Uber for doctors: U.K. app hails a GP to your home
No reason there couldn't be a similar service in Canada, says health policy professor
Of course, it comes with a cost. The semi-privatized British health care system allows GPDQ to charge between $190 and $240 Cdn.
'Relieve pressure' on public system
Dr. Anshumen Bhagat, the app's founder and a public health care physician, says the system is struggling with long wait times, short visits and overworked doctors — all concerns familiar to Canadians.
"We are not here to replace it. And we never will … it's a phenomenal beast and we should continue to be thankful that we have it," says Bhagat. "But we need to help relieve some of the pressure."
There are several reasons Brits are opting for house calls. Bhagat estimates 40 per cent of GPDQ patients are children and 20 per cent are seniors. And while most visits are to private residences, he has also seen an increase in calls to corporate settings.
"Every patient we see, quite frankly, is one less patient that the NHS is having to see," he says.
With 1,100 patients registered since GPDQ launched in London last December, the app has now expanded operations to Birmingham.
Canada can learn from U.K.
Colleen Flood, director of the University of Ottawa Centre for Health Law, Policy and Ethics, says that while the "Uberization" of health care is interesting, it differs from other sharing-economy apps. Those services are about untapped capacity, such as spare bedrooms or idling cars, but the same can't be said about health care.
"I don't know that many doctors that are sitting around on their asses doing nothing," she said. "An Uber app for physicians would be awesome if it's tapping into physicians that are otherwise lying around doing nothing."
But there are many who think this kind of innovation is a leap forward.
We use our cellphones for just about everything. Why can't we use the technology for something as important as access to good primary care?- Douglas Angus, University of Ottawa
"There is absolutely nothing in the Canada Health Act that would prevent something like this from happening," says Douglas Angus, a health policy and economics professor at the University of Ottawa's Telfer School of Management.
"We use our cellphones for just about everything. Why can't we use the technology for something as important as access to good primary care?"
Angus says Canada is not particularly good at looking to other countries for inspiration in health care management.
"In the U.K. they spend a heck of a lot less on health care than we do in Canada, and their results are at least as good, if not better," he says.
He's right. Canada spent $219 billion on health care in 2015 — an average of $6,105 per person, according to the Canadian Institute for Health Information. The U.K. had a smaller budget to care for nearly twice Canada's population — around $3,000 per capita for a total of around $192 billion, NHS figures show.
Not only are there lessons to be gleaned from other countries, but Angus says Canada can also learn from the private sector when it comes to doing things more effectively.
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For instance, Canadian doctors are prohibited from charging for insured services regardless of how they are delivered. But Angus believes there is room for innovation.
While fee-for-service is the standard pay model, he says many clinics are starting to form family health groups and share costs among practitioners, meaning they could make resources available for new approaches.
'A quality doctor service'
In founding GPDQ, Bhagat's goal was not just better care for patients but also to address the concerns of British doctors, whose morale, he says, is at an all-time low. He hopes GPDQ will help improve their work-life balance.
It's working for Dr. Mateen Jiwani.
He sometimes sees as many as 80 patients a day at the public hospital where he works. But once a week he is on call for GPDQ, and says there is difference in how he practices when he can exceed the time limit imposed by the public system.
"If I've got 10 minutes to do something, I am not going to do exactly the same thing as if I have 25 minutes," said Jiwani. "There's no pressure. My whole manner has changed."
He says he is offering better quality care, and that his time spent at a house call rejuvenates him.
All GPDQ doctors must also be working for the public system, but the extra workload from the app doesn't seem to be deterring anyone. On top of the 35 doctors he has serving London, and 20 in Birmingham, Bhagat says there are 150 waiting to get on board. The only thing that might give them pause is crossing into privatized care.
"We aren't shying away from the fact that we are not a free service, and when you are competing against a free service, naturally the challenges are much greater," said Bhagat. "So, one of the things that I strove to do was, how do we make that private service affordable?"
Beyond toeing the line between the private and public health care, Bhagat is also sensitive to the fact that using technology for health care purposes is not the same as grabbing an Uber. "We're not ordering a pizza. We're not ordering a taxi. We're ordering a quality doctor service here," he says.
"We're a group of doctors that want to make a difference."