This is maybe a little bit off topic, but I am glad to see that Doctors on Demand would be doing general medical house calls in the US. This seems like a good idea, I hope it spreads.
I don't live in the US myself, but I've always wondered why doctors doing house calls was a UK thing but wasn't a North American thing, even in Canada.
Are there real obstacles preventing doctors from making house calls in the US, or is it just tradition to "go see your doctor" instead of them coming to see you?
I've never heard of house calls in Scandinavia either, unless it's strictly necessary (immobile elderly patient, etc.). It takes more of the doctor's time, therefore is more expensive, and generally we don't want medical care to get more expensive when it's possible to avoid it. For example a typical GP in Denmark sees 6 patients per hour, which seems difficult to do with house visits unless the patients live in the same building or something.
In Finland, at least in Helsinki, they have a "home hospital" system (http://www.hel.fi/www/Helsinki/en/socia-health/health/hospit...) for "patients who do not need the services of emergency units or specialist care". In case the patient is "healthy" enough to go home and has somebody to look after him there, they arrange for a nurse to visit e.g. even four times per day, to give meds, provide IV, and even take blood tests. Also sometimes a doctor visits the patient, though not as often as the nurses. Staying at the hospital is very expensive (for the country), so I have heard that the outpatient care ends up being cheaper.
Lets say a doctor charges $1,000/hour and each trip takes 20 minutes, plus 10 mintues to egress a building and parking garage/pick up a taxi. The overhead for a single visit is...$1,000 give or take...
You can adjust the numbers around a bit but the point remains the same unless you radically change the transit time and the wage by a factor of 10.
Couldn't the price of a house call just be increased to account for this?
Or rather, a health care system where visiting a doctor is free, but house calls are only included in the health care plan if your have a disability that restricts your movement, allowing you to pay for house calls out of pocket if you chose to.
You said it'd have to change by a factor of 10, but your estimation of a GP's salary is off by at least a factor of 10 - $100/hour would be a much more reasonable estimate. A bit high, even. http://www.bls.gov/oes/current/oes291062.htm
This makes the assumption that home visits are the same level of productivity as office visits. For the elderly, infirm, those who work during normal doctors' office hours, etc., home visits might reach a population that isn't getting good care currently.
Well, here's the thing. I'm not actually sure doctors will be out of the mix with legalization on the horizon. Because to expand the cannabis market and poach alcohol sales - you could have doctors vouch for cannabis & cannabis-infused products as remedies for common ailments (when is the last time a doctor did this for a brand of vodka?)Think Mary-Kay - but for doctors who endorse weed. This market is going to be a lot bigger than I think anybody realizes.
Actual legalization would kill this industry. In Washington and Colorado (states which have actually legalized, not merely implemented a medical system or decriminalized) there is no need to see a doctor first. You just walk into the store, show a photo id to establish your age, and hand over cash.
It's my understanding that under the WA system, some things still require a doctor's recommendation.
EDIT: A recommendation increases the amount of marijuana or marijuana-based product one can legally possess (strictly speaking, it offers an affirmative defense for people possessing more than the amount authorized by I-502).
These sort of "house call" or "doctor-on-location" weed businesses rely on people trying to get high that day. I find it incredibly hard to believe that they could be sustained by people who want to remain legal while owning more than an ounce of weed (a rather large amount of weed for all but the heaviest users...).
If it is merely a matter of keeping more than an ounce legally, the urgency is all but gone, and with it the advantage of the house-call system.
Also I sure as hell wouldn't start a business based on the current state of medical marijuana in Washington state; the system will likely be gutted and reworked relatively soon. Furthermore states that legalize in the future will likely follow Colorado's example more than Washington's.
I think one of the remaining advantages of medical marijuana in WA and CO is that it is significantly cheaper than recreational, because no tax is applied.
Medical cannabis still exists in Colorado. You can still go to a doctor and get a recommendation, and many dispensaries will give a discount to qualified patients.
In CO, buying MMJ still requires a medical card. If you go to a medical/recreational dispensary without a medical card you can only purchase recreational MJ, which tends to be sativas or hybrids while medical tends to be indicas and indica hybrids.
