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Question: Describe the genesis of the idea for Hello Health.

Jay Parkinson: When I finished residency at Hopkins, I really didn't know what I was planning on doing with my life.  But I knew that there were a ton of my friends who were photographers, like myself, who didn't really have any sort of connection to the healthcare system.  So they would always send me an email or an IM chat with some photo of some rash or something like that they they'd be like, "What's wrong with me?"  And being the nice friend that I was, I would reply with some advice, or you should just see the doctor or hang tight you'll be fine.  But then I just thought if I could do that for my friends, I think I could do that for my neighborhood.  So, that's what really gave me the idea.  Just knowing that we are all sort of communicating differently as a culture now, especially millennials and Gen Xer's, I just figured why not tailor a practice in Waynesburg Brooklyn that makes internet communication with house calls and PayPal?

Question: How did you execute on that idea?

Jay Parkinson: I just designed my own website that had a different promise.  And that promise was I'm a new kind of doctor.  You can communicate with me the way you communicate with your friends.  And that to me was just sort of the beginning of everything, and it just had a little button that said "Make an Appointment," and that would bring up my Goggle Calendar where you could input your symptoms and your address and that would send an alert to my iPhone and I would go do a house call and they would pay me via PayPal.  But it was great because I could charge anywhere from $100 to $200 a visit, which is less than most office visits in New York, and do five or six a day and make a very comfortable living because my overhead was nothing because I worked out of my apartment and didn't have an office or staff.  It was really about simplifying things.  Simplifying my life and that led to simplifying my patient's lives.  So, to me, healthcare should be simplified down to its bare essence because 90 percent of us are sort of light users of healthcare in America.  So why can't we just make it simple again?

Question: What is Hello Health?

Jay Parkinson: In the very beginning, you create a profile and you search for a doctor in your neighborhood, and you like a doctor, so you add him to your team.  When you add a doctor to your team, they can read and write to your medical records.  They are all encompassed within HelloHouse.com and your profile.  So, once you add a doctor to your team, you can make an appointment with them and it's all sort of like renting a zip car, it's a really nice interface to just sort of make an appointment with your doctor, and you meet up with that doctor in his or her office and the doctor's got total freedom to set how much time they spend with you.  So, they may only need a half hour or so, or an hour.  But it's really about just establishing a relationship and maintaining a relationship.  Because once you've seen the doctor in person that opens up a whole new world of communication tools; so you can email or you can video chat, you can IM with your doctor.  But your doctor has to get paid for communications, so he or she charges an hourly rate for communicating.  So, if it takes your doctor 15 minutes to reply to an email, that's a quarter of an hour.  It's up to the doctor to have a membership fee if they want.  But I don't know if that's the future.  I think it's just pay as you go. 

It just changes the way doctors are paid.  Doctors right now are paid for office visits and procedures and that encourages them to do as much as they can.  If you pay them an hourly rate that they set, it changes how they practice medicine 

Question: How does the relationship evolve between doctor and patient? 

Jay Parkinson: Right now the evidence says that about 50 percent of all doctor visits are unnecessary.  But they only get paid to bring you into the office, so that's what they do.  So, if you don't have that incentive, that means 50 percent of problems can be taken care of without physically seeing you, but augmented with good communication.  So, it actually depends 100 percent on the doctor and the patient.  There are some doctors that are very, they just want to see you all the time and some doctors are sort of, you know, if they know you and know you're a great capable person that can take care of themselves; they might tend to do more over the internet than in their office.  So, it's really a difficult question to answer because we don't know.  It's very patient and doctor dependent. 

Question: Are house calls more effective than office visits?

Jay Parkinson: I think that it depends on the situation, absolutely.  But, yes.  If you can see a person's life and see where they live and how they interact and see what's in their refrigerator, see if there's Twinkies on the counter.  You can say, well hey, I don't know if you're really living the best sort of lifestyle for you.  However, at the same time, it doesn't really -- most people know that they aren't living the best lifestyle if they aren't living the best lifestyle.  Doctor's aren't really trained to encourage you to change your behavior, we're trained from day one to write prescriptions and do procedures.  We're absolutely horrible to get you to change your lifestyle.  So, I actually think that doctors shouldn't be involved in lifestyle changes. For the past hundred years, our training is fully focused on making a profit off of sickness.  Which is wrong.  So, I think a whole new profession needs to come in and start making a profit off wellness and keeping you out of the sickness industry.  The best way to do that is through most likely just careful listening and careful understanding of the client to understand whether or not they can change certain aspects of their lifestyle. 

House calls are probably a good situation for that profession, but for doctors, I mean, their time is just too expensive to be traveling all over a city.  It's probably not the best use of resources. 

Question: Does giving out your cell phone compromise the traditional doctor / patient relationship?

Jay Parkinson: Whenever you give patients a number and there's a real person on the other end that's they're doctor, they're not going to call you at 2:00 in the morning unless there's really something wrong.  If they get a 1-800 number to some faceless person, they'll call at 2:00 in the morning because they just don't care.  But yeah, so the deal is, I think that increasing accessibility in the doctor patient relationship actually minimizes poor communication because I think there's a certain respect that people have for one another. 

Now, that's not saying that there are a few patients, every doctor has a few patients in every practice that are just sort of over the top in terms of communication.  And yeah, that's when it gets sort of difficult.  But at the same time, there's ways to handle that.

Recorded on March 9, 2010

More from the Big Idea for Saturday, April 10 2010

 

The Doctor Will Text You Now

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