A nurse with Pager makes a visit to a mother and child. (Pager)
Each day, emergency room physician Kim Henderson travels by foot, cab or subway throughout New York City’s five boroughs to tend to her patients. Sometimes she treats sore throats or minor lacerations. She recently journeyed to uptown Manhattan to remove stitches from the forehead of an elderly person who’d injured herself in a fall.
“I literally did it at her bedside,” Henderson says.
Henderson was an emergency medicine physician for 12 years, and now works full-time for Pager—the company produces a smartphone app that dispatches physicians right to your doorstep for a fee of $50 per visit.
She says the app keeps people from going to the emergency room for minor treatments. And that saves money for patients who don’t need to be paying for the extra services and facility fees of emergency care.
“There are definitely certain patients that belong in the hospital emergency room,” Henderson says. “But someone with a sore throat or minor laceration can just as easily be treated in the comfort of their own home. So why disrupt their entire day or pull them out in the cold when you can go to their bedside? It’s a better model.”
The era of physician house calls may be returning. Several smartphone apps have emerged in the past 18 months that bring doctors and other medical professionals directly to your home.
Pager is currently available in New York City, but officials say it will expand to two unnamed West Coast cities this summer. Heal, which began in Los Angeles and has spread to San Francisco, charges a flat fee of $99 to bring doctors or pediatricians to your doorstep, for consultations of 20 to 60 minutes. Curbside Care offers house calls from doctors and nurse practitioners in the Philadelphia area. And Go2Nurse, which operates in Chicago and Milwaukee, offers a range of services that include in-home pregnancy care.
Pager’s team of medical professionals currently includes 20 physicians and 15 nurses. Toby Hervey, general manager and part of the founding team at Pager, says when the company launched a year ago, the initial goal was to serve patients on evenings and weekends in Manhattan. It didn’t take long before Pager expanded to cover all five boroughs.
Hervey says he and his founding partners conceived of Pager to help fix what they see as a broken healthcare system.
“As a country, we spend more per capita on health care than any other developed country,” Hervey says. “People are using emergency care as their health system.”
Hervey says one of Pager’s founders, Oscar Salazar, was a founder of Uber, and influenced the company’s approach.
“We have some of that Uber DNA, where we are technology driven and there’s a direct connection between doctors and patients,” he says. “We saw a really bad experience for the consumer and decided to use technology to fix and create a better delivery of care.”
Edward Ben-Alec, chief technical officer and a founder of Go2Nurse, says he and his founding partners were similarly motivated by a desire to improve the healthcare system. Go2Nurse started serving customers in September 2014, and currently operates in the Chicago and Milwaukee metro areas.
Although the original intent of Go2Nurse was to be an on-demand smartphone service for nurses, it has since evolved into a business focused primarily on case management: tasks like follow up, education and compliance. As a result of this shift in strategy, Go2Nurse usually gets paid by insurance companies and seldom needs to collect payments directly from patients.
“Mostly our nurses get involved in making sure patients get everything they need and that money is not wasted in the process,” says Ben-Alec.
But not all tech-driven medicine is moving into house calls. Pat Basu is chief medical officer of Doctor on Demand, the world’s largest video provider of medical doctors and assorted medical professionals. He says his company has no plans for expanding into that arena
“The benefit of telemedicine at the patient level and national level is a ten-fold increase in operational efficiency,” Basu says. “House calls—even if it is the best example of in-patient care—does not have the same magnitude of efficiency. If a patient calls from Sacramento, my doctor can take care of them. House calls are really hard to operationalize. In telemedicine, with some common ailments like urinary tract infections and pink eye, meeting the doctor (in person) is not really necessary.”
Get the best of KQED's science coverage in your inbox weekly.