One Medical S-1
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If you actually want good medical care, over your lifetime, your best bet is to build a strong relationship with a good doctor. If you also want to never wait, concierge medicine is where you ultimately need to be (doctor is trading off a higher volume of patients for a fee to a small number of patients).
Hmmm... never would have guessed that. In my experience, the One Medical doctor that my wife and child see is excellent. I've met him and think he is great. A colleague is also extremely pleased with her One Medical doctor.
Maybe you just had bad luck with your doctor selection? I don't mean to invalidate your experience, but it certainly varies from my experience.
The worst graduate in a medical class is still a Doctor somewhere...
This is probably the same feeling business guys have about engineers...
If you were on an antibiotic for strep throat, finished your course, and then asked your doctor for more of it without any symptoms, should they prescribe it again? You wouldn't cause grave harm (unless the aggregate risk of super resistant bacteria counts).
All of this shouldn't be conflated with patient centered care, though. I too agree that the patient should be in charge and the doctor should be there to support. But it shouldn't mean that doctors have to do whatever the patient asks of them.
I'm taking about stuff like modafinil, for example.
It's hard for the average person to know if their doctor is doing a good job until something goes wrong and it's too late.
My doctor now is excellent, he's excellent because he actually listens to what I'm saying. That doesn't mean he always agrees with me, I would hope he doesn't! But at least he is paying attention. Many other doctors seem to go into a keyword search mode when listening to patients. It's the difference between reading a page thoroughly and skim reading it.
One Medical removes some friction from the overall system, which as a non-American I find incredibly frustrating.
There is significant amount of doctors providing mediocre quality services in US (and given the developments like the rise of AI there will be even more of it). What does economics suggest you're to do with mass amounts of cheap low quality goods? Fastfood it. McDonalds for medical services. If that is what One Medical really does, then we have another Uber/AirBnb/etc.
>If you actually want good medical care, over your lifetime, your best bet is to build a strong relationship with a good doctor. If you also want to never wait, concierge medicine is where you ultimately need to be (doctor is trading off a higher volume of patients for a fee to a small number of patients).
Yes, good restaurant with star chief and great ambience where you're a valuable regular ...
Most of the value of one medical was the easy app based scheduling, but since I've realized that something like zocdoc exists, most of it's value has disappeared for me.
Also they don't integrate with things like apple health, while larger hospitals tend to have integration built into them.
Because of that, I'm not very bullish about one medical overall, since a combo of zocdoc + apple health provides most of their benefit, with an expanded set of services available with a set of doctors that are larger than what one medical would provide.
The primary care checkups were nowhere near as thorough as ones I've had with one-off doctors. The only benefit that I value that they provide to me is the ability to schedule appointments online, but I frequently find that it is more and more rare to find an open slot the day of (or I have to travel way further across town than I would like, with degree of urgency affecting how eager I am to do this), and many practitioners seem booked 1-3 weeks into the future. With such full scheduling, sometimes I just end up going to a local chain of urgent care clinics instead and usually see someone within 30 minutes or so.
“ For the year ended December 31, 2017 and 2018 and the nine months ended September 30, 2018 and 2019 (unaudited), the Company had customers that individually exceeded 10% or more of the Company’s net revenue...For the nine months ended September 30, 2018 (unaudited), individual customers accounted for 15% (Customer A), 12% (Customer B), 10% (Customer C) and 10% (Customer E) of the Company’s net revenue. For the nine months ended September 30, 2019 (unaudited), individual customers accounted for 14% (Customer A), 12% (Customer F), and 10% (Customer E) of the Company’s net revenue.”
“Certain of the Company’s investors are also customers of the Company. The Company recognized revenue under contractual obligations from such customers of $2,112 and $22,273 for the years ended December 31, 2017 and 2018, respectively, and $15,984 and $19,801 for the nine months ended September 30, 2018 and 2019 (unaudited)”
Sounds like they’re beholden to a handful of entities for the next year or two as they scale out.
Edit: My question is what caused these corporate customers to churn? Did they maintain spend levels with One Medical while the other customers grew spend? Did they decrease spend below reporting thresholds? Did they stop using (or sponsoring) these services entirely?
