Designing a Better Primary Care Experience: An Interview with One Medical’s Founder & CEO, Tom Lee, MD

What does personalized healthcare mean to One Medical? 

Tom Lee: The premise of One Medical is to treat individuals like individuals again.  The healthcare system, for the most part, treats the masses like the masses.  Instead what we try to do is understand that each person has a different health philosophy and motivations, and incorporate those directly into their care.  We provide information that is critical to patients while being open-minded to allow them to direct their treatment and care based on their own preferences and what works best for them as individuals.

Improving patient experience is at the heart of what One Medical does.  What are the critical components to creating a positive patient experience?

TL: There are many components to making a great patient experience but, at the end of the day, it’s about hiring people who truly want to make a difference.  And a leadership team that works to support those people.

What would you consider to be an equivalent ideal consumer experience to the ideal in healthcare, but in another industry?

TL: I don’t think there’s one specific model that we would call “ideal” – particularly when translating it into the health care arena.  We’ve looked at a variety of great service models across many industries and have chosen to incorporate elements that best reflect our personality and philosophy of care — one that’s more approachable and less stiff.

 It’s interesting that you mention that your brand of hospitality is meant to be approachable, because very frequently One Medical is conceptualized within the concierge medicine phenomenon, which makes you think “Oh, that’s expensive.” 

TL: Our philosophy is to be open and accessible to everybody and to be egalitarian about it.  It’s not meant to be an exclusive service just for the wealthy.  It’s intended to be a great service for anyone who wants high quality health care, so approachable is a big part of it. If you take an analog in hotels, the Ritz, for example: while it’s a great service organization, it also isn’t the most approachable.  And frankly, many people feel uncomfortable with their service design, and so that’s not a paradigm that we’ve looked to in designing our model.

You’ve said that a significant part of health care is now essentially a content business.  What implications does that have for your business and other businesses disrupting the traditional healthcare space or model?

TL: I think any content/distribution business should be cognizant of what the trends are, particularly when it comes to technology and the potential for disintermediation.  As I pointed out several years ago, I think it’s applicable to some aspects of health care, just as it is with other industries.  But, to be clear, health care is a very large industry with many dimensions to it, even within a single specialty.  So, not all aspects are equally at risk.  It depends mostly on the complexity of the issue, the level of personalization needed, as well as the necessity for physical interaction.

How does One Medical deal with the increasing use of the internet for information relating to what primary care would usually provide?

TL:  It’s about complementing how the internet is used given the One Medical service offering.  Our goal is to help patients make great decisions about their health.  They can certainly find lots of information on the internet, and that’s great.  But they also need a trusted expert who can help them navigate the options and choices available.  For most individuals who are making decisions about their health, they appreciate the advice of someone who knows them well, such as a primary care provider.

You’ve made products that both doctors and patients/consumers both love and use.  What are some secrets for understanding these groups of users, as users of technology or a healthcare product? 

TL: I think the design thesis for both Epocrates and One Medical has been similar — to offer something distinctive, super simply. Great design and innovation occurs by providing something that is hard to get in a much easier fashion.  For Epocrates, the question was: how do I take this really thick book of outdated information and make it accessible, faster, and easier to use.  With One Medical Group, it’s been about how to get a simpler, easier-to-access primary care experience that people trust.  The challenge with the latter is that it also involves people (not just software) and that’s what makes it that more challenging and fun — and hopefully more meaningful for patients and their health.

You seem to be very interested in design for health.

TL: It’s an intense focus of mine, yes.  And obviously the organization’s.  It’s complex because we are dealing with many dimensions: brick and mortar, people and process, and technology.  And for us, a seamless experience is critical.

You’ve said in the past that you feel that physicians are under-utilized and much of what they spend their time doing could be outsourced to technology.  What are your suggestions for how we can improve the way we train and manage our healthcare workforce? 

TL: That’s a big challenge, as much as reforming our educational system in general.  The problem is that the structures that oversee and manage the system for education today are the same ones that built it in the past.   That being said, there are some innovative educators and systems that are trying to evolve the system.  One example is the primary care program from where I graduated at Brigham and Women’s Hospital / Harvard Vanguard in Boston.  Not only do they give residents more exposure to primary care, but they also expose them to other elements of health care delivery that are critical to make it work better.  The question is whether the US medical educational system needs a revolutionary change, rather than an evolutionary one.

Do you have any tips for entrepreneurs interested in disrupting healthcare?

TL:  The tip I would give specifically to healthcare entrepreneurs is to avoid ignoring the business model or how healthcare is financed in the US.  Relying on a Facebook business model to work in healthcare is a riskier proposition, given that the healthcare market doesn’t behave quite like a consumer-facing free market.

Tom Lee is Founder and CEO of One Medical Group, based in San Francisco. Previously he was the Chief Medical Officer, Editor-in-Chief, and lead designer/marketer of mobile applications for Epocrates.