How To Find A Doctor Wherever You Are.

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Pounds, get ready for non run of the mill cutting edge content from BenGreenfieldFitness.com. Hey folks, it's Ben Greenfield and health insurance and finding doctors are something that I have to admit are kind of fresh on my mind about the past decade. I've used a health savings account or what's also known as an HSA here in America for you listeners in the usa. And I've combined that with managing my own high deductible health insurance when the Obamacare Affordable Health Care act got passed. That for several reasons which you can read about in the show notes if you want to Basically it ironically tripled my private health insurance costs and left me forced to find a new plan. So I've spent the past several months kind of going through the Washington Health Plan Finder here in my local state and you know, enduring everything from tech support nightmares to nerve wracking lapses in my health insurance coverage. And fortunately I now have health insurance and I'm good to go on that front. And as far as finding a physician, I've certainly interviewed in previous podcasts, my own physicians on this show, like Dr. Todd Schlapfer, the naturopathic physician who I work with over in Coeur d' Alene, and Dr. Toby Hallowitz, the Chinese medical practitioner who does a lot of my medical care in the Spokane Val. And I've also talked about websites like PrimeDocs.com or the Paleophysicians Network.com or FunctionalMedicine.org that I've recommended in the past for helping to find a good functional medicine or naturopathic medical practitioner in your area. But a few months ago I was actually over in Utah skiing and I met at a convention that I was at this guy named Ari Tola who I have on the call today. And Ari was telling me about an app that he's created along with a website that helps people not only find physicians, but also find specific medical procedures, insurance, medical practitioners, doctor ratings, and all sorts of interesting things when it comes to this process of kind of navigating your way through the modern medical care system. So the name of his website is betterdoctor.com betterdoctor.com and we're going to jump in today and talk about what that is and how you can use it to do things like find health insurance or find a specific procedure or find a medical practitioner who's appropriate for your needs. So, Ari, thanks for coming on, man.

Hey, thank you, Ben. Great intro.

Oh, thanks. Yeah, I tend to drone on for a long time on those things. So usually I just either wait until my guest completely interrupts me or just kind of go until I feel like being done. So hopefully it wasn't too long for you. So I'm curious if you can share with us, because I actually didn't really get a good grasp of this when I was talking with you in Utah. How exactly did this website come about? Was this a personal frustration that you experienced or just a good tech idea that you had?

Yeah, I think I'm like many of the other healthcare entrepreneurs who come outside the healthcare where I had a personal vendetta on making and creating something better. So my medical story started 15 years ago. My wife became ill in Europe. And seven years ago when we moved to California, I had a cold plated insurance plan. I had access to every doctor I can think of, but we couldn't find the right one. Nobody could help us. We talked to the insurance company, HSR department and the rest, and they couldn't really give us guidance. And after seeing about 30 doctors and finally finding the one who was able to help us, kind of idea stuck in my mind that this is something very complicated. This is something that most people will never do. We had the tenacity, we had the capacity to do it. And that started kind of the idea of thinking. And about a couple years later, I then jumped out of my previous post and started the company with my co founder, Tapir Tolvanan. And the idea really is to help people find the right doctor when they need one.

Okay, gotcha. So as far as how this actually fleshes itself out, did you guys wind up creating a website first? Did you create an app first or what was the actual process at that point?

Yeah, that's a great point. And I mean, I'm a mobile guy, so I've been doing mobile apps and mobile games for a long time and I kind of started to think about mobile first we need to do an app. And then we did that first. We got some tracks, but we found out that most people are still on the web looking for doctor information. And we fairly quickly we went from the app. We still have an app on iPhone and mobile websites, but the web is predominantly where the traffic is coming today.

Okay, gotcha. So you've got an app and a website and what's the actual process. When someone gets onto a website and they want to say, find a doctor, what kind of things can I look for? What do you think is important for someone to be able to look for when they're searching for a physician?

Yeah, I can talk about my own personal experience. And also we have about 20 million people who we helped already to find a doctor. So I know I have some data on the topic. So most people, they of course look somebody nearby and you often look by speciality, you know that you need to have an orthopedist or you need to have an arthropathic doctor or something like. And then of course, like you said, you need to find somebody who is in your network. If you go out of the network, you're going to pay a ton more money. And that doesn't really make sense. So those are the first things we did. And then we added a quality layer on top of it. So we have information about. We have our own rating system that is kind of like a 360 degree rating of a doctor. We also show the consumer feedback and be able to kind of give you the good local doctors in your network. And now the final thing we've been adding in the last months is about adding also information about procedures, knowing what the doctors are doing. Of course it's not so relevant for the primary care doctor, but it's very relevant for, let's say orthopedist or a surgeon. You want to go to a doctor who is doing the thing you need often.

