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WC Docs on Demand

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It's 5:30 on a Friday and everyone is scrambling to clear their desks and get the weekend started. And here's "Jack." A relatively new employee, Jack races barefoot to the copy room, trips over a box he forgot to remove earlier and sustains a nasty gash on his right foot. It's not an emergency, but requires treatment beyond a couple of bandaids.

The problem is, he can't drive himself to the closest urgent care center and nobody seems to have the time (or desire) to drive him. Medical transportation appears the only option, expensive as it may be.

Let's take this same scenario, but suppose you could swipe an app on your phone and, voila! like magic, a board-certified physician and her assistant appear at the worksite, treat Jack's foot with stitches and a prescription for antibiotics and go on their way -- all for $99.

A company out of California is hoping to be the "Uber" for doctors, and has its sights set on treating injured workers. While the company is relatively new, the idea of providing on-the-spot medical services to injured workers at companies that don't have, or can't afford onsite clinics may be worth considering.

"Heal" is the brainchild of Nick Desai and his wife Dr. Renee Dua, a board-certified kidney specialist. As Desai tells it, they had taken their 7-month-old ill son to the ER late one Friday, waited for more than 7 hours and found out it was just a fever.

On the drive home they thought there had to be a better way and, thus, Heal was born. As a "serial entrepreneur," Desaiu knows a thing or two about raising money through venture capital and turning an idea into a successful business.

Heal began in January in Los Angeles and has since spread to San Francisco. Desai has raised over $5 million and aims for another $15 million by the end of the year.

The focus is on treating kids and adults in their homes or at work. Desai says the company has just signed to be the primary care provider for several Fortune 50 companies and is aiming to also be their workers' comp provider. He is negotiating with these as yet unnamed companies to become part of their medical provider networks in California and hopes to eventually take the company nationwide.

As he explains the process, a phone app alerts the company to the need and location for a physician. The doctor and assistant show up within one hour, often in less than 30 minutes.

The more than 70 physicians with the company include ER and internal medicine specialists. They can do anything onsite that can be done in a primary care physician's office: physical exams, routine vitals, blood draws, urine tests, lancing blisters, stitches, administering IVs, etc.

And just who are these physicians and why are they doing this? They are board-certified docs who are frustrated with their current situations.

"Our model is dependent on the recognition that primary care physicians are leaving the profession in droves," Desai says. "The amount of dissatisfaction is at an all-time high."

Physicians come out of medical school and provide work in what Desai describes as a factory setting. "They don't get to invest in quality care," he says. "It's volume, not quality."

Desai cites a survey of physicians' wishes, in which "more money" was number 4 on the list; "more time with patients" came out on top.

"They want more flexibility, they want respect and to be treated like they are helping people," he says.

While the $99 fee per visit may seem higher than a typical trip to a primary care physician's office, the company touts the time and convenience factors, in addition to what Desai says is higher quality care for the injured worker. Instead of the usual 5-minute visit per patient, Heal's docs average 25 to 30 minutes per patient.

Heal is admittedly new and unproven in the workers' comp space. But the idea of such a service speaks to several challenges facing the workers' comp system:

  • Shortage of physicians. A top concern among many workers' comp experts is that the expansion of health care coverage to millions of Americans as a result of the Affordable Care Act could greatly reduce the number of physicians available to treat injured workers -- or at least, in a timely manner.
  • The aforementioned frustration among physicians required to see umpteen patients a day, working up to 60 hours a week and with little to no flexibility in their schedules. With the recent trend toward companies buying up private practices, that frustration is growing.
  • Medical transportation, which is eliminated. Heal docs provide follow-up care, including scheduling additional visits to the injured employee at his worksite.
  • Potentially helpful in the accident investigation. By not only seeing the patient within an hour of the injury, the Heal folks are privy to onsite insights that might otherwise be missed in subsequent written reports.
  • Early identification of comorbid conditions, especially mental health issues such as anxiety. Again, being onsite with the injured worker can offer glimpses into problems that might otherwise go unnoticed.

With all the talk about the need for quality medical care to achieve optimal outcomes for injured workers, an idea like Heal may be one whose time has come.

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