The doctor will see you now — even if you’re still at work
Inside a small conference room, feet away from her desk at San Francisco fitness app maker Strava, Camilla Ring got her blood pressure and heart rate taken by Dr. Anju Goel.
“It felt normal, aside from it being in a conference room,” Ring said after the nearly hour-long checkup, which Goel had come from her Peninsula home to conduct.
Ring’s appointment, booked through a Santa Monica startup called Heal, reflects the tech industry’s affinity for perks that save time. Not only are companies providing in-office meals for their employees, but they’re also bringing in doctors — so nobody has to leave work to get examined. Over the last two years, Heal doctors have seen employees at Hulu, Activision, Snap, AEG, GoPro, Twilio and Pure Storage. They usually handle nonemergencies, like physicals, allergic reactions or minor wounds — conditions that typically might send patients to an urgent care clinic.
About 40 percent of Heal’s house calls are done at large companies, according to cofounder and CEO Nick Desai. Heal physicians have seen about 70,000 patients, Desai
said, and the vast majority — 65,000 — used insurance to pay for the visits. Patients who do not want to use insurance can pay $99 out of pocket.
Heal makes money by keeping a portion of the payments from patients and insurance companies, similar to a traditional doctor’s office. A Heal spokeswoman declined to share revenue figures but said the company has turned a profit in its Los Angeles market. The company has raised $59 million from investors and plans to expand to other regions, including New York and Georgia.
Health insurers are taking notice. Two and a half years ago, Blue Shield of California, headquartered in San Francisco, began including Heal house calls in its preferred provider organization plans. About 11,000 Californians have used the house call benefit since then, according to Jeff Bailet, the insurer’s executive vice president of health care quality and affordability.
The house call option saves consumers considerable money, Bailet said. A Heal visit costs between $14 and $74 out of pocket — compared with a visit to the emergency room for non-life-threatening injuries and illnesses, which costs $200 to $400 out-ofpocket, the insurer estimates. Generally, emergency room visits can be very expensive because patients are charged a facility fee to pay for hospital overhead costs like building maintenance and utilities.
Goel and other Heal doctors work a roughly 40-hour week. Her medical assistant drives her to appointments and drops her off at the end of the day, and she does patient charting in the car between appointments. She travels with a suitcase of medical equipment that includes a rapid strep test, bandages and gauze, a glucometer for measuring blood glucose, slings and surgical glue. Heal provides doctors and medical assistants with cars and pays for the gas.
“What I like is it allows us to have a lot of time with patients without being distracted by other patients,” Goel said. “We don’t have the same time constraints as a typical (doctor’s) office setting. I can spend as long as I need with a patient.”
The business model is challenging, experts say, but could be successful if a company like Heal has enough patients and the travel time for doctors is relatively short.
“The transportation issue is a big one,” said Glenn Melnick, a health economist at the University of Southern California who led a recent study on a health system’s house call program in his region. The study found that doctors could only see three or four patients a day and were spending much of their time driving. The “doctor on demand” model essentially takes away the burden of time and travel from the patient and shifts it to the doctor, “the most expensive input,” he said.
“For consumers, it sounds like a great deal,” he said. “But I don’t see how it’s anything more than a very small niche in cities where transportation is much more efficient.”
Ring, a product specialist at Strava, had used Heal twice before for home visits when she was ill, and liked the convenience of not having to leave work in the middle of the day for an appointment.
“If I’m already here, it saves me a ton of time,” she said.
Because Ring’s appointment was for a checkup, which is considered preventive, it was covered by her insurance at no cost to her. But Strava also funds up to $2,500 per employee for medical expenses if they have a health savings account or health reimbursement account as part of their health plan. Many employees use the fund to pay for Heal visits at work, said Strava’s human resources coordinator Chrissa Urquiola.
Once a year, Strava asks a small team of Heal doctors to come to the office for the entire workday so Strava employees can get their annual physical done there if they wish.
Heal also offers more minimal services, like on-site flu shots, at companies including the consulting firm Korn Ferry, e.l.f. Cosmetics and Sequoia.
Traveling doctors, of course, are an age-old tradition in medicine, especially in rural areas. And plenty of tech giants with sprawling campuses have installed medical clinics. Many Googlers can access on-site doctors, physical therapists and massage services. Facebook has a medical facility in Menlo Park. Amazon, which has grand plans to revolutionize the health care business, reportedly plans to add clinics for Seattle employees.
Startups have recently rediscovered the merits of house calls in dense modern cities. Some have failed: FirstLine and the House Doctor, two Bay Area firms, started in the last decade but folded, according to Yelp. Both companies attempted a house call service in which patients could request a physician to their home.
Urgent Med Housecalls, founded by an emergency doctor in San Francisco in 2007, has survived. It provides house calls at hotels for tourists, whose medical care is covered by travel insurance or paid for out of pocket.
UCSF has long operated a home-care program for seniors and people with disabilities and chronic illnesses who have a hard time leaving their home to get to medical appointments. The program, which began in 2001, serves about 300 patients in San Francisco and focuses on primary care, palliative care and hospice.
At Strava, the at-work medical benefits don’t stop at doctors visits. Last month, the company began offering its employees in-office vision exams through OnSight, a company that sends opticians and optometrists to corporate offices to do eye exams. In September, Strava plans to start providing on-site teeth cleanings and whitening through San Francisco’s Dentists on Demand.
“People are very health conscious here,” said Urquiola of Strava. “I wanted to create a community where we could bring everything here.”