I’m about to change your life. Do not miss this post, especially if you live in California. On Friday, I had a doctor’s appointment to renew my depression meds. And the appointment happened in my home, on my sofa, less than 2 hours after being scheduled.
I’m going to say that again. On Friday morning, I realized I was down to 3 pills. I used Heal to make a doctor’s appointment, and then I kept working (blogging, emailing, prepping for a photo shoot, etc.). Within 2 hours, a doctor of internal medicine, and a medical assistant, were at my door.
It was amazing. I feel like I experienced the future of medicine. And I can’t stop talking about it.
Heal makes house calls. Their doctors can do anything your primary care physician can do, from wellness checks, to flu shots, to treating ear infections and UTIs. And they’re not expensive — the house calls cost the same copay you already pay at the doctor’s office. Not a penny more. Plus, getting an appointment is much, much faster, and worlds more convenient. Affordable doctor house-calls. It’s revolutionary. Just picture for a minute what that means:
Imagine your toddler is sick with a barking cough that sounds like a seal and it seems to be getting worse. You need a doctor’s appointment. And you also have a 4 month old baby. Normally, you’d have to call the pediatrician’s office to see if they can fit you in. Wait 5 hours for your appointment. Get the kids dressed (and bundled up if it’s cold — and you know your toddler should be in bed!). Buckle them into carseats. Drive to the office. Find parking. Wait in the waiting room for another hour. Worry your baby is getting exposed to all sorts of germs. Finally get called back to see to the exam room. Make your toddler wait in a cold room wearing a paper sheet. Get 5 minutes or less with the actual doctor. Then try to pay and handle paperwork while your baby cries because she missed her nap.
A nightmare. And I have lived through that exact scenario a hundred times.
With Heal, that whole nightmare situation disappears. You use their website or an app to scheduled an appointment. It’s just as simple as ordering an Uber or Lyft. So easy. The doctor shows up at your house within a couple of hours. Your sick toddler can remain in his pjs. No one has to be put in their carseat. No parking needs to be found. You don’t even have to put your shoes on.
The doctor can see your child on his bed or on the sofa or wherever your toddler is most comfortable. No paper gowns. No waiting. And the copay happens through the app, so no dealing with a cashier or paperwork either.
It seriously feels like a miracle. Like this is how medical care should be.
I keep thinking of all the different scenarios where Heal would save the day.
If you get sick while traveling, Heal will come your your hotel room.
If you’re new in town and don’t have a doctor, Heal will show up. (That was me when we moved to California and I fell into a deep depression, and then couldn’t find a doctor. It was so awful.)
If it’s the weekend, and your doctor’s office is closed, don’t drive 40 mins away to the nearest urgent care, and then wait in the lobby for an hour or more. Use Heal instead. Heal is open 7 days a week from 8:00 to 8:00, 365 days a year. (Yes! That means you still have time to make an appointment when you get home from work. It’s not too late!)
If your aunt doesn’t have a car but needs a flue shot. Use Heal and they’ll go to your Aunt’s home.
If you’re stuck at a desk all day but really need to see a doctor, Heal can help you at your office.
If your schedule is packed this week, but your teen needs a physical before she joins the track team, or he goes on a scout campout, Heal will come to you at your convenience.
If you or your spouse haven’t had a physical in years because who has time? Heal can make it happen today.
If you have a crazy rash (or yikes! an STD) and are too embarrassed to leave the house? Heal will take care of you in the privacy of your own home.
I’m telling you, this is a life changer.
Let me walk you through my own visit, so you can see just what it was like. And then let’s talk clearly about money and insurance.
At around 9:30, my appointment is scheduled through the app (you can get the app for iOS or Android — or you can skip the app and schedule your appointment on the Heal.com website). Then I work as usual in my house. At 11:00, my phone gets a text that a doctor is on his way. On the app, I can see his photo and bio. I learn he went to UCLA. A few minutes later, the doctor, Matt Walvick, and the medical assistant, Kiran Kaberwal, are on my front doorstep.
They come in, and while the doctor talks with me on the sofa, the MA sets up. She uses the coffee table for some of the equipment, and then sets up a sterile area on the dining table. I take a second to sign my paperwork on the doctor’s iPad.
The doctor checks my eyes and ears and mouth, listens to my heart. The MA checks my blood pressure and temperature. We chat about Wellbutrin, the medicine I take — what’s my current dosage, how are things working, are there other options I should consider.
There is zero rush, zero hurry. It is clear they have all the time in the world. There is no patient waiting in the next room. At the dining table, the MA is all set up to draw blood and give me a bandaid. They’ll drop the sample off at the lab for me, and then the doctor will call or text (whatever I prefer) when the results are in.
The doctor uses his iPad to send my prescription to my favorite pharmacy right before my eyes. We shake hands. I resist trying to hug them both because I am so grateful. And then off they go while I get right back to work on my laptop.
