When it came to my primary healthcare, I had a charmed life during my time in New York and San Francisco. In New York, where I lived for more than 20 years, my primary care doctor was Harry Lodge, a distinguished Columbia medical school professor, a best-selling author, and the doctor of choice for New York’s best doctors. Ask anyone in the know to name New York’s top healthcare facility and they’ll tell you New York-Presbyterian. Many of the hospital’s medical professionals were Lodge’s patients.
Lodge was a modern day Marcus Welby, the caring and knowing doctor featured in the 1970s television series. Lodge personally escorted his patients from the waiting room, and before examining them, talked to them in his office to get a sense of what was going on in their lives. Lodge, who died of cancer two years ago, was a big believer in the mind/body connection. He also was a big believer in fitness, and he was a proponent of alternative forms of medicine, such as acupuncture. Despite his prominence, he always returned emails promptly.
In San Francisco I experienced Stanford Health Care, which is to healthcare what the Four Seasons is to the lodging industry. Stanford’s modern and sun-drenched facilities in and around Silicon Valley are so technologically advanced that I’m only slightly exaggerating saying I’d received my test results while the phlebotomist was still drawing blood. In addition to providing world-class medical care, Stanford places considerable emphasis on the entire patient experience, including how one is greeted and the responsiveness of doctors and their support staffs. Stanford consulted with Ron Johnson, who oversaw the development of Apple’s retail stores, in designing its futuristic hospital that opens on Sunday.
My Stanford doctor was Kurt Hafer, who is involved in numerous groundbreaking hospital initiatives and is now medical director of Stanford’s concierge and executive medicine. Silicon Valley’s wealthy pay more than $5,000 a year up front to access Hafer’s knowledge. I benefited from Hafer’s superb care when he treated peasants with crummy PPO insurance.
So, when I moved to L.A. four years ago my primary care expectations were unusually high, even by Starkman Approved standards. I wanted a doctor affiliated with Cedars-Sinai because I mistakenly assumed it was the best local hospital given it’s where Hollywood celebrities go for their critical care. In fact, UCLA Hospital ranks even higher.
I quickly learned that Cedars is light years behind Stanford on the administrative side of patient care. On multiple occasions I visited a Cedars affiliated doctor where the front desk person asked me for ID and proof of insurance without ever looking up. I suspect Cedars’ doctors benchmark their practices against Motor Vehicles, but even DMV employees make eye contact.
I stumbled upon One Medical doing an internet search for a doctor who was available for a same-day appointment to treat a virus I thought needed antibiotics. The company, a fast growing primary care chain that is beloved by Google employees and other tech geeks in its home city of San Francisco, is concierge light: It charges an annual $199 “membership” fee, which gives you access to its medical offices in San Francisco, Los Angeles, San Diego, Phoenix, New York, Boston, Chicago, Washington, D.C. and soon Atlanta.
One Medical’s management is decidedly among the most impressive in the history of U.S. healthcare. Amir Dan Rubin, the CEO, is the former CEO of Stanford Health Care; under his watch, the hospital network garnered the highest patient experience and quality scores in the nation. Several of Rubin’s lieutenants also worked at Stanford Health.
One Medical is redefining the primary care patient experience. The company’s waiting rooms are brightly lit and have a spa-like feel, replete with fruit-infused water and comfy couches and chairs. There are no televisions blaring or intrusive drug infomercials on monitors. It would be a waste of money because there’s no one to watch them. Among the benefits of One Medical is that patients are guaranteed to be seen within five minutes of their scheduled appointment. In the three years I’ve been using One Medical, I’ve never seen more than one person in the waiting room.
My first One Medical experience was a disappointment. The millennial doctor I saw in the Beverly Hills office seemed reasonably competent, but his failure to respond to a critical email about a drug interaction concern for more than two days blew his credibility. I called One Medical asking for a refund on my membership fee.