Gotcha. And how are you getting that data? Like how do you know, for example, how often a doctor has done a certain surgery or how good a doctor is at a specific procedure.

Yeah, this was really the kind of the gold mine that I had in mind when I started the company. I wanted to be able to give you doctors who know and they have done, you know, the ACL surgery the most. And now finally we can kind of take a step that direction because the government has opened the Medicare data, meaning that now you can see on a doctor level exactly what they have done in Medicare for Medicare patients. So it's not 100% of the market today yet, but we know because there's a lot of, you know, things happening in the market that the complete data will be open maybe even sometime this year, meaning that you would know exactly what each doctor in the country are doing that year. But the Medicare data already gives you a really good indication of going to the right place.

In addition to knowing, like how many of the type of Procedures that you're interested in getting or how many of the type of cases that the physician that you're looking at has actually done. What else goes into the doctor rating? Like what kind of things have you found to be important when it comes to determining whether or not a doctor should rank higher or is going to be the right doctor for you?

Yeah, so we have the beginning really started from qualifications. So is this doctor qualified? Of course you need to have medical license, you need to be board certified. That's given. Then we are looking at your experience from education background. And we think that if you are a doctor who went through a very tight funnel, you will be clinically a good doctor. Think about in a way, if you have a doctor who went to Harvard Medical School, one of the hardest place to get as an aspiring doctor, then they did an internship in Stanford, for example, one of the hardest place to get an internship in. And then they did the fellowship in Sloan Kettering, one of the best places in the world for many different cancers, for example. So if you go through that funnel, we know that the doctor has to be qualified. And then we are looking at the PubMed, we are looking at the research, how much research a doctor has done, is it relevant for you? And then we are also going and looking at doctors referrals. So that's data that we got from the Medicare about a year ago and we've been working heavily on being able to extract information out of it. What it means is you would like to go to a doctor likely who is referred by other good doctors. So because we know the data now, we can actually do the analysis and all this work we have done for you, so you don't need to worry about it anymore, you can do it yourself, but it will take you weeks and weeks.

Gotcha. Now what about for example, I noticed that you have a blog post about this on your website. So this is why I want to ask this things that might influence a doctor negatively. Like the title of an article on your site is called Cities where Big Pharma Pays Doctors the Most in a situation like that. First of all, how did you get that data? I'm curious if that's just public, where big Pharma pays the doctors the most. And then can you expound on what you go into in that specific article about how much Big Pharma pays specific doctors?

Yeah, so I think like you were referring to the Affordable Care act in the intro already, it has done some things that are not ideal, but what it has done, very positive, is that More data has been opened up. We have seen more transparent on things like this specific study and a website where the payment data is now openly out there for the public to see. So which health care companies and big pharma companies are paying for the doctors for medical trials or paying for speaking sessions and so forth? And that data is now publicly open. It's not complete, it's about 100,000 doctors. But it gives a great indication on who are the doctors who might be prescribing you, let's say certain pills, because they were getting paid from the big pharma. And this is, I think, a fundamental thing that will open up the healthcare and the debate when you actually can see these underlining influences. And some of the doctors actually on our study that we published, they got paid a lot. I mean, they get paid thousands and thousands of dollars. So are they making.

What do you mean? Just like paid straight up cash?

No, you can't of course get cash directly, but it could be you go to London and do a speaking gig and get 25,000 for that.

Okay, gotcha. Now what about gifts? Can doctors get gifts?

It's getting very, very tight. So it used to be 20 years ago that doctors were getting gifts left and right. And now the medical regulations and other regulations have been making it a lot harder to accept anything to a level that if you are working at Kaiser, for example, in California, you can't even have a lunch. I mean, I meet a friend of mine, a doctor, I can't even buy their lunch because I'm in the industry. And it would be seen as a conflict of interest.

Okay, gotcha. So if I go to betterdoctor.com and I'm looking for a physician, is that something that's taken into account? Am I able to see that if I select a doctor, like, hey, I wonder, has this doctor been paid by big pharma?

That's a great point. So why we do these studies and why do we do this blog post? And we constantly try to open up more and more data to the patient. So when we do something and people get excited about it, then we are asking always, do you think this would be valuable and enough to be on the doctor profile? If they say yes or enough people say yes, then we're going to put it there. But we also have a problem of the user experience side. There's so much information on doctors already that if we put all of that in one place, then you will get confused. You don't know what to look at.