Elsewhere in the S-1:
"In 2017, 2018 and the nine months ended September 30, 2019, our top customers accounted for 42%, 37% and 36% of our net revenue, respectively. These customers included Google Inc., which accounted for 10% of our net revenue for 2018 and the nine months ended September 30, 2019."
(Disclaimer: I work at Google, and they do pay for my One Medical membership.)
I've been confused how they're able to do this and not charge more than they do (only $200 a year).
I one time showed up 2min late and they sent me back home, that is when I knew they were the real deal. I'm so glad they did, because 1. I was never late again, and 2. I know they wouldn't be late for me in the future.
I think many times when doctors are late, it is often because
0. They have a cascade of latenesses with really just a single early appt that is actually late causing the domino of late starts and hence ends.
1. They have a patient come in late or w/o appt, cater to them or "squeeze them in"
One thing OMG has going for them is the generally professional clientele -- many of the clients dont want to arrive/leave later either, so that is good for everyone.
But yeah, I use One Medical and it's amazing. For primary care, they really respect your time like none other.
For most primary care practices i've used, lateness is expected and there is no design or system.
For OMG, lateness is unexpected and designed out of the system.
They are just much nicer to use than some alternatives.
Curious how this will all play out.
Been thinking about my current medical care and wondering the advantages
Their online platform is very UX-focused. The app is nice and easy to use, and makes things like firing off a quick message to your PCP for an Rx refill super super simple. My old primary care doc had nothing of the sort. It was the old 1990s way of doing things. Try to get scheduled... by phone... a month out... for a refill of a skin cream I've used for 20 years. I get that they want me in yearly, but that's inconvenient and annoying.
OneMedical's practice management/online tool for patients makes scheduling dirt simple. Their offices are REALLY nice. It's a little touch, but it's trying to raise the bar on that. And they offer their own teladoc services as well, which are then obviously integrated into their EHR for your PCP services, so everyone is on the same page.
OneMedical tries to combine PCP with some urgent care services, so they have a same day component, as well as some specialty services.
Just a lot of small but meaningful ways in which they're better than a traditional PCP office. They're also apparently offering practice management and holiday support for existing practitioners, which is interesting from the perspective of the S-1. If their EHR/PMS software is as nice as their app, I imagine that's a welcome change.
However, if you’re not keeping your own tabs on your, or someone you love’s, health, it’s easy to fall through the cracks. I wish they would improve on actual active management of subscribers‘ health. I’ve had or discussed many experiences where people expect follow ups that never come. Have an uncommon condition? Make sure you keep bugging someone to schedule the visits and lab work you need to maintain good health. With a $200/yr subscription on top of any insurance you pay I feel like these type of maintenance tasks should be handled for you. It feels more like each visit is an IT ticket/case which gets resolved shortly after your visit. It would be nice if it felt more like One Medical were managing a personalized care plan for your health profile.
I probably assumed OneMedical did more of this than it intends to based on previous experiences and the subscription fee. Like I’ve had good care, nice offices, etc. in the past why should it now cost $200/yr?
For One Medical, it’s super easy to stop by for a 10 minute “something isn’t quite right” appointment, last minute travel immunizations, etc, and, at least in NY, it’s likely there’s an office within 10 mins of where I’m going to be in the city that day.
I think a specific practitioner makes a lot more sense if you’re often sorting out several long-term issues and having a long-term affiliation with one specific practitioner is important, but if you’re a yuppie in generally good health where you’re mostly looking for annual physical, and fantastic availability for quick “I’m sick and may need a prescription” visits and std tests and such, One Medical is perfect.
For my shoulder injury they sent me to their sports medicine doctor, who was not only rude and rushed, but told me I was fine just common tightness in shoulder. Was still in pain for a year until what I consider a real doctor correctly diagnosed it as a mild shoulder dislocation. Thanks One Medical SF.
If you have money to spend on healthcare, I would not bother with them.
I'm not sure why you think they are cheap. They charge insurance just as any other doctor. The annual fee is on top of that.
My assumption was -- the GP is thinking that "cheap" meant the $200 Annual Fee is how they get paid. No, the Annual Fee is just for the system they provide, the care is a typical insurance paid practice.
In the DC offices Ive been to, I do not feel the same. Instead I feel like I receive top quality care compared to other local doctors.
Overall, I generally use OMG when I need fast and convenient care, not necessarily quality.