I’m going to get teary thinking about it. Trying to stay on top of my depression has been an incredibly hard part of the last few years. Finding a doctor, trying to get appointments scheduled in between work trips and conferences. It’s a non-stop worry.
And trying to get out of bed or out the door, to see a doctor, when a depression is in full swing, is almost impossible. On Friday, when I realized the whole thing was being taken care of with an app, I felt a huge weight lifted, a huge problem solved.
Clearly, I am a fan.
Now, as promised, let’s talk about fees and insurance. When I first heard about Heal, I assumed it would be cost prohibitive. I assumed it was a service aimed only at the wealthy. I assumed an in-home visit must be crazy expensive. I was wrong. A Heal visit is the exact same price I pay for an in-office visit. Actually less — because I don’t have to pay for parking!
After you download the Heal app, you’ll take a couple of minutes to input your info — name, address, payment preference, etc. — and then, you’ll take a photo of your insurance card. The app will use the photo to automatically populate your insurance info, and before you’ve even made an appointment, you’ll know exactly what the co-pay is. There are no surprises or hidden fees. With my insurance, the copay is $35. It’s the exact same copay I would have if I went to a doctor’s office. If your insurance offers a free preventative physical every year? It’s free with Heal too.
So essentially, whatever your insurance covers, it will work the same way with Heal. But you can skip the waiting room!
But what if you don’t have insurance? Or what if your insurance doesn’t work with Heal? No problem, the flat fee for an in home visit without insurance is $99.
People. If you’ve ever used Urgent Care or the Emergency Room on a weekend because your doctor’s office is closed, you know $99 is a total bargain. And again, they come to you typically within two hours of calling! You make the appointment, put on a movie, and tada! Heal is at your door.
So what’s the downside? Well, there’s only one: Heal is currently only available in California — San Diego, Los Angeles, Orange County, San Francisco, Silicon Valley, Berkeley, Oakland (and the whole East Bay). They’re growing fast, but they’re just not everywhere yet. I know. A huge bummer. But if you live in California (and millions of you do), I encourage you to give this a try.
A few more questions I had that you might have too:
– What sorts of doctors are on staff?
Heal staffs internal medicine doctors, family practice doctors, and pediatricians too. So they are ready to take care of both adults and kids. And the doctors are excellent! Vetted, high-quality licensed physicians and pediatricians. You can read about them on the website.
– If you love a particular doctor who visits, can you request her next time?
Yes. Yes, you can.
– Are visits only same day, or can you schedule them?
You can totally schedule them. They make it super easy and convenient.
– Do you have to clean the house before they come?
Nope. They could care less what your house is like. They see patients from all walks of life and all socio-economic levels. They just want to help.
– What about the doctors? Is this is big pay cut for them?
Actually, the doctors make the same salary they would if they were working in an office. But they get way more time with patients and have much more control of their schedule. Dr. Wolnick, who came to my home, was the first doctor to work for Heal in the Bay Area. He’s been with them for a few years and says he would never go back to an office. He feels like the quality of care is so much higher with Heal that you can’t even compare.
Okay. I’ve talked and talked. I’m clearly a Heal evangelist. Now I’d love to hear your take. Have you ever had an in home doctor visit before? Can you picture an instance where it would be especially convenient? Do you typically find doctor visits hard to schedule and manage? Do any of you find renewing your depression med prescription to be overly difficult? What are your thoughts?
This post is sponsored by Heal — High-Quality Pediatrician and Primary Care Physician House-calls, On Demand. Photos by Kristen Loken for Design Mom.
Paige
February 27, 2017 at 11:27 amThis is amazing! I hope this comes to Atlanta soon because this would be a total game changer for us. My son gets sick a lot, but I also have a daughter with special needs who cannot walk, so as you can imagine getting out the door when my son has his latest respiratory infection is… a pain in the butt. I so, so, so, want this to be a thing in our area!
Paige
http://thehappyflammily.com
Design Mom
February 27, 2017 at 11:35 amI’m picturing you trying to get out the door and can feel your pain! I wonder if there’s any sort of similar service in your area?
Renee P.
February 27, 2017 at 11:28 amI’m going to send this article to my husband! He finds it difficult to get to appointments because of leaving work, and therefore he just never goes :-/ We’re in Silicon Valley, so our area is covered.
House calls are an amazing form of healthcare and I’m so glad that technology is helping us get back to this “old-fashioned” way!
Design Mom
February 27, 2017 at 11:34 amYes! I felt the same way. It’s a super modern take on an old-fashioned practice. So great!
Meline Castruita
March 11, 2017 at 10:37 amHow can i get the app???
Demiah
February 27, 2017 at 11:41 amHope they come to Sacramento soon; this sounds amazing!
