If you could text your doctor anytime from anyplace for free, would you? McKay Thomas, CEO of recently launched virtual doc app First Opinion, is betting you will.
“We believe texting will be the new paradigm of healthcare in the U.S.,” Thomas says.
Wait times to see a doctor are increasing nationally, government data shows. According to the Centers for Medicare and Medicaid Services, patients have to wait on average close to 22 days to see a doctor, up from 19 days in 2009.
The long wait times for office appointments drive patients to the emergency room with no place else to turn. A 2014 study done by Indiana-based healthcare consultants Press Ganey found that over 70 percent of ER visits in the U.S. are unnecessary.
The lack of physical access to doctors has led to an explosion in “virtual doc” apps over the last two years. You don’t have to leave your home anymore to talk to a doctor. Companies like Teladoc, Doctor on Demand and American Well offer pay-for-service video chats costing about $40 for a 10-minute call with a doctor.
Michael Cherny, a senior health technology analyst at Evercore ISI, says investors are excited by the new trend in medicine toward virtual access. “I think by all means, what we’re seeing now in the industry is that there’s very much a need for a more preliminary [screening] before going to the ER,” Cherny said.
Text message alternative
Thomas believes texting offers greater flexibility for users than video chats because it allows patients to reach a doctor at any time.
First Opinion is free. However, users can pay $9 a month to get enhanced features, including quicker response times and the ability to send photos. Such “freemium” models are popular today among many successful tech services like Evernote and Dropbox.
First Opinion hires its doctors as full-time employees, another distinct difference between the text messaging service and its video-service counterparts. Thomas said his doctors are more engaged when they don’t have to split time between an in-office practice and his service.
Thomas, 29, seems to have a knack for predicting hot markets. At just 17, he launched Pooltables.com with his brother and cousin. By 2007, the company was the largest pool table manufacturer in the United States. His second family startup, Baby.com.br, is now the leading online retailer for baby products in Brazil.
First Opinion is Thomas’ first solo venture. Inspired by his own wife, a mother of two with another on the way, Thomas says he wanted to give moms a trusted source they can reach out to day and night. Fittingly, the app’s doctors are all moms themselves who service patients from home.
In its first year of service, the app has had 35,000 unique users. First Opinion COO Dr. Vikram Bakhru, M.D., says most users have non-emergent medical issues. About 54 percent of questions fall within primary care; 24 percent within women’s health and parenting; and 14 percent within emotional health, including depression and anxiety.
Investors getting the message
First Opinion is backed by Bay Area venture capital firms, including Greylock Partners, 500 Startups and True Ventures. Since its inception in 2013, the company has raised $2.6 million.
Sundeep Peechu, a general partner at Felicis Ventures, First Opinion’s largest investor, says people find going to the doctor too stressful and time intensive.
“The biggest issue [in medicine] is that people have gotten busier and busier … and healthcare is becoming more and more inaccessible,” Peechu said. “It doesn’t fit in with modern day-to-day life of people.”
Dr. Angie Jelin, M.D., a maternal-fetal medicine specialist at MedStar Washington Hospital Center in Washington, D.C., says wait times are a real issue at her practice, even though she gives patients her personal email to reach her during off-hours.
“If you call our center and request a consult appointment with me, it’s a month wait,” Jelin said. “For regular routine doctors, our wait times are probably one to two weeks.” Jelin previously practiced at UCSF Medical Center in San Francisco and noted similar wait times.
First Opinion doctors say the service enables them to spend quality time with their own family, while doing what they love professionally.
Dr. Bosky, who declined to give her last name, lives in New Delhi, India, and has been practicing medicine for nine years. She has a three-year-old who she says keeps her constantly busy, but she still manages to dedicate about 50 hours a week to the service from home.
“First Opinion is the platform which has given me wings,” Bosky said in a text message. “I get enough time to spend with my family. Being a doctor and a mom isn’t always easy.”
First Opinion users are paired with a single doctor for continuity. A brief description of the doctor is sent to the user, including her location and how long she’s been practicing medicine.
Although the company offers doctors from the United States, some of its doctors are outsourced, lowering the cost of care. Thomas says the app offers doctors in Canada, Australia, the U.K. and India.
The service is made available 24-hours a day so that patients feel in “constant” contact with their doctor, Thomas says. Doctors have an assigned after-hours team to service their patients when they’re off-duty.
Jelin says she has concerns about the quality of care First Opinion users receive because of the differences in practices and standards of care across countries.
“I worry especially about physicians who are at home helping patients,” she said. “There are frequent changes in practice, and the person who has hands-on experience is more qualified to counsel a patient.”
Thomas says First Opinion’s doctors do not focus on diagnosing or prescribing medications, but rather “listening” and “evaluating patient options.” The app is more like a concierge service to let users know if they should seek local medical help, he says.
‘Nailing’ the niche
Users of First Opinion say they like the fast response time and the fact that they can consult a non-judgmental source.
“New moms need a lot of emotional support and sometimes I don’t feel comfortable talking to friends or family about what is going on in my sleep-deprived, hormonal brain,” said Marin County user Felicia Rawlins, who uses the app while nursing in the middle of the night.
Kasi Campbell, a San Francisco first-time mom, recently discovered the app and says she appreciates its ability to allow her to multi-task. “I like the fact that the doctor’s response time is so quick and you can see they are [immediately] writing back to you.” Campbell says she often uses the app while grocery shopping or on breaks at work.
For patients, there are some limiting factors to the app. For one, you must have an iPhone with the iOS 8 operating system. The service, of course, also requires you to be adept at text messaging.
“We may not be the solution for everyone,” Thomas said. “But right now, we think we’re the perfect solution for moms.”