Jurassic DPC: One Medical Gets Bought by Amazon and the DINOs are Loose!
This article is a repost from DPC News. I think it is important enough to share here.
BIg news. Amazon bought One Medical. Who is One Medical? Well, they are a DINO (DPC in Name Only). Maybe. The description of One Medical is slippery. They don’t call themselves DPC in the buyout announcement, though others put them in the DPC category:
One Medical is a human-centered, technology-powered U.S. primary care organization on a mission to make quality healthcare more affordable, accessible, and enjoyable through a seamless combination of in-person, digital, and virtual care services
One Medical combines in-person care in inviting offices across the country with digital health and virtual care services, making it easier for patients to schedule appointments, renew prescriptions, access up-to-date health records, and advance health outcomes
Human-centered? Yeah, I guess. If you were animal-centered you would be a vet. WTF? What about the rest of their description? Well, it sounds like every other DPC doctor. The difference is that we charge a low monthly fee and DO NOT bill insurance companies. One Medical is more concierge medicine. They charge $199 and still bill insurance. They are NOT DIRECT PRIMARY CARE.
Also, here is how their numbers break down for doctors vs. other clinicians:
If you add them up you get 292 physicians of their self-described 782 “providers”.
Wow, they have almost a 3 to 1 nondoctor-to-doctor ratio and are being described as concierge medicine? Interesting. Are they even that?
And what about Amazon. This is what Kenneth Qiu, MD shared with me:
One Medical just bought Peak Med, a DPC network in Colorado, a few months ago. They bought IORA a few years ago I think as a way to enter the DPC space. This news means Amazon understands the value proposition of DPC and wants to get in on the action or they see some potential and want to make their own Frankenstein version. Either way, now more than ever we need to grow the organic DPC movement and show our communities what DPC is and should be before more DINOs emerge.
People might not know that companies like One Medical and Forward are about profit. Big profit. You can read this article to see why. When private equity and VCs get involved they want a 10x on their return. And they may have gotten it with Amazon. This means others are going to try and do the same thing, which includes hijacking the term Direct Primary Care. This will result in more DINOs on the loose who will be terrorizing more people than all the Jurassic Park and Jurassic World movies combined.
In summary, Amazon is obviously smitten with doing something in healthcare. They have their Amazon Pharmacy but the prices are mediocre. I don’t know many docs using Amazon Pharmacy for their patients. Too many better choices.
And let’s not forget Haven Health:
Haven Health, sparked by an idea from JPMorgan Chief Executive Jamie Dimon and supported Jeff Bezos and Berkshire’s Warren Buffett, sought to “transform health care” and reduce costs for hundreds of thousands of workers at the three companies by pooling resources and technology.
The joint venture, which was announced in 2018 with expectations high enough to push down major insurers’ shares, will cease operations in February without having achieved those aims.
Haven’s transformative ambitions proved too difficult to achