While a big hit in France, an app designed to facilitate home visits by a clinician is unlikely to gain traction in the U.S. marketplace. It’s the latest incarnation of trying to provide Uber-like services in healthcare. This model is derived from SOS Médecins, which founder Gaspard de Dreuzy brought across the Atlantic in 2013. He and Uber founder Oscar Salazar dubbed their brainchild Pager, an Uber for home healthcare. Available on the App Store, it connects patients to a nurse, who takes the relevant information so the system can decide whether a physician visit is warranted. If the physician goes to the patient’s home and finds still more care is needed, the patient has to leave his or her home to visit another provider or local hospital. No matter what level of convenience it may—or may not—provide for patients, the model is likely to be unsustainable, if purely for economic and logistical reasons. Consider the following:
- Provider salaries take up the single biggest proportion of a healthcare facility’s costs. In a typical clinic, each clinician needs to see 3.5–4 patients per hour in order for the model to survive. Even in a congested city, where patients are more likely to be closer together, it’s hard to imagine a physician driving to a location, setting up and breaking down equipment, documenting a chart without a medical assistant, actually treating the patient, then driving to the next patient’s location in less than an hour.
- The Uber comparison is a poor one. Where Uber matches people who need rides with people who have excess capacity in their cars (thereby providing an alternative to poor taxi experience in major cities, as well), there is a physician shortage in the United States—and one that’s projected to get worse, at that. Dispatching physician from an environment full of patients to far-flung sites to see one patient takes vital capacity away by decreasing the efficiency of our provider workforce.
For further discussion of the pitfalls of the “Uberization” of healthcare, please see “Are Uber-like Medical Services Really a Practical Replacement for Urgent Care?” in the JUCM archives.