Design Mom
February 27, 2017 at 1:29 pmThat seems like a natural next stop, right?
Annie Amos
February 27, 2017 at 3:11 pmI hope so, too!
Robin Amato
February 27, 2017 at 11:41 amI was right there with you… until you said it was for CA residents only. Le sighhh…
Tamara
February 27, 2017 at 12:31 pmditto!
Design Mom
February 27, 2017 at 1:31 pmOh I know. I’m so excited to tell everyone about this, and simultaneously cringing because it’s such a bummer it’s not nationwide.
Still though, California has so many people, and attracts so many tourists and businesspeople, that I think it’s valuable to get the word out.
Melissa Leyva
February 27, 2017 at 12:06 pmWhen I was growing up in Brooklyn, NY in the 1980’s my grandparents’ doctor made house calls. I guess its easier to do this in a densely populated area. It was really a help to the elderly.
Also, after my first child was born, I had a lot of issues related to breast feeding along with all the other postpartum challenges to getting out and about with a newborn. I was referred to a breast feeding specialist (not a lactation consultant, but an M.D.) and she made a house call!
Doctors can understand the whole picture (or at least a lot more of it) when they see a person’s living environment.
Design Mom
February 27, 2017 at 1:29 pmI love hearing about new moms who are able to receive house calls. It makes so much sense!
Amy3
February 27, 2017 at 12:10 pmThis sounds amazing. Years ago, we were on vacation and we had to take our daughter (then a preschooler) to the local ER due to an asthma attack. We’d called her pulmonologist to let him know and he asked us to stop by his house on our way back home. Sort of a reverse house call. Not a routine thing he does obviously, but I’ll never forget him making the effort to see us in the fastest way possible.
Design Mom
February 27, 2017 at 1:27 pmLove that. What a great doctor.
Amy D
February 27, 2017 at 12:15 pmOh bummer!!!! I want one on the EAST coast now! Right now! (Yeah, I’m pouting like my 4 years old daughter!) I hope the program Heal comes to DC fast enough!!! So hopeful! I’m liking home visits so I don’t get sick or anything from other people. I am a germophobia gal so visiting urgent care is out of question unless I break a bone. Eeeeek. And dragging kids. Ugh. Home visits is a must! I think I’ll ask Heal company to hurry up and come here!
Design Mom
February 27, 2017 at 1:26 pmI am feeling the urgency for you! I’ll reach out to my Heal contact and see if they have any public info about expansion plans. I’d love to see if they have a new city launch calendar they’re working toward.
I want this to be everywhere. Honestly, the experience was so good — such an improvement for both patient and doctor — that I will be shocked if in home services don’t become widespread.
amy
February 28, 2017 at 12:30 amHeal will be coming to DC soon….
Kaelie Kung
February 27, 2017 at 6:13 pmIf you’re on the Hill, Heidi is wonderful!
http://heidijohnsoncpnp.com/
Yvonne
February 27, 2017 at 12:17 pmWhat an awesome idea! And thank you for documenting it all for us (loved the photos)!
I’m curious that your doctor was a DO (per his coat) and not an MD. Have you seen a DO before? I haven’t yet, but think I would like to. Maybe it’s hard to say because the whole visit was so different to begin with, but did you feel a difference with him being a DO in terms of comprehensive care?
Anyway, awesome company, thanks for profiling them!!
Design Mom
February 27, 2017 at 1:23 pmI just had to go look up the difference between DO and MD. I hadn’t even noticed the DO on his jacket. Hah!
I don’t think I saw a difference in comprehensive care, but if I had known to ask if/how he approaches things differently, I totally would have. Now I’m curious!
Yvonne
February 27, 2017 at 2:40 pmMe too! From what I’ve read it seems DO’s have a more ‘comprehensive’ approach to medicine, more integrated, which I really am drawn to. It’s actually interesting that the boards/testing are different, and I read that it’s harder to get into the (albeit many) fewer DO training programs than the MD programs….this whole topic from Heal to DO’s has really got me interested today – thanks for that!!
heidi garner
February 27, 2017 at 4:02 pmMy husband is in the medical field and from what i know it is easier to get into a DO program than an MD program- so some people do not look at a DO as qualified as an MD. I however, love DO and the whole Comprehensive approach, so I love when I have a DO and do not think it is negative at all. My husband is neither a DO or an MD, he works in the Business?Administration side of Medicine.
Jacquie
March 12, 2017 at 10:37 pmMy primary care doctor is a DO, and that’s why I chose her. My brother-in-law is a DO, and my sister is an MD. From my experience, DOs look for the root cause rather than just treating the symptoms. The DOs that I know ask many more questions of me and of themselves and colleagues and are willing to try new and/or different approaches than MDs and standard Western medicine.
