Interview with Evan Falchuk of Best Doctors: Giving consumers the opportunity to double check diagnosis and treatment decisions
Interviewed Evan Falchuk, President of Best Doctors, on their product allowing consumers to get additional information and options regarding diagnosis and treatment options.
The interview took place at the World Health Care Congress and both a podcast and a transcript lay out the conversation below.
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Evan Falchuck
Best Doctors
Vijay Goel: Hi, this is Vijay Goel. I’m here with Evan Falchuck of Best Doctors. Evan, tell us a little bit about Best Doctors, and what your company is about and what does it offer consumers?
Evan Falchuck: Best Doctors is an employee benefit that helps people take charge of their care, make sure they’re getting the right diagnosis and the right treatment.
VG: And when you say “right,” how does that differ from, say, going to the doctor, doing something else the way they would before they would use your service?
EF: The problem that people have when they go to the doctor is that very often they don’t have enough time with their physician. And because of this, there is a lot of data that shows about 1 in 5 people have the wrong diagnosis. And that can be as drastic as, they told you it is cancer and it’s something else. It could be that your cancer has been improperly staged. It could be any gradations in between. So about 1 in 5 people have that problem, and about 60% of people have issues with their treatment. And again, it can be drastic or not so drastic. So the issue for consumers is that they’ve got good reason to feel uncertain about their care, and what we do as a benefit is help them get on top of that, take charge of that, make sure it’s being done and done correctly.
VG: So that’s interesting. So it sounds like overall for consumers, the issue is, how do you know that its right? What do you guys offer in terms of your network that gives them more assurance that the person that they went to now, with you, is going to do a better job for them than their previous?
EF: So the approach is that patients stay with their doctors. I can give you an example that helps you understand how it works. We had a case of a woman in her 30s who over the course of a few months had lost her vision. She had been to her doctor, and they did appropriate workups and they found a mass in the front of her skull, and it was pressing on the optic nerve, which was what was interfering with the signals of vision. They said “this is a tumor, and we need to do surgery to get this out.” And they scheduled it. So she’s thinking, “wait a minute, is surgery the right treatment for my brain tumor?” She has Best Doctors as a benefit, she calls us. And we get her information from her on the phone, we get a medical release, we collected all of her medical information, the imaging studies, everything else that had been done, and consulted with a leading expert in the kind of problem that we’re dealing with here, and found out that she did not have a tumor, but instead had a sarcoidosis that had been incorrectly diagnosed, which is an inflammatory disease as you know. And so the answer to the question, is the surgery the right treatment for my tumor? In her case, the answer was no, you need anti-inflammatories and you need to be seen by an endocrinologist, a specialist for that kind of a problem. And so that’s the way that works. We focus on solving that patient’s problem without moving them to another doctor in order to do it.
VG: Interesting. So is your service more virtual? Do they go into, say, a facility? How does it work?
EF: It’s virtual in that sense, we’re not moving anywhere else—we’re working off of the medical data and information. And if its cancer cases, we’ll review their pathology and so they’re not moving, they’re not going anywhere else—we’re looking at data.
VG: And how does their doctor tend to react to their use of this service?
EF: Generally, good. They’re human beings, after all, doctors, so they’ve got a whole range of reactions to things, but we give them good, actionable information from recognized experts that’s on an issue that is pertinent to the care of their patient. So it’s hard not to react well to that.
VG: Right, interesting. Now you guys mentioned you are an employer-funded benefit. So can you talk a little bit about that business model?
EF: Sure.
VG: Versus, say, being something the consumer pays for directly?
EF: Sure. We sell to groups, employers, they pay us somewhere between $2-$3 per employee, per month–covers employee and their family. And there is no additional cost, then, to the consumer. We found this a much better model. It’s expensive to try to sell it to the individual, when they need it, and if you can sell it to a group, you can leverage the size to make that happen.
VG: And what’s the business proposition for the employer group? Is this a traditional benefit? Do they expect to see some kind of ROI?
EF: They do. The benefit is the big thing that employers tell us. So we’ve signed on many large employers. EMC, in the state of Delaware here, at the World Healthcare Conference are presenting on their experience with us, but other very diverse types of groups, Genzyme, pharma companies they love it because it’s a benefit that helps employees when they’re sick take charge of their care. They have also experienced a lot of cost savings. You avoid the brain surgery that I had described a moment ago.
VG: Right, and you still have to treat the sarcoidosis.
EF: This is correct. But think about the difference between doing open-head surgery and doing an anti-inflammatory treatment, where the cost of waking up the patient and saying, “Good news, it’s not a tumor, it’s an inflammatory disease.”
VG: Right. So you’re seeing it’s not just the diagnosis upfront, but it’s also the rework, the re-diagnosis, and kind of the wasted treatment that you guys get to take out of it.
EF: That’s right, there’s a lot of that.
VG: Terrific. And tell us a little bit about how your experience reflects what consumers should be looking for out in the marketplace, or what kind of choices are available to them that they may not know to look for?
EF: Well, first thing for a consumer is to make sure you’ve got that right diagnosis and treatment. Don’t assume, no matter how good your doctor is, and there are a lot of great doctors out there that you’ve got the right answer. So if you have a benefit like Best Doctors, call and ask for help. If not, perhaps you want to ask your employer, do we have this program? But ask questions. Become an informed patient, and make decisions based on the best information you can.
VG: Right, so this kind of reinforces the point and it’s been a continuing theme—many doctors need to do things quickly and they’re forced by the current reimbursement model to do things quickly, and so having somebody else kind of look it over with a clear head and make sure that it all makes sense, is never a bad thing.
EF: Doctors tell me all the time that I spend 5-6 minutes with my patients. So think of a patient whose got an illness, whose been seen by their primary care doctor for 7 minutes, and seen by specialists for 7 minutes, and a third doctor for 7 minutes—the opportunity for stuff to go wrong is enormous, and you need somebody to be that hub and be able to look
at everything and make sure it’s done right, I agree wholeheartedly with that.
VG: Sounds terrific. Well, until the issues with the primary care system and the timing in terms of how much patients can spend with their physicians changes, it sounds like this is a great place to—
EF: We will be driving to our doctor’s appointments in flying cars on the day that that’s solved, so…
VG: [laughter] Terrific! Thank you very much Evan!
EF: Thanks!
