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Circle Medical (YC S15) Brings a Full Service Medical Practice to You (techcrunch.com)
22 points by dh on Aug 17, 2015 | hide | past | favorite | 13 comments

Interesting concept, but I'm skeptical that the economics work out. It's true you save on office space, but you lose on volume of clients (patients) you can see at any given time.

On top of that, in a practice, doctors are able to "outsource" a lot of the low-skill labor to either office managers or nurses - the receptionist takes your paperwork and handles the cancellations, the nurse draws blood and takes your vitals, the doctor just rolls in for 15 minutes and listens to your complaint and read the results.

There are already doctor practices that are doing this, but they're going the opposite direction and charging much more or annual fees, for the convenience factor of having the doctor come to you.

I'm one of the founders of Circle Medical. Great to see a thoughtful discussion here.

Most people don't realize how most of the payment for an office visit with a doctor doesn't actually go to the doctor. We eliminate the need for office space and having someone handle paperwork and insurance and replace it with software.

You're right that there are other doctors with concierge medicine who charge for the convenience. The point is we are making this accessible to patients who have a regular insurance plan and can't or won't pay extra for the convenience factor.

Thanks for replying, and kudos on trying something new.

Couple of points that I was hoping you could clarify:

1) A quick google search yields [1], which says that a typical family doctor has 34 hours a week of patient interactions, 92 patients a day, at about 22 minutes per interaction.

How will you be able to get to those numbers given that you have to coordinate schedules, transport the doctor from appointment to appointment, and make the doctor responsible for all of the secondary aspects of care, like taking vitals and drawing blood? Doctor offices work partially by queueing up people, so that when an appointment runs long, people pile up, and the next appointment is short, and they catch up. How does this work when the doctor does everything, and has to be transported from gig to gig?

2) What's the comparable amount of money a doc will make with circle medical vs. the median amount a doc will make with a group practice, where rent and office management are pooled?

3) With doctors salaried (fixed-cost) but their income variable (number of appointments/day), how will you stay aligned towards patient care? What's to stop you from putting pressure on the doctors to try to cut time down/visit?

1 - http://www.washingtonpost.com/news/to-your-health/wp/2014/05...

For those of you in sfbay, one medical ( https://onemedical.com ) is awesome. For $150/year, you get doctors that read and answer email; the ability to get same day appointments, though not necessarily with your pcp, but with a doctor; online appointment scheduling; and a phlebotomist in the office (at least where I go). It's a huge time savings.

They've also done a good job at solving one of the plagues of the medical industry - hiring competent and friendly admin staff.

Circle Medical founder here. We like One Medical. They have really moved the ball forward in terms of patient experience. But why stop there?

one medical website is dead as I can't access it. Is that right?

weird, they don't redirect to www

this works http://www.onemedical.com

FWIW, I haven't seen a doctor in years and I like the concept. I have a compromised immune system. I stopped going to see doctors in part because sitting in the waiting room with other patients tended to leave me horribly ill. Using a public bathroom used by other patients was also a serious problem. Etc. I have long lamented that doctors going to see patients was something we no longer did.

I hope you are very successful.

Thanks for the love!

"…the service specializes in things like annual checkups, flu shots, and blood tests… not just time-sensitive urgent care issues."

These tasks are generally left to physician assistants and nurse practitioners who are paid on average about half as much as primary care physicians (about 100k vs 200k).

In many states, they can be found practicing in pharmacies and supermarkets and seem to see around a half dozen patients per hour.

I think it will be tough for mobile medical practitioners to beat price/convenience levels of retail nurse practitioners and physician assistants.

This idea has been around for a while and is really better solved by the concept of community paramedicine [1], which several areas in the US are currently piloting. Like other commenters have mentioned, the economics of having a physician perform these basic tasks severely limits the profitability.

1. http://www.naemt.org/Files/MobileIntegratedHC/UC%20Davis%20C...

When do you expand to Seattle area? I hate to wait for 2 weeks for visit and then it rains...

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