10 Month Report

Our Pre-R experiment continues, and folks in town are gradually getting to know we exist. Word of mouth, followed by Google, followed by Yelp seem to be our top three referral sources. Facebook is probably helping too, though hard to tell. (You may think we’re crazy with all these Pre-R posts, but it’s basically our steady shout to the world that we’re still here. If you’re ever feeling kind, please share our page with your friends.)

Phone calls are pretty consistent now and new callers usually have a surprised tone when I answer instead of a receptionist. We’ve fielded some calls from far away places too, a friend in Peru being the furthest. As for “telemedicine”, Skype and Facetime are essentially non-topics. Nobody ever suggests we talk over a screen. Either the problem is solvable with phone conversation +/- a texted image, or a visit is next up.

Our payment scheme is getting more and more refined too, and my naïveté is more and more obvious. Initially, we tried “pay what you think we’re worth.” Then we offered suggested fee ranges. Now we have specific suggested fees. This hopefully still leaves the door open for people who may be struggling financially, but also leaves little guessing for what number we feel is appropriate. While I was hoping suggested ranges or “pay what you like” would be a way for us to help people independent of their income, it seems that providing freedom to name fees separates people along some other personality traits. (i.e. Some struggling patients pay generously, while those with means sometimes suprise us by simply not paying.) As an added bonus for me, Vanessa likes our current approach much more too.

For a time back in August we also considered a membership model, but opted against simply because it would kill the joy of getting calls. Today Vanessa and I are excited when that Pre-R Google Voice number rings. Most certainly it would be the opposite with memberships, because of the “80/20 rule” (or 99/1 where even one single patient can make you envy pathologists). Plus, I never want to have to fire patients. No memberships means no firing. For Pre-R, the ‘block’ button is always available… though we’ve never used it.

As similar, but much larger services, like Pager, Medicast, Heal come to life, I’ve read accusations that we’re part of a growing market that is essentially cherry picking low hanging medical fruit. I can’t speak for these other services, but I prefer to think that we’re treating that fruit better, while keeping expenses down.

There’s just no system or universe where charging $1000+ and involving insurance companies for a cold or minor injury makes sense.

Plus we’re not just getting calls about minor lacerations and colds. On occasion we’ve gone to houses for elderly patients who can’t get in to see their doctors, can’t get out of bed, and feel vehemently opposed to calling 911. I’ve also had calls from patients who were miserable while sitting in ER waiting rooms. That call from Peru was to talk about someone unconscious following a pesticide poisoning – he survived and hopefully we helped a bit.

MedicalBusinessExperimentOn the IT side, we’re working with a team from Cal Poly to develop a Pre-R app to help better connect us with patients. Perhaps we’ll be unveiling it next June. Our Anxiometer continues to grow as well, though I’ve really no clue if anyone finds it helpful.

Well… the experiment continues. Onwards!

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