Lauren B
March 19, 2017 at 2:09 amI see a DO. I have since I left my pediatrician at 18. I LOVE them. When I moved, I found a DO who took care of acne/dermatology, depression meds, and my primary care. So amazing to see one office that got a full picture of my care than 3 different ones! I just found out that my daughter’s pediatrician and my DO are both leaving- and we’ve decided to move to a family practice DO. I will definitely try to keep seeing them because I love the level of care and the comprehensive look.
julia g blair
February 27, 2017 at 12:28 pmSounds really marvelous!
Design Mom
February 27, 2017 at 1:18 pmI’m so impressed!
Wendy
February 27, 2017 at 12:47 pmI would pay any money for that service. I wonder how you follow up on the results of your blood test. Do you do that with a phone call or will the dr come back to discuss?
Design Mom
February 27, 2017 at 1:18 pmA great question, and one I asked about while the doctor was here.
The lab alerts the doctor once the results are in, and then he follows up with patients personally by phone.
He said having time to follow up with patients has been one of the best things about this job change. He really makes the most of the driving time. While the MA drives from one house to the next, the doctor will update the patients file while everything is really fresh, and then use the extra time to check in on patients he saw a couple of days ago.
He said they’re usually so surprised when he calls. We’re just not used to having a doctor follow up personally after an office visit. With conventional office visits, follow-up is rare, and if it happens, it’s usually an assistant. So this is a major improvement.
Susan Mazzoni
February 27, 2017 at 12:49 pmI would love to know from the doc if, in his experience, people open up more when they are in the comfort of their own home? I understand that it’s just you and the doc in the exam room in an office setting but there is something about being at home that I think would allow people to feel more connection to a provider and, therefore, share more. Especially if it relates to mental health issues.
I would have loved this when I was nursing my first-born, she had a terrible time breastfeeding and it would have been so much easier to have the provider stop by the house and see her in all screaming glory to understand what was going on (it was wicked reflux, without vomiting).
Design Mom
February 27, 2017 at 1:12 pmOh my word, I was in full-on reporter mode when the doctor was here. I must have asked a hundred questions. And related to what you asked, the topic of white coat syndrome came up.
I had never heard of it, but apparently blood pressure can seem higher than it really is in a doctor’s office, because patients often feel anxiety during exams. And he has found that people are much more relaxed in their own homes, as you would expect.
Mrs. LIAYF
February 27, 2017 at 1:47 pmI would love for this service to come to Seattle. It would definitely be a game-changer for my household. Both my husband and I work, and have 2 kids in school, so our schedules are crazy busy!
I wanted to also thank you for a different reason. I really appreciate that you are so honest and open about your depression. I have always had a hard time dealing with stress, and have suffered bouts of depression in the past. The last year has been especially hard as I have attempted to handle an aggressive, confrontational work-situation while trying to balance my family responsibilities. I find myself crying nearly every day before and after work, and now realize that I’m very likely depressed. Your article has encouraged me to make an appointment with my doctor ASAP. Thank you.
Design Mom
February 27, 2017 at 3:43 pmI hate depression with the heat of a thousand suns. So I’m sad if you are depressed. I wouldn’t wish it on anyone. And I hope you really do make an appointment ASAP. I’ll be thinking of you.
Whitney Patterson
February 28, 2017 at 3:40 pmSwedish has PAs that do home visits within 90 minutes of making an appointment! We haven’t needed to try it yet, but I want to.
Tina
February 27, 2017 at 2:14 pmI can see how from your point of view this service is a huge relief, however I am appalled to read what regular health care situation it stands in contrast to. From my experience here in Germany, we value seeing the same doctor for years, maybe decades (especially in cases of mental health or where decisions of treatment are otherwise not black and white) and receive swift emergency care on the weekends including if necessary home visits for free for everyone including children. A midwife also visits your house regularly before and after giving birth for free (as often as daily once you have had your baby regardless of how or where).
So, what seems normal to me in terms of practicality seems to be exceptional for you with the drawback of not establishing a continuous treatment.
In addition, if you cannot schedule a doctors appointment during your time off, you have the right to do so during work hours here.
Thus, thank you for the insight into a completely different system.
Michelle H
February 27, 2017 at 2:49 pmYou would be exponentially appalled if you had to navigate our medical system here in the US. My in-laws from the UK could never fathom that our well being comes and goes depending on insurance tied to a job…the prospect of medical debt/bankruptcy, etc. In home visits from birth to at least 3 mos should be standard as the US has an appalling infant mortality rate for a “developed” country. The ACA was at least a step forward but now its future is in peril.