Gotcha. Okay, so as Far as selecting a doctor, you've got this doctor search engine. What if I have a specific type of insurance? How do I know if my insurance is going to cover the the specific doctor that shows up when I go and search for a doctor? On your site?

Yeah, on the site and on the apps, you can select your health plan. We're covering about 80% of the market today. Why not 100? It's a good question. So today there are about 1500 private insurance plans in the country and you can add on top of that all the new Obamacare plans. And we are getting to roughly two and a half thousand altogether nationwide. So just knowing everything behind those two and a half thousand is going to be monumental task. And we've been working that for three years and we got to 80% today. But basically what you can do, you select, let's say UnitedHealthcare and your PPO plan and you're gonna see the doctors nearby who will accept your insurance.

Okay, gotcha. Now what if I'm a doctor, can I go to your site and like pay to have a featured ranking or something like that? I mean, are you monetizing the side of things for doctors as well?

Yeah, so the doctor. So what we do really on the monetization side is a little bit, you know, separate from the website. So the website is really a system where it's completely open in a way that only the doctors who are high quality are listed on top of the list. Every doctor, they can go in and claim their profile, edit their information, but that will not impact on the ranking. So we try to be completely neutral on the way how we recommend doctors.

So it's not like, is it like ebay or Craigslist where a doctor could like pay to have a featured listing or something like that, or does it just list them basically according to patient rankings?

It's really basically listing everybody based on the better doctor ranking, not the consumer ranking, but the pedoctor score that is based on the experience educated and the referral score and so forth. And we also work with number of doctors on, on the other side of the business, which is helping them to have a better mobile and web presence. But that doesn't really link into the better of the website.

Okay, gotcha. Now how about health insurance? It looks like you have something called an insurance radar. How does that work?

Yeah, so I mean, we've been trying to doing this again, another open transparency idea we had and we have a lot of data on doctors. We have doctor ratings for every doctor in the country, more or less. So we started to look at in a way that, which are the health insurance plans that have the highest quality doctors in them. So I think we're first ones to open up a view into, let's say, your United Healthcare plan and seeing if they have high end doctors or not. And we compare these different plans together and kind of surprisingly found out that all the big healthcare networks have almost the same doctors in them. So if you pick, you know, United Healthcare, Aetna, Cigna or Blue Cross, you're gonna have the same doctors, more or less, some very small variance. But then if you look at the Medicare, for example, suddenly there's a huge difference. You know, the Medicare only, only has about one third to one fourth of the doctors. So this is something that we are again asking from the consumers, do you like this? And if enough people say they like about it, we're gonna make a real tool out of it and we're gonna put it as part of the doctor profiles.

Okay, so like Blue Cross Blue Shield is my health insurance plan. And when I use your health insurance radar, I can see like the state of California. 17% of the doctors in California who accept Blue Cross Blue Shield are rated as good doctors by better doctor. Like they're highly rated. So California shows up as a dense state. But then when I go up to say like Idaho, 7% of primary care doctors in Idaho who accept Blue Cross Blue Shield are highly rated. And again, just remind me, when you're looking at ratings, you're primarily looking at the number of procedures the school. Is the algorithm pretty complex when you're looking at how you're going to rate a doctor?

Yeah, complex. And why do you see, it doesn't really mean that necessarily that Idaho has the worst quality doctors. It could be the case, but it means more that we haven't get enough data from Idaho. I mean, of course California has a little bit better transparency on the government side than Idaho in this case. And there's more data online. What we do, we try to collect all the data in one place. And it could be that in Idaho, for example, some of the data is still in PDFs sitting in a corner of office. We can't access that very easily.

Okay, gotcha, gotcha. Now what about differentiating between like alternative medical practitioners, like a naturopathic doc versus a Western allopathic doc, let's say. I, you know, a lot of our listeners, like, they want a doctor that doesn't necessarily think inside the lines of popping pills and doing surgery, for example, and they want someone who focuses more on natural medicine. Is there a way to differentiate between those type of things on the site?

We are just at the moment working on adding about 300,000 more specialists. And I believe we are also adding now a specific way to look at naturopaths and also acupuncturist and I think even massage therapists. I need to verify that. But now we are finally adding the more alternative side of medicine. People been asking us a lot, and I'm personally a big believer in holistic medicine. What I see the most important thing, especially if you have a primary care doctor, you need to find somebody who thinks like you do, somebody who can help you to navigate with your health, being like a health coach or health consultant for you, and somebody who can actually be with you for a long time. The worst thing that happens is that you have a primary care doctor that you only see once or twice, and then you change to another one. It's like going to a barber or something. You don't want to have another barber every time you go, you're never gonna get a nice hairdo. Same applies to healthcare in my mind. So a lot of people ask us and we try to provide also access to the more holistic alternative medicine.