The San Francisco-based woman I spoke with was extremely professional and without hesitation said she would refund my money. But she made me an offer I couldn’t refuse: Although Bruce Olmscheid, then the company’s medical director for Los Angeles, was no longer taking new patients, she would override the restriction and assign me to him. She also would waive the membership fee for the first year. I was impressed by the woman’s determination to keep my business and that she had the authority to exercise her best judgment on how to do so.
Olmscheid is well credentialed: A graduate of his home state University of Minnesota, Olmscheid in the 1990s directed the HIV education and training program at St. Vincent’s Hospital in the heart of New York’s West Village, where the AIDS epidemic was most pronounced. He also served eight years as the Director of Medical Affairs at Gilead Sciences, a leading biotech company.
The first time I saw Olmscheid it was instantly obvious why he has only five-star reviews. He is a warm and caring Midwesterner who listens intently and asks insightful questions. Olmscheid clearly loves practicing medicine and he commands trust and engenders confidence. I’d defer to his medical judgment literally in a heartbeat.
Olmscheid has a good eye for medical talent. One of his Beverly Hills hires is Michelle Grotz-Rhone, who did her residency at New York-Presbyterian and was extremely knowledgeable about a rare pelvic ailment that often is treated with unnecessary surgery. Another A-list hire is Jackie Yaris, who did her residency at Cedars-Sinai. A fitness advocate, Yaris provides volunteer medical care to L.A.’s homeless and goes on regular medical missions to Guatemala and Nepal. (A word of caution: Yaris isn’t what one would call a warm and fuzzy doctor.)
I recently went to see Yaris for a foot pain issue, but she astutely detected a medical issue that troubled her more. And therein lies the limitations of One Medical’s model. Yaris was correct that the issue she observed was more critical and required immediate treatment, but my allotted time wasn’t sufficient to investigate the foot problem.
Only half the medical professionals in One Medical’s offices are doctors. The rest are physician assistants and family nurse practitioners. PAs and FNPs are well trained to treat routine medical conditions, but it takes a very experienced doctor like Yaris to diagnose a condition a patient doesn’t even present. One Medical charges the same fee regardless of whether you see an MD, PA, or FNP.
One Medical offers some great benefits, including 24/7 online access to a medical professional. I used the service once in the late evening and was surprised by the speed and detailed quality of the response. Another great benefit is that if you need a prescription renewed off hours or on the weekend, One Medical has someone available to take care of it. Olmscheid has referred me to some outstanding Cedars specialists; the company has an affiliation with the hospital. One Medical accepts most insurance plans, including California Blue Shield’s virtually useless Silver PPO.
One Medical’s model frees up doctors from the time-sucking unpleasantness of dealing with insurance companies and gives them the flexibility to work part time, which many seem to do. The downside is that they must adhere to time efficiency standards much like Amazon’s warehouse workers. In fairness, most primary care doctors can’t afford to linger with patients so One Medical’s patients possibly are getting more primary care attention than they would from a sole practitioner.
Scaling a national chain of medical offices of the quality of One Medical’s L.A. area operations is a formidable challenge. Finding top-flight doctors who also have good management and people skills won’t be easy. I’m guessing that’s why One Medical recently transferred Olmscheid to San Diego to launch the company’s operations in that region.
I visited Olmscheid last week in San Diego and was impressed with the operation he’s already got up and running. It speaks volumes that several people from the Los Angeles region followed him there, including a phlebotomist extraordinaire named Toni, who can draw blood without you even knowing it. Another transfer employee is Gina, who works the front desk and clearly loves working for One Medical. She instantly knew the name of the company’s CEO and volunteered that he’s a “rock star” and “everyone at the company loves him.”
The Ginas of One Medical determine patient first impressions. It’s rather extraordinary when a front-line person feels such a strong personal connection to a company and its CEO, particularly in the healthcare industry. Rubin obviously appreciates this, which sets him apart from his industry peers. That’s why I’d bet on One Medical’s success – and I’m not a betting man.