Thursday, April 10, 2008

Physician Business Ideas - New Parkinson’ Law: No Office, No Staff, No Waiting Room, No Overhead, No Bureaucracy, No Problem

Work expands so as to fill the time available for its completion

Parkinson’s Law, 1955

I keep running across MD innovators in their thirties. They want nothing to do with old ways of doing things. Today I spoke to Jay Parkinson, MD, 32 year old founder of a new web program, It debuts in June, 2008. will be an online site allowing doctors and patients to talk to each other. There will be no third party, no doctor’s office, no office staff, no health plan. All patients will need to talk to their doctor will be a personal phone call. Parkinson envisions a mobile neighborhood service. Doctors will make house alls and work calls, whatever is most convenient to patients.

Parkinson is a 32 year old year old who cut his teeth on computers at age 5. He graduated from Washington University Medical School, did a residency in pediatrics, and restricts his practice to the under 40 crowd (average age, 27). His patients come from Gen Y, those under 30. His patients are largely artists, writers, artisans, freelancers, digital media folk and other young professionals in his Williamsburg, Brooklyn neighborhood.

Parkinson regards patients as online pals. They trust him and each other, but tend to distrust those in the medical establishment over 40. Parkinson is big news these days. He’s the cover boy in the most recent issue of Hospital and Health Networks, HH&N, the American Hospital Association’s main publication, “America’s most wired healthcare magazine.” HH&N dubbed him “Dr. IM” (IM is Instant Messaging) on its cover and ran a 2300 word article “Your Future Chief of Staff?” Among the young MD entrepreneurial crowd, that’s an impressive and memorable debut.

Dr. Parkinson is six months into his practice, has 3000 active patients, and makes 8 visits a day to his clients, Half of patients are uninsured and willingly pay his $150 to $200 fee. Parkinson never leaves ZIP code. You communicate with him by email, text messaging, or by cell phone video, not by snail mail.

Dr. Parkinson answers phone calls in person. He says his clients are responsive and comfortable with the convenience of online neighborhood care, and often refer their friends to him.

Gen Y, he asserts, want understandable, transparent, and, above all, convenient care. They seek the same level of service they get from banks and other commercial firms. They don’t balk at online care. They expect it.

When patients need a specialist or a surgeon, or a hospital or free standing clinic, Dr. Parkinson is ready. He has done his homework and knows prices and quality. Of his approach, he says, “Keeping in touch with clients is cool. I think it is quite revolutionary.” is venture backed. This online service will guide patients to a pleasant consumer experience, provide free generic drugs when needed, negotiate discounts from neighborhood merchants, provide personal access to physicians. For doctors, Hello Health will allow provide more freedom, more money, closer patient relationships, and more personal care.

Personally, as someone well beyond 40, of an age where I
may come down at any moment with a chronic disease requiring coordinated comprehensive care, I’m dubious about, perhaps because I may be moving soon towards, or even

Besides, as time passes by, I may have to trust somebody over 30, even over 40. Sir William Osler once said, tongue-in-cheek, that we ought to eliminate everybody over 40 to make health care more efficient. Fortunately, we’re not there yet.

The HH & N article doesn’t restrict its comments on online medicine to Parkinson. It also cites the work of Dr. Allen Wenner, a South Carolina primary care doctor. He developed the Instant Medical History where patients can tell their story using structured clinical algorithms

Dr. Parkinson’s online concept reminds me of the young lad who, after mastering hands-on bicycle riding, lets loose of the handlebars, looks at mother, and yells, “Look, Maw, no hands!” In Parkinson’s case, it’s no office, no staff, no paperwork, and presumably no problems, provided he doesn’t fall off hi bike and his patients don’t need to go off-line.

I wish Dr. Parkinson luck. He is a great geek and a fine doctor, and extremely innovative. All cash may be a bit rash, but it might just work, for the young and healthy at least.

In any event, the new Parkinson Law bids well to replace the Old Parkinson’s Law -
Expanding bureaucracy to fill the time and space provided for it. The New Parkinson’s Law cuts bureaucracy, and fills the time left to care for patients. It’s a noble idea, and I applaud it.


jayparkinsonmd said...

I have a few comments and clarifications.

Hello Health is a consumer branded healthcare delivery service along the lines of Netflix, Zipcar, or Apple. I can't stress enough the importance of the strong branding of this service. Without the brand, it simply becomes a tech enabled group of doctors in Brooklyn. With the branding, it can spread anywhere and everywhere and will be recognized by all of America as a trusted, efficient, convenient way to see your neighborhood doctor (not a doctor, but your doctor). We will create the first brand of healthcare that people love...because every other healthcare brand has a cringe factor to it.

HelloHealth will be online, that's true. However, it is really a portal that opens up a secure dialogue between you and your doctor. It is a repository of your health information that you co-own. Everything is recorded and archived, even the in-person visits so that if you forgot what I said, you can simply press play to hear what I said about that medication I prescribed for you. It is also going to be a heavily branded experience designed by the same firm that does work for Volkswagen, Virgin Airlines, Apple, T-Mobil, Samsung, Comcast, and Burger King. It's not a healthcare brand. It's a friendly consumer brand.

Also, there is going to be very little phone conversations. It's going to mostly be online emailing, IM'ing, and video chatting. To make an appointment you just go online and intuitively tell us your symptoms and schedule yourself. A doctor then shows up at your house like a Geek Squad of doctors.

A clarification. I went to Wash U for undergrad and Penn State for med school.

I also stopped seeing patients in January to devote my work full time to building the platform and the Hello Health brand. After three months of practice, I had 300 patients enrolled.

We're also not venture backed. It is privately funded by the founder and his business partners.

HelloDeath is funny!! Come on! You aren't that old!

As far as only taking cash, that's true, we accept payment up front, submit their claim for them, and the patient gets reimbursed. However, because we charge a fee that's less than a traditional doc here in NYC (by $50), the people with insurance typically get reimbursed 70 to 80% of our fees and therefore only pay about $30 to $40 out of pocket after they're reimbursed (which, as explained by us, is only a few more dollars than your co-pay).

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