Design Mom
February 27, 2017 at 3:45 pmI can’t help but laugh because I can totally see things from your perspective, and I’m sure it sounds so bizarre to be excited about this. But still. I am SO EXCITED about this. It’s such an improvement on what typically happens here.
maike
February 28, 2017 at 3:17 amI live in Germany, too, and while I agree that the care by midwives before and after birth here is excellent, I cannot say that about the rest of the medical care. I often change my doctors because it doesn’t seem to matter where I go (when I find a good one, I hold on to him/her of course), also I never had a home visit nor ever heard of anybody having one. And on weekends I already spent senseless hours waiting in ERs with dislocated arms, bladder infections, ear infections, toothache – sometimes being send from hospital to hospital because the doctor who was there couldn’t treat what I (or my kids) had.
The service described in this article sounds fantastic, also to my German ears. :-)
The only thing that shocked me was that you have to pay for ER visits in the US. That you have to pay for medical treatments in general, on top of your insurance.
Melanie
March 8, 2017 at 11:25 amSame here, Maike. I’m from Germany, too and I would love such a service… and if it would be covered by the insurance it would be a dream!
bdaiss
February 27, 2017 at 2:14 pmAmazing! I love this idea. Unfortunately, one of the disadvantages of the bliss of living in a rural area is that we will be the last to reap the benefits. But look! Heal announced a nationwide roll-out plan on their blog (link at bottom)! So maybe it won’t be too far off for most of the population? (I would argue rural areas, particularly poor rural areas, need this asap! So many people who can’t get themselves to a doctor because they lack a vehicle, there’s no public transportation, or they have no family support to help get them there/watch kids/etc.)
http://blog.heal.com/post/157574682079/heal-planning-national-rollout
Yvonne
February 27, 2017 at 2:46 pmI was thinking the same thing, that those in poorer or more rural communities could really use a service like this! And maybe even find a way to crowdfund so that people could opt to pay a little more or buy a visit for someone who can’t afford it – kind of like the insurance pooling system……Let’s hope they are able to spread and grow!
Design Mom
February 27, 2017 at 3:48 pmOh! Thanks for finding that link. I just shared it on Facebook.
And yes, I can see how helpful it would be in rural areas. I’m not kidding when I say I feel like I experienced the future of medicine. This just makes so much sense.
Sara Danner Dukic
February 27, 2017 at 3:13 pmThank you so much for sharing this!! I’ve used something similar with the telemedicine apps, but this is a level above. I would have been so grateful for this when my son was a newborn. We did get one house visit from a nurse, which was a huge help, but trying to get to regular appointments, not to mention unexpected ones, with two small children is so difficult. I’ve been in the same exact situation you described at the beginning (sick toddler, small baby) so many times I’ve lost count. It would still be a game changer for us – the kids are 2 and 5, and still get sick a lot (in fact everyone is home sick and napping as I write this).
Thanks also for the detailed photo story! It helps to visualize what it would be like.
Here’s hoping it makes it to Cincinnati soon.
Design Mom
February 27, 2017 at 3:46 pmYes. The first thing I thought of when the doctor arrived was: This would have saved the day so many times when I had new babies. Having a newborn is hard even when everyone is healthy!
Heather Ponce
February 27, 2017 at 3:29 pmOh my gosh your scenario with kids just described my whole day! Please come to Boulder, Colorado. This is amazing!
Design Mom
February 27, 2017 at 3:50 pmYou can relate? I know you’re not alone. It’s the worst!
Elizabeth Dansie
February 27, 2017 at 4:49 pmI don’t think his would
Ever appeal to me except maybe on vacation. My kids have been seeing the same pediatrician for 12 years and we have a relationship with him. I actually haven’t been to a doctor since my youngest was born almost 7 years ago and am in the market for a new doctor. But this idea does not appeal to me at all. I want a doctor who I can develop a relationship with like my kids have with our pediatrician. Even when I had to take my son to the instacare for an after hours accident, I did not appreciate the wait but still appreciated the experience. And maybe it’s because I live in rural utah and we have a pretty good chance of running into our doctors at the dairy queen or movies.
Design Mom
February 27, 2017 at 5:18 pmI hear you on having a favorite pediatrician. We actually pay more for insurance each year than we have to, just to be able to keep our favorite pediatrician, Dr. Tracey, on our plan. She’s amazing.
For well visits, she’s always the one we see, but, for sick visits, we almost never get to see her — we’re just assigned to whomever is in the office that day and we often have never met the doctor before. My ideal would be if Dr. Tracey started working for Heal, because you can actually choose the doctor you want to come to your home. So we could pick her for the kids every time.
Valerie
February 27, 2017 at 5:09 pmI remember when I was a child( an eternity ago) our family doctor doing his rounds and stopping by our home if someone was sick and could not travel. I think it was probably the same in most French provinces at the time but is no longer the case. At least I have not heard of it in a long time.
I wish I could use a service like that again even for non emergencies.
Totally unrelated but our mailman always stayed to have a drink and a chat with my grandparents. Ours was not the only house he stopped at, not sure how he finished his round walking straight…
Design Mom
February 27, 2017 at 5:14 pmI agree. For sure it makes sense when someone is too sick to leave the house, but it’s also great for people who simply won’t make time to go to the doctor. I’m thinking of Ben Blair who hasn’t had a check up in years.