Gotcha. Now, what if you want a specific medical procedure? Like, let's say that I know that I need. Gosh, I'm just gonna, like, pull something out. Let's say I know I need a medial meniscus surgery on my knee. Is there a way for me to say, okay, this is what I think I need to have done? How can I figure out which doctor is gonna be the best doctor if I want to go to the guy who's done more surgeries than anybody else for this specific issue?

Yeah, this is the huge new feature that we are, we are rolling out. And you can go to the website, very bottom of the footer. We have access to procedures. It will be more prominent there in a moment. We have now listed the hundred most common procedures, and you click any of them, you will find the list of doctors who are doing that procedure the most often, who are highly qualified, rated by us, highly rated by patients. And you can also see the price in Medicare. That price is something that you will probably have a different price if you have a private insurance plan, but the price gives you indication if this doctor is very expensive or if the doctor is less expensive. And this is the first time ever this data has been publicized in this way. And I mean, I sold this to everybody and they're like they're blown away. They're like, wow, this is what the transparency looks like.

Is that the price map feature? Is that what you're referring to?

No, it's another one. If you go on a website and you go on the very bottom of it today, it says procedures in the footer. It will be on the front page and front and center in a moment. But we've been testing it out for a couple weeks and the feedback has been phenomenal.

Yeah, I see that. I'm looking at it right now. Okay, so if I click on, say, like, let's just go with something relatively harmless like bunion surgery, it says the average cost of bunion surgery is 3,796. So it shows the average cost, and then it shows the average number performed by a doctor per year. Okay. And then it shows the top doctors. And then would this allow me to, for example, search in my area for whichever doctor is best qualified to do bunion surgery in my area today?

It will automatically go to your area. If we find enough doctors. I think we have a limit of about 20 doctors in your area. If you find that, then you're gonna go to your city and in your locality. I think in your case, you might not have enough bunion doctors in your vicinity. So that's why you are seeing the nationwide.

Yeah, but I can see, like, for example, if the average cost is 3,796. For example, there's one doctor on here who has performed more bunion surgeries than anybody else listed. Looks like Stephen Howell in Wichita, Kansas. He averages 19 bunion procedures. I don't know if that's per year or the total number that he's done, it looks like per year, but he's at 2,331. So basically, he's charging $1,400 less than the average cost of a bunion surgery versus good old Chad Altmeyer in Columbus, Missouri, who's only done 14, but who is charging 4,295. That's really interesting. So that. That's what they're going to be billing your insurance, you mean?

Yeah, that's the least price that your insurance is paying. And of course, you know, the price that you. You cannot pay might depend if a high degree of plan you pay. You know something, if you have a PPO, you might pay 40 bucks. So it really depends in the end. And that billing is such a messy area because we never know how much we're going to pay. And even the doctors don't know. So you Are very frustrated when you go and ask how much I'm going to pay. Nobody will know. Nobody can give you the price.

Yeah. Well, it's kind of cool, though, because you've also got Yelp reviews from patients who have actually worked with some of these doctors. You're pulling in. You have like an API to pull on things like Yelp.

Yeah, we work with Yelp and get the data in. And we are now actually starting to work with a lot of other people also on the quality metrics side. And this is the thing. I mean, we want to compile all the information in the one place so we can help you to make a good decision. And funnily enough, I was just in a big healthcare conference in Chicago and a lady came to me and we were looking for this specific thing, the bunion. She was looking for a doctor, and I was able to show her the best doctors for this procedure in Dallas. And she was so happy about it. She had been looking for a week already. So she was like, wow, this is amazing. I had no idea this exists. So there is a huge value. And now what we are trying to do, and I would love to hear feedback from listeners on how to do it better, we now have the data. So how do we package the data in a way that we can help you make a better decision?

Yeah, gotcha. Now, is this related to the price map as well, or is the price map something completely different?

Price map is basically the same data that came out about a year ago, but that wasn't yet on a doctor level. So we looked at the same procedures and we looked at them on a hospital level. So, of course, you know, we have the doctor ratings. We have also built a hospital rating, so we can look at how highly are different hospitals rated, and then you can look at the price difference. And we looked at things like hip replacement, and the cost can be $70,000. And we found out that if you do it in San Francisco, you're going to pay 80,000 bucks. And if you're going to go to Midwest, you actually might end up paying 25,000 bucks. Think about if you really are out of pocket paying that, you could go and live like a king in Dallas for two months and have a funnel there and still save money. So there's a huge difference in price. And the quality in this case was the same. The Dallas hospital was really good. The one in San Francisco was also very good. So you don't sacrifice quality, but you pay about four times less or three times less.