Sidenote: I like how going to OMG is always in-network regardless if I'm home or traveling (for my insurance plan anyway).
1. When I was a crazy-busy and overbooked professional, I could simply not afford lateness in my schedule. With OMG, I can leave my office at X:52, be at their office at X:59, be seen between X+1:00 and X+1:15 and be back at my desk by X+1:23, and be confident of making my next meeting.
When the chief variability is how long an elevator takes to arrive, you know this is a serious operation!
2. Because many doctors front desk booking services tend to become authoritarian and making booking way harder than required. I can do everything electronically w/ OMG.
3. Because they do everything electronically, which saves everyone time -- including them
4. Because they provide detailed records of everything for FSA/HSA purposes as well as for your records.
5. Because they offer multi-tier service (NPC, PA, MD // video/email/inperson) so you can save everyone's time for minor things.
6. Because they do lots of things in one place (vaccinations, bloodwork, etc.) rather than you having to go to many places
To laser-focus on the peninsula/south-bay in the bay area; going to PAMF or Stanford Medical typically results in a 2-3 day wait to see a Dr.
If you're sick, you want to see a Dr asap. I have a doctor at PAMF, a doctor at Stanford Medical, and One Medical. If I am sick, I simply book an appointment at One Medical usually 30-min ahead of time, see them, get whatever treatment I need and go back home and be sick.
When something is truly wrong I start at One Medical for temporary help, and immediately book either at PAMF or Stanford depending on who is available sooner.
Most affiliated PCPs will do same or next days.
I would probably not use One Medical if I was still living in central FL, where I never encountered these problems.
I've had really bad experiences with anything labeling itself an "urgent care clinic," and pricing.
- integrated online doctor visits, so you often don't need to go in
- you can message someone with any health question and get a response within 24 hours
- you can go to any location and they automatically pull up your full medical history, no need to fill out a form
- it is easy to get an appointment the same week or same day if you need it
- you can come any time without an appointment for lab work
Kaiser provides an HMO plan, but Kaiser's HMO is not typical of most HMOs because most HMOs aren't integrated practices owned by the health insurer (for better or for worse).
This might sound like a nit, but the previous primary care doctor I went to in the Bay Area emailed me a follow-up message in the form of a Word document—which mistakenly included several pages of someone else's medical information, too.
This happens all the time with archiac or manual systems, but it is not a minor nit. That's a hairs edge away from being a reportable HIPAA breach and thus a headache for the doctor. If you made a fuss about it, they would have to report it.
Having good data security processes is not something a doctor's office can afford to ignore. That's definitely an advantage of a more technologically focused approach like One Medical.
I use my PPO plan to get a specialist directly if I need one (usually sports medicine/getting too old for this shit).
If I had chronic/serious health issues I might seek out a regular PCP and use One Medical for the routine stuff (physicals, vaccines, cough/cold/flu etc.) Depends on if you have PPO or HMO plans of course.
Their raising fees every other year is beginning to stick in my craw though.
Most doctors are just guessing, some are just better at making it appear they know what they are doing to improve placebo. I rather have a doctor that's using Google than one that thinks he knows what's wrong but doesn't fact check.
> Historically, our revenue has been concentrated among a small number of customers. In 2017, 2018 and the nine months ended September 30, 2019, our top customers accounted for 42%, 37% and 36% of our net revenue, respectively. These customers included Google Inc., which accounted for 10% of our net revenue for 2018 and the nine months ended September 30, 2019.
One Medical is the name that most people know the clinic by, because that's how they present themselves to patients.
Of all the complaints to register against One Medical, this has got to be the weirdest. For the customer base that they're going after (higher-income people, oftentimes those who have this fee covered by their employer), $200/year is a drop in the bucket for medical expenses.
One medical advantage is if I feel sore/sick I can always get a same day appointment and they treat me like a person .... which is a huge advantage.
I tried HMO and my "doctor" needed a minimum of 30 days notice to see me .... basically not helpful for being sick
Even worse, you will get a random set of bills from random providers - making it VERY hard to track what ties to what where.
Basically - if you are cash payor - you will show up and pay what they surprise you with at the end. A lot of folks going to one medical have insurance - they just find one medical MORE transparent.
And worse, you will get billed 3x-5x the rate the provider negotiated with any random insurance company.