Deborah Goldberg
February 27, 2017 at 5:36 pmI’ve used Heal about 4 times (in San Francisco) and Dr Walvick has been my doctor each time it’s funny to see him as the featured doc in your post! I’ve been telling all my friends about Heal – this is one app that is truly a game changer.
Design Mom
February 27, 2017 at 6:52 pmSeriously? That’s so funny! I love that you love Heal too.
Rebecca
February 27, 2017 at 6:03 pmIt sounds great, but I’m very curious about the math. My best friend is a (non-profit) clinic administrator and although nobody there wants to schedule 15-minute appointments, she says it’s the only way for the budget to come out right. I don’t know enough about health care to have a good guess as to how Heal makes it work (lower overhead because of less office space? Not seeing patients who can’t pay? Lower malpractice insurance?), but would be interested to know!
Design Mom
February 27, 2017 at 6:51 pmI was curious too! I asked the doctor and he mentioned that overhead is immediately cut in half because they don’t have office space. So that’s definitely a big part of the math.
BerlinBound
February 28, 2017 at 5:00 amThank you for introducing this service to us. It sounds really nice, but I immediately had the same reaction and questions as Rebecca: how is it being paid for, at what (or whose) expense, and is this model sustainable? If you add the doctor’s and medical assistant’s driving time to the already longer in-home appointment, they are seeing infinitely fewer patients than a regular in-office doctor does during the same amount of time. If the co-pays are the same for both and the insurance pays the same for both, then — by definition — the in-home doctor service must make much less money. Lower overhead alone cannot explain the difference. I would be very interested in hearing more about the math behind this.
Design Mom
February 28, 2017 at 8:51 amI’m not sure where we can find more info on the math. If I hear anything, I’ll let you know!
Gillian Goddard
February 28, 2017 at 9:25 amI am a private practice physician. My guess is they save not only on office space but on office staff and furniture (chairs in the waiting room, exam tables, chairs in the exam room), the daily cleaning service. Not just rent goes into the overhead. In our office the staff out-number the physicians 3:1.
They take a limited number of insurance plans and do not accept medicare or medicaid. They can select for those insurances that reimburse the best for office visits (vs. reimbursing better for office procedures or radiology services).
They also don’t have to take into account no-show patients. In some primary care offices as many as 30% of patients don’t show up for their scheduled appointment. As a result offices overbook and/or book shorter appointment times. When the doctor comes to you and you just booked the appointment a few hours before you are unlikely to not “show” for the appointment.
They don’t appear to have a physician on call at night (maybe this just isn’t obvious on the web site), so they likely don’t pay for an answering service.
These are just an example of all the things that a traditional practice has that this one doesn’t that allows them to see fewer patients.
Oh, and I can assure you that there malpractice rates are the same as any other internist’s. Rates are based on the risk profile of the specialty practiced and have absolutely nothing to do with patient volume. Part time physicians pay the same rate as full timers.
Gillian Goddard
February 27, 2017 at 6:16 pmI am a physician and I trained at a program that had a visiting doctors service. It was limited in size and as a result patients had to be unable to travel to the doctor to qualify. As a student it was amazing to see patients in their homes. You can learn so much about people by seeing what they choose to surround themselves with. In the program I worked in the patients had one doctor who followed them over years, but other doctors could see them for urgent visits (this is the way most practices operate in the office too) so the continuity of care wasn’t lost. Most were on Medicare so insurance wasn’t an issue. Graduating residents were eager to apply for spots to work in the practice. Some things are limited in the home setting–it would be pretty tough to get a Pap Smear at home for example–but most routine care can be given in the home setting. I work in specialty care, but I think this is such an interesting model of care. I am not sure I would move away from our beloved pediatrician for this convenience (I couldn’t even switch when we moved to the suburbs from NYC and still drive the kids into the city for the doctor), but if you are establishing new care, why not!
Design Mom
February 27, 2017 at 6:50 pmI’m glad you brought up pap smears. I actually asked Dr. Wolvick about ob/gyn services, and he said they don’t bring the right equipment for something like a pap smear, but that in theory it would be doable. He thinks if lots of women are requesting in home gynecologist services from Heal that it could probably happen.
I know I would have LOVED to receive my prenatal care at home. It’s so many appointments, and most of them very basic, and often I had another very small child while I was pregnant, so it was always a challenge.
I also told him I thought women would be way better about getting their mammograms, if there was some sort of portable, in-home option.
Gillian Goddard
February 28, 2017 at 8:47 amPrenatal care at home would be amazing!!! I am the mom of 4 (ages 9, 6, 3, 1) so I too was often receiving prenatal care with a little one at home and paying for extra child care hours to make it work. Other than detailed sonograms most prenatal care could be done at home.
