 years this month. And over the years, I’ve heard cries of “show me the evidence!” and “that’ll never work!” on an almost daily basis. They come from randos in comments on LinkedIn, doctors in comments on WSJ articles, or potential employer customers looking for something to help them mitigate their increasing healthcare costs. It goes something like this: … Continue reading How to deal with evidence and skepticism in healthcare startups

Jay Parkinson, MD, MPH

The advantages of asynchronous medicine: the doctor perspective

Yesterday, I wrote about the advantages of asynchronous communication and problem solving from the perspective of the patient. But what about for doctors? Does it make their practice easier or harder? Are they better doctors or worse? What can asynchronous doctors do that their traditional counterparts cannot? After 7 years of practicing exclusively asynchronously, our doctors believe practicing asynchronously is far safer, more efficient, and … Continue reading The advantages of asynchronous medicine: the doctor perspective

Jay Parkinson, MD, MPH

Why the doctor-patient relationship should move primarily online: the patient perspective.

First, let’s define “asynchronous” as “not real-time conversations.” Instead of oral conversations, it’s messaging you respond to when you have the time. Of course, jumping on a call or video is always an option when necessary. But we all know how many emails we send vs. how few out-of-the-blue calls we make in a given day. Traditional healthcare has always been a real-time oral conversation … Continue reading Why the doctor-patient relationship should move primarily online: the patient perspective.

Jay Parkinson, MD, MPH

The physical exam is a surprisingly uncommon critical piece in determining a diagnosis.

Most people without medical training drastically overestimate the sensitivity and specificity of the traditional physical exam as a means of diagnosis. In reality, for the vast majority of medical conditions, it is one minor data point that leads to a diagnosis. In fact, many, if not most, conditions have almost zero physical findings. Of course, some things are diagnosed exclusively by physical exam. But those … Continue reading The physical exam is a surprisingly uncommon critical piece in determining a diagnosis.

Jay Parkinson, MD, MPH

Primary Care fails people surprisingly often.

Patients view doctors as problem-solvers. And this perception works extremely well in doctors’ favor throughout your life. When you’re young, you get sick or hurt. You go to the doctor. They cast your broken arm or prescribe you your bubble gum-flavored amoxicillin and soon you’re all better. From day one, your doctor works miracles. Then you turn 18 or so and graduate from your pediatrician … Continue reading Primary Care fails people surprisingly often.

Jay Parkinson, MD, MPH

Every company needs a primary care strategy

Primary care is the entry point for people to get care. It comes in a few flavors that fluctuate in popularity over time: • Dr. Google • Nurse triage lines • Retail clinics • Traditional PCP office visits • On-site employee clinics • Urgent Care • Traditional specialist office visits • Emergency Rooms As you see, I define primary care not by who’s delivering the … Continue reading Every company needs a primary care strategy

Jay Parkinson, MD, MPH

What is a “benefit-aware” doctor?

What if your company could hire doctors and arm them with services and partnerships that could support a higher quality and cost-effective practice of medicine? What if, at any point in care, your doctor could be aware of health benefits available to you and leverage them to maximize the quality of your care and decrease your costs? The biggest disruption we’ll see in healthcare is … Continue reading What is a “benefit-aware” doctor?

Jay Parkinson, MD, MPH

Keep away from Fee for Service

Companies have tried the High Deductible thing. If the goal was to control costs, the evidence is clear they don’t accomplish that goal. They just make people spend their own money in an extremely opaque, hostile industry. And they penalize the sickest. So if high deductibles failed, what’s next? “Go online first to get care” plus a bundle of cost-saving services on top of that … Continue reading Keep away from Fee for Service

Jay Parkinson, MD, MPH

Go online first instead of doing what you used to do.

Think about that statement for a second. That’s the secret behind Google, Uber, Lyft, Seamless, Ticketmaster, Waze, Airbnb, Silvercar, Hotel Tonight, etc, etc, etc. If you go online first, new processes can emerge. Those new processes are designed to scale at a fraction of the cost of the past. Sure, the library could bring in a computer instead of microfiche, but it’s still a trip … Continue reading Go online first instead of doing what you used to do.

Jay Parkinson, MD, MPH