Yeah. Now, what about International, obviously, like international medicine, travel medicine, that kind of stuff that's getting big these days. Are you guys just looking at the US right now?

We are only in the US and I'm getting a lot of questions coming from other countries on could they use our data because there are also a lot of people in Europe and elsewhere who want to come to the US and understand the price is better. But I think medical tourism is going to be huge. I mean already now a lot of people are flying to Dallas from the western state and southern states to Mexico and doing cosmetic surgery, dental surgery. I think it will be a lot more that we're going to see in the future. And you have now aspiring places like in India where you can actually have certain eye operations done with the fraction of the cost, with high quality. And why is that? Because they specialize. They only specialize on a few things and they do them better than anyone else. The doctors actually are educated in the US in the top schools and they are using the latest equipments that are hardly used in the US So that will be very interesting way to look at it going forward. What if you can go and save money and also have a holiday along the way?

Yeah, exactly. I know a lot of people when I go to Thailand, they go there to do medical tourism in Thailand. It's honestly a lot of sex change operations and stuff like that. But that's besides the point. What I'm trying to go after here is that the hospital rooms themselves are like these five star hotel rooms that are amazing concierge style experiences compared to what we experience here in the U.S. so yeah, I'm on the same board with you. Medical tourism seems like absolutely, like it's absolutely going to explode. Especially if medical care degrades at all in the US So what else is planned for the site as far as things that you want to build out in the future?

I mean we have a pretty amazing year ahead of us. So we already been releasing these things like the procedure data. We're going to expand that to cover all the procedures, not only the hundred most common ones. My idea of the vision in the beginning was really to be able to help doctors find the right patient and also other way around. So how can we match make you better to the right position and also get the doctors right kind of paces because then they're going to be happier. It's a win, win. A couple things we're working right now which are interesting. We have about 10,000 doctors already with online booking on our platform. We are expanding that to be far more before end of the year so you can actually book online and without worrying of making a phone call. We're also working with telemedicine providers, so I believe that in many cases you could have a call to a doctor over Skype instead of going to visit them because the visit takes a ton of time and it's really not always needed in many cases. I think the biggest thing we are doing this year that I'm really thrilled about, we are expanding the service via APIs so we actually have a developer site where other people can use our data to build better apps for themselves. And we already have 100 companies who have signed up in the last few months and this will probably have a bigger than even our own website can be in the end because we are giving this data, we are giving the better search for other people to implement on their apps or websites.

Right, Gotcha. Interesting. Okay, cool. So betterdoctor.com and does the app cost anything by the way?

No. We are going to want to keep it always free for the patient and as long as we can also free for the doctors. So this will be the very independent transparency site that you can go on and always find the best doctors, not only the doctors who pay.

Okay, gotcha. Well, I'm going to put a link to all this stuff as well as previous articles that I've done on with some of my physicians here locally and everything else we talked about over@BenGreenfieldFitness.com BetterDoctor so if you're interested in grabbing this app for your phone or surfing around the website looking at specific medical procedures, insurance plans or doctors in your area, it's actually a really cool resource. So Again, go to BenGreenfieldFitness.com BetterDoctor to check this out. Ari, anything else that you want to share with us here?

I think I've been on this thing for a while and one thing that I feel very heavily on is that we have still too few people who are coming to healthcare and trying to make a difference. I mean, I meet all the time young kids who are coming to the Bay Area, founding a new company around, let's say photo sharing or games or whatnot. And very few of them are thinking about healthcare. And I'm an outsider. I came to healthcare not knowing much about it. And we are able to build a company that has staying power. So we are writing actually a book right now about the topic of how do you build a company? How do you make a difference in healthcare? We've been interviewing opinion leaders and leaders overall and also patient advocates and researchers. And we're going to tell the story on our book that comes out fairly soon. And the idea is to inspire other people to come to healthcare and start innovating because we really need more help. We need to have smart young people in healthcare building new companies.

Yeah, interesting. What do you know what the name of the book is going to be called?

We're going to call the book Quest for Better Care.

Okay, cool. Cool. Quest for Better Care. I like it. All right, well I'll make sure that I link to all this information over@BenGreenfieldFitness.com BetterDoctor Ari, thanks for coming on and sharing this stuff with us.

Hey, thank you Ben. It was great.

All right, folks, this is Ben Greenfield and Ari Tula signing out from BenGreenfieldFitness.com BetterDoctor have a healthy week. Visit BenGreenfieldFitness.com for even more cutting edge fitness, nutrition and performance advice.

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