6 Month Report

The experiment continues and we’re still enjoying. We’re getting about a call a day now, and happily, from people who seem to be 3-4 clicks removed… not just FOM (friends of mom). We actually got a referral from Yelp on July 4th, which made Vanessa’s day.

In the past 3 months Vanessa has revamped our entire website and released her iOS CrowdCentsing app (version 1.0), which shows amounts billed by California hospitals vs. amounts actually paid to those hospitals by Medicare, based on diagnosis related group (DRG). It’s not the holy grail of real time price transparency, but a nice step in that direction. If you are a hospital administrator and you want to know where you land amongst other hospitals, you may find it useful. If you are uninsured and you want to know which hospital is most likely attack your wallet, you may also benefit. Vanessa’s next release will have data for other states.

As you can see, our blog page has been split into two sections called “Musings” and “Anxiometer.” The Musings page has thoughts on a variety of medical topics. It’s also my way of releasing steam. The Anxiometer is meant to help our readers understand what treatments they may expect in clinics/urgent cares/ERs for a variety of basic medical problems, along with how anxious they should be. Very much of medicine is reassurance and we hope our posts will help to alleviate anxiety while also saving people time and money. This page will grow for years, so we’re happy to take requests for Anxiometer topics.

Medically, Pre-R is definitely pushing me outside of my ER comfort zone, but that’s actually been a pleasure. It’s forcing me to address medical questions I don’t often encounter and to learn how medical systems work (or don’t) throughout the community. Questions cover everything from malaria prophylaxis, to outpatient MRI ordering, to pre-op physicals, to PPD placement, to Botox. Also, because of Pre-R and our friends at All-Out Events we’re now providing medical direction for a nine day adventure race this summer in the Lake Tahoe area called Primal Quest. It’s forcing me to massively shift my thinking from reactive medicine to preventive medicine.

Telemedicine vs house calls? The verdict is in… house calls.

I talk with many patients by phone and occasionally images are sent by text, (for example to assess a minor burn from a sparkler on July 4). But nobody seems to care if we can see each other online or not. Much preferred is the home visit/mobile urgent care, which suits me fine. It’s such a paradigm shift for me to be able to sit and chat with one patient at a time, with no other patients, nurses, consultants, phones, ambulances yanking me in other directions. Finally I’ve found a way to grow old.

Financially, by popular demand we now offer suggested fees. Initially we asked our patients to pay us what they felt our service was worth with zero guidance. But that turned out to cause a different kind of angst; the kind you may feel after a good meal at an empty restaurant on July 4th where the pitiful waiter tried really really hard. We still solve medical problems first and talk money second. We still don’t use coders, billers or collectors. We still issue superbills on request. But now we also offer suggested fee ranges based on prices charged by other house calls apps and urgent cares.

Stay tuned for the next 3 months!

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