I love the idea of mammograms at home, but I suspect the current technology is limiting. The quality of portable x-rays is not great and they are still quite large. I gal can dream though!
Laura Royster
February 27, 2017 at 6:40 pmGabrielle, thank you so much for this post – this is amazing to find about about! Any idea why Dr. Walvick is not listed as one of the doctors on the Heal site? Can’t wait to try this for our family!
Design Mom
February 27, 2017 at 6:46 pmHmmm. No idea why he’s not there. Maybe it’s a geographic thing?
Jasie Parsons
February 27, 2017 at 7:46 pmI needed this today. I get such terrible migraines. Today I had to take an Uber to urgent care. It would have been so amazing to have a doctor come to me and give me the meds I needed to feel better.
Design Mom
February 28, 2017 at 8:52 amI hope you’re feeling better, Jasie.
Jeanne
February 27, 2017 at 7:50 pmThank you so much Gabrielle. This is absolutely A-mazing!! I downloaded the app immediately. I hate going to the dr…long waits, lots of sick people. This is an incredible game changer for me and my family. Thank you so much again!!!!
Design Mom
February 28, 2017 at 8:52 amYay! I hope you love it as much as I did.
Amanda
February 27, 2017 at 8:51 pmI love this idea, but if Heal grows throughout the U.S., what does mean for paramedics and EMTs? If they are getting fewer calls, that means people in that field may potential lose their positions.
Design Mom
February 28, 2017 at 8:59 amYou bring up a good point, Amanda. I think it’s a challenge that affects every industry experiencing innovation. Robotic manufacturing comes in, and people lose jobs. Uber disrupts the taxi industry, and people lose jobs. Solar energy gets better and better, and people lose jobs.
I certainly don’t have a perfect solution, but I would love to see more flexible, ongoing, accessible training programs available, so that people can retrain for a job at anytime. As someone who had a career switch 10 years ago to a brand new industry (blogs were invented, and magazine/newspaper workers lost jobs), I’m constantly aware that my current career could change at any moment.
It actually has changed quite a bit even in 10 years with the addition of Facebook, Instagram and Pinterest. Always something new to learn to stay caught up!
CB
February 28, 2017 at 10:00 amI don’t see this affecting paramedics and EMTs all that much. I mean, if someone in my household has just collapsed, fallen down the stairs, eaten poison, spilled boiling water on themselves, or whatever, I’m not going to use an app to book an appointment for a doc to show up in a couple hours. I’m calling an ambulance.
Whitney Patterson
February 28, 2017 at 3:51 pmIf people are only using ambulances as a means of getting to an ER because of lack of transportation, this would be a positive change. I don’t think the visiting doctor would see people in true emergency situations.
JLD
February 28, 2017 at 7:04 pmCB, I am an EMT and most of the calls I receive are not emergencies. I worry that if this app becomes popular, the calls I will receive on a daily basis will be far and few between. Less calls means there is less of a need for me and my co-workers and therefore cuts will have to be made.
kelleyn rothaermel
February 27, 2017 at 9:43 pmWould love it if they had this in my city. need to go to the dr. because I hurt my knee, but don’t have time to go to the doctors.
Design Mom
February 28, 2017 at 9:00 amYour poor knee! I hope you make it to the doctor soon.
Haly
February 27, 2017 at 11:06 pmWe have several home doctor services in Australia which cost $0 and I use them frequently because I’m a mum with young children and have still yet to settle with a regular family doctor (my own fault but I just can’t seem to get past how hard it is to get a timely appointment with your preferred doctor when you need it), and when I’m sick and feeling awful the LAST thing I want to do is get out of bed and go to the doctor. But there are a few downsides I’ve noticed. Firstly, although it doesn’t cost me anything, it is still a more expensive form of health care (doctors fitting fewer patients into their day etc) so somewhere along the line it is raising the cost of healthcare and somebody must be absorbing the cost? Secondly, the home visit doctors I’ve used usually provide less comprehesive care than I experience elsewhere. They’re running blind everytime with no access to your medical records. Third and most importantly, it’s much MUCH better to consistently see one doctor – they get to know your health, they can give you more accurate, comprehensive and holistic care. Plus, you can go back to them if they got their diagnosis wrong or if they didn’t quite solve your problem. Home doctors don’t get this kind of feedback nor do they get to know their patients. When your child has a chest infection and you call out one doctor this time, do you want a brand new doctor to start from scratch with the child next time? I know it’s convenient but it’s poor continuity of care. That said, accessing health care is difficult and it’s far better to get a doctor in your home than to miss out on care or to encounter obstacles that make you reluctant to seek professional care in future. I’m pretty thrilled that you got to have your Rx renewed from your couch, that’s bloody awesome.