There are also different tax and quantity rules around MMJ in Colorado. Medical card holders pay 2% (I think) tax while recreational pay over 20% tax. Medical card holders can also purchase 2oz at a time while recreational users can only buy an ounce at a time. Medical card holders can also grow twice the amount at home than non-card holders.
Until there's no differentiation between medical and recreational MJ, there will still be a need for doctors who are willing to fill out the paperwork for medical cards.
Stores and the law are set up as if there is a real distinction between recreational and medical cannabis. It's sort of silly because it is all the same strains, grown by the same people who are growing it for the black market 10 years ago, or still may be. There are some legitimate true medical strains, like the ones high in CBD or CBN. As far as your standard cannabis though, the goals of people growing your average medical cannabis are exactly the same as the recreational… Make it as potent (high THC by weight) and flavorful as possible. At this point stores use the quality and price difference to try to encourage you to sign up through their clinic service, which they make money from. Medical in CO is about like a club you buy into.
Here in Colorado, the best thing to do is to still just go to my friends house, where I can get an ounce as good or better as the highest quality medical available, for 50 or $100 less with no government involved - just like 10 years ago but cheaper and higher quality.
What bunkydoo is saying, is that doctors touting cannabis may still be a thing, because it's legal to tout cannabis as a health product. Which is an interesting thought, because doctors totally used to do that with alcohol and tobacco.
People making house-calls selling knives is also still a thing, but I wouldn't recommend getting into that business. The business existing doesn't mean it is a smart business to get into.
The high-availability-doctor/one-stop-shop variety of weed business relies on loose medical laws but draconian recreational laws. Recreational users don't want to shop around for a doctor to approve their "condition", so these businesses do very well for themselves. Legalization, combined with regulation of medical, will remove a large segment of these businesses target audience.
Some people seem to think I am saying that medical marijuana will go away. I am not. I am just saying that these "convenience businesses" cater primarily to recreational users in markets with draconian recreational laws. Those people are their bread and butter.
Do you think that Florida's infamous "pill farm clinics" would still do well if you could buy Vicodin over the counter in 7-11's? Doctors would still be prescribing Vicodin because it is a useful medication, but would those businesses that specialize in getting prescriptions for middle-class addicts stay in business?
I think you're missing the point entirely. It's that marijuana will be sold recreationally, under recreational law, but with the guise of specific medical or "wellness" benefits as a competitive differentiator. Much like nutritional supplements are legal, but there are still doctors who make money promoting them because the endorsement stimulates demand for that particular product vs. its otherwise indistinguishable competitors.
And the reason that we're likely to see this for marijuana, is that there is now a well-established narrative that marijuana is chock-full of health benefits. So people (the sort who are wealthy and anxious enough to eat organic and "natural" and question "traditional medicine") are going to be likely to buy into that sort of doctor endorsement to make them feel better about their recreational drug habit. And the market will provide...
To reiterate my lead in a different way, this has nothing to do with doctors writing prescriptions for medical marijuana.
I find it interesting that YC and other significant investors/players in the startup space to be investing in a product that still remains illegal in the United States. It's still a schedule I drug.
I think the floodgates have opened towards full legalization, but for VC/Investors/Accelerators to invest in a company who's product is illegal -- that's bold. Good for them!
Perhaps it's just because I live far from the valley and have never used Uber, but I had to scan the article repeatedly to figure out what the headline meant.
(No, I didn't read it, I simply scanned, I stopped reading after the first sentence. If you cannot bother to tell me in the first sentence why I should continue, I don't. And telling me you visited a website doesn't tell me why you did so. Whatever.)
What does it mean, you ask? That the company described has struck a deal with local physicians to perform on-demand evaluations for medical marijuana prescriptions.
A better headline, less link-baity, would be "Meadow (YC W15) hires doctors for {just in time|on demand|favourite term here} medical marijuana evaluation.
But that wouldn't be as sexy as uberizing, now, would it?
I almost gave up after your own first sentence. Your post could've been simply this:
A better headline, less link-baity, would be "Meadow (YC W15) hires doctors for {just in time|on demand|favourite term here} medical marijuana evaluation."
I don't live in the US myself, but I've always wondered why doctors doing house calls was a UK thing but wasn't a North American thing, even in Canada.
Are there real obstacles preventing doctors from making house calls in the US, or is it just tradition to "go see your doctor" instead of them coming to see you?