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One Medical S-1

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Re: One Medical S-1

#91

Post by surfmike »

winfred wrote: post #47
surfmike wrote: post #33

The two times I used One Medical, me and the doctor just ended up googling my symptoms together. Don’t have a lot of confidence in their staff. It’s a nice idea though, although concierge care like this probably pushes health care costs even higher.

Do you have any idea how much can go wrong with a human body and in how many different ways? And we're not even close to figuring out all the illnesses. Sure, brain cancer they can detect just fine, but try to go to a doctor because you're fatigued or have joint pain or other inflammation related issues. See the shit show you'll run into then. 9 out of 10 times they'll toss you through a few machines and then claim i…

Yes medicine is complicated, but I question whether a general purpose search engine, searching potentially untrustworthy or out of date medical information, is the best tool for diagnosis.

Re: One Medical S-1

#92

Post by surfmike »

pxlpshr wrote: post #37
surfmike wrote: post #33

The two times I used One Medical, me and the doctor just ended up googling my symptoms together. Don’t have a lot of confidence in their staff. It’s a nice idea though, although concierge care like this probably pushes health care costs even higher.

Direct primary care is (generally) much cheaper for better quality/more holistic care. I think DPC is particularly attractive if you’re a low utilizer on an HDHP and never hit your deductible.

Much cheaper than what? I also can get direct primary care through Sutter, and although the experience is probably worse (less time during appt, longer wait time) it’s probably cheaper than the concierge model of One Medical. At the very least it allows a doctor to scale to more patients.

Re: One Medical S-1

#93

Post by utopian3 »

mantap wrote: post #89
Godel_unicode wrote: post #70

Earlier quoted context omitted.

I'm always really curious what people mean when they say a doctor is "great". Is this just biases about smiling and seemingly having it together, or are there medical aspects to the greatness which set them apart as doctors? How does an average person know if your doctor is, in fact, doing a good job?

A good doctor is one who pays attention. I've met my fair share of bad doctors who are overworked and just are not paying attention to what they are doing. Then they end up making mistakes, such as misdiagnosing a condition, prescribing the wrong medication, etc. 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…

Same. I have a GP who takes 40-60 minutes per patient, and gets into detail of what’s going on. I felt he truly cared. Compare that to the ~5-10 minutes of my previous GP

Re: One Medical S-1

#94

Post by JshWright »

surfmike wrote: post #91
winfred wrote: post #47

Earlier quoted context omitted.

Do you have any idea how much can go wrong with a human body and in how many different ways? And we're not even close to figuring out all the illnesses. Sure, brain cancer they can detect just fine, but try to go to a doctor because you're fatigued or have joint pain or other inflammation related issues. See the shit show you'll run into then. 9 out of 10 times they'll toss you through a few machines and then claim i…

Yes medicine is complicated, but I question whether a general purpose search engine, searching potentially untrustworthy or out of date medical information, is the best tool for diagnosis.

That's the reason for the doctor. They have the foundational knowledge to evaluate the information and the source.

Re: One Medical S-1

#95

Post by JshWright »

surfmike wrote: post #92
pxlpshr wrote: post #37

Earlier quoted context omitted.

Direct primary care is (generally) much cheaper for better quality/more holistic care. I think DPC is particularly attractive if you’re a low utilizer on an HDHP and never hit your deductible.

Much cheaper than what? I also can get direct primary care through Sutter, and although the experience is probably worse (less time during appt, longer wait time) it’s probably cheaper than the concierge model of One Medical. At the very least it allows a doctor to scale to more patients.

Presumably they mean cheaper than using a fee-for-service PCP, but I don't really see how (especially in the low utilization car they mentioned... DPC makes more sense in high utilization cases, since the overhead cost is fixed)

Re: One Medical S-1

#96

Post by asdfasgasdgasdg »

totalthrowaway wrote: post #88
dbcurtis wrote: post #62

Earlier quoted context omitted.

> In my experience, the quality of doctor was incredibly low, 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 ex…

In my experience, they are often young and at the beginning of their career. They are still medical doctors, not to take anything away from them, but I mostly rely on them for referrals to specialists as needed. One Medical removes some friction from the overall system, which as a non-American I find incredibly frustrating.

Fwiw some studies show that young doctors have better outcomes. Maybe because they have been to medical school more recently, when evidence based techniques were taught with more rigor. E.g. https://www.bmj.com/content/357/bmj.j2286. Now this study only concerns hospitalists, and it's just one study, so it shouldn't make you avoid older doctors necessarily. But definitely what there is no data for is a bias against younger doctors.

Re: One Medical S-1

#97

Post by rossjudson »

karl11 wrote: post #61

Medicine comes down to human-to-human interactions (doctor and patient) and those are really hard to scale. One Medical is basically a novelty offering nice offices and predictable visit times. It takes some of the most common complaints you have about your doctor and removes them. In my experience, the quality of doctor was incredibly low, however, the quality of doctor will not be super important to you if you are…

I'll contribute my anecdata, and state that the One Medical doctor I've seen was great.

Re: One Medical S-1

#98

Post by damnyou »

epmaybe wrote: post #87
damnyou wrote: post #75

Earlier quoted context omitted.

The most important thing to me is an understanding that the patient is in charge of their health and the doctor's just there to support the patient. For example, if a patient is already on meds from an online pharmacy, the doctor (after ensuring that the patient isnt causing grave harm to themselves) should be willing to write a prescription for those meds.

At the same time, I think it is unethical for a doctor to continue prescribing medications that they do not believe you actually need based on your current health. To them/me, it would be malpractice. 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 ri…

Of course, antibiotics are special because of their externalities.

I'm taking about stuff like modafinil, for example.

Re: One Medical S-1

#99

Post by mnutt »

chucky_z wrote: post #46
cgb223 wrote: post #10

Why do people use One Medical vs just having a doctor? Been thinking about my current medical care and wondering the advantages

My answer is "Why doesn't everyone use One Medical and have a doctor?" 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…

OneMedical used to be that way in NYC, now the Manhattan locations often have no appointment slots for a few days and you’ll have to go out to a Brooklyn location to get same-day or next-day care.

Re: One Medical S-1

#100

Post by TuringNYC »

maxerickson wrote: post #57
TuringNYC wrote: post #42

Earlier quoted context omitted.

Long-time customer here and totally agree -- they are awesome on timing. I think they do this by virtue of having a system. They seem to have a systematic effort thru the entire office of abiding by schedule appt times. Some of that is systematic scheduling to prevent overbookings, etc. 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, becaus…

I look forward to reading what you say after they are late for you in the future.

I dont think they are perfect and dont expect them to be. I think the difference is --

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.

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