Design Mom
February 28, 2017 at 9:04 amI love hearing from someone who is already used to using home care!
For sure it’s not a perfect system, but it’s such an improvement! And it sounds like Heal has 2 features that you would appreciate:
1) You can choose to have the same doctor visit every time (unless they’re on vacation or something like that). So with Heal you can totally get continuity of care from one provider.
2) For return visits, doctors are never flying blind, because everything about previous visits is already in the Heal system. So if I doctor is on her way to your house, she can look up your profile on Heal and find all the notes from any previous Heal visits.
haly
March 1, 2017 at 5:54 amstop the train. i’m moving to oakland.
Beth
February 28, 2017 at 8:17 amI love this idea! I’m from a small town in upstate New York, and I doubt something like this would come to rural areas, but it’s so wonderful! In my town, we still have a (now in his 50s) doctor that will occasionally do home visits, particularly for older patients that have trouble getting out of their homes. I’ve always had a lot of respect for him for doing that, as it is certainly not the norm nor was expected by the hospital he works for.
Design Mom
February 28, 2017 at 9:05 amWhat a good doctor he is!
Liz Hendriks
February 28, 2017 at 9:07 amIf regions don’t have a corporate company providing this service that doesn’t mean there are not medical professionals who don’t provide this service. My husband is a physiotherapist and runs his own business where he sees people in their home. Not only is it great for the customer but he gets to provide the type of service he believes in. The clinic he was working for had 20min slots and he never felt he could provide the type of service he wanted and this way he can. So this is also really good for the medical professionals providing the service. Never mind the flexibility it provides our family since I travel a lot with my work. It’s a superb way to go!
Catherine
February 28, 2017 at 10:42 amWhile Silicon Valley save us from our health care system? judging from this post, they just might!
Shecki
February 28, 2017 at 11:25 amThat’s awesome! They need to expand insurance providers and come to Sacramento! :) I checked the app, and they don’t partner with my insurance yet.
Elizabeth
February 28, 2017 at 11:29 amSuper interesting. I love to hear a good “technology for good” story, and it’s so fascinating how once was old is new again with home visits!
SB
February 28, 2017 at 1:08 pmEverything truly useful always seems to be attached to an app, which is unfortunate for anyone (there are still some of us) who do not/will not have smartphones. *sigh*
Chris Clayton
February 28, 2017 at 2:13 pmI have a chronically ill young adult daughter who spends a tremendous amount of time in specialist offices–she has five neurologists, three gastroenterologists, endocrinologists etc. . To have this service available for the routine stuff–sinus infections, migraines, acne–would be such a blessing! Because she has a limited amount of energy to spare, it would give her the ability to use her energy for what really matters instead of for shuttling to the doctor’s office. Come to Portland, Oregon metro area, Heal!
Kate Hare
February 28, 2017 at 4:25 pmThis is so interesting to me! I’m a family physician on the east coast, and I am always interested in hearing about new innovations in care delivery. I know that at our (large, teaching) practice, overhead can be up to 70-80% of our costs. So, I think I could see how, if you really minimize the physical plant, costs would go way down. Sort of like micro practice. I love continuity of care, and the time I spend with my patients, but tire of carrying the stress of running behind. Heal sounds wonderful in terms of relieving that!
I wish I could do a hybrid. I enjoy doing women’s health, minor procedures, etc., and that would be hard to do in this type of service. But if you could do a combo, I think that would be awesome.
The idea of seeing my pre-existing patients in their homes doesn’t intimidate me. But isn’t it sad that as a female doc, one of the things I thought about was safety? I guess you’d always have an assistant, but in this crazy world, the idea that I’d be daily going into homes of strangers who can request me there, does give me pause. I’ve had a few creepy patients, who I already felt uncomfortable with in the office. I wish I didn’t have to go there in my mind. Maybe I’m still scarred from watching ‘Patch Adams’ and ‘Private Practice’? ;)
Anyway, glad you posted this. So, so interesting.
cal
March 1, 2017 at 10:27 amThis is great! but I don’t understand the cost structure. As an rn I get paid more than $99 to do a home health assessment…so how can a Dr and med assistant be get compensated enough at $99 a visit… assuming the process is currently being supplemented by startup investment money, which means chances are it won’t be leaving ca any time soon. Or the prices well go up. Like I said I love the idea and I’d certainly use it at the current price but economically it doesn’t exactly add up in my head
Jess
March 1, 2017 at 11:29 amThis is amazing! I hope they spread out across the US soon!!
Janan Welch
March 2, 2017 at 4:45 amThis has got to be one of the coolest things ever. Wish I lived Heal’s area!
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Julie Bouckaert
March 21, 2017 at 5:24 amHave you not used SOS Médecins when you lived in Normandie? This type of service is indeed very convenient. Glad for you it is in CA now :)