Uber is completely revolutionizing the market for urban transportation.
Could a similar revolution occur in other fields, including medical care? That’s what University of Chicago economist John Cochrane wondered in June. But we no longer have to speculate. Uber medicine has already arrived.
There are a number of firms that will bring a doctor to your doorstep at the flick of a cell phone app, including Doctors Making House Calls (North Carolina), Pager (New York City), and Heal (Los Angeles).
Pay With Your Own Money
Insurance rarely pays for these services. Like so many other innovations that meet the medical needs of patients, such as walk-in clinics and telephone consultations, these firms cater to patients who pay with their own money.
Take Sarah Sheehan, a Brooklyn resident who was reeling from a painful earache one weekend. Her conventional choices were to endure the hassles and long waits at a hospital emergency room or to wait until Monday morning and take a 45-minute subway ride to reach a doctor’s office. Pager offered her a better option: have the doctor come to her.
Here’s how Pager works: Customers pay a $50 fee for a first visit and $200 for subsequent visits from one of the company’s 40 health practitioners, including doctors, nurses, and physician assistants. Assuming that first-visit charge is a loss leader, Pager’s services cost a lot more than a typical doctor’s office visit. But it’s a lot less than the national median emergency room charge of $505.
Heal, which launched in the Los Angeles area and has now expanded to San Francisco, promises a doctor within an hour, between the hours of 8 a.m. and 8 p.m., seven days a week. The charge is $99 a visit.
Pay Money, Avoid Waiting
One reason why there is likely to be a large market for these kinds of services is that they address a big problem with the nation’s health care system. Although the rest of the world tends to view our system as “capitalistic,” the fact is patients in this country pay for care the same way they pay in most other developed countries: primarily with time and not with money. Almost all the new and interesting free-market innovations designed to meet patient needs address this problem. They give patients the opportunity to pay money to avoid waiting and inconvenience.
For example, the Doctors Making House Calls (DMH) website advertises its services with this pitch: “Next time you find yourself waiting interminably for an appointment or languishing in a doctor’s office, urgent care clinic, or emergency room, worrying about exposure to other sick people, not to mention the bill you’re going to receive for care that is not a true emergency, please remember—there is a better way! DMH offers prompt appointments in the comfort of your own home or business, for any medical condition except life-threatening emergencies. We come to you when and where you need us, seven days a week, so you’ll get the right care, in the right place, at the right time—and never have to wait in a doctor’s office again.”
These house call services are not currently “hyper-localized.” You can’t see where the doctor is in relation to you by looking at the app on your cell phone. Unlike Uber, they don’t automatically connect the closest doctor with the closest patient, and unlike Teladoc—a telehealth platform that offers consultations via phone, mobile device, or secure video—the house call doctor does not have access to your electronic medical history.
But I suppose all that will be coming next.
John Goodman ([email protected]) is a senior fellow at the Independent Institute. An earlier version of this commentary originally appeared at Forbes. Reprinted with permission.
John H. Cochrane, “What health care should learn from Uber,” Capital Ideas, June 17, 2015: http://chicagobooth.edu/capideas/magazine/summer-2015/what-health-care-should-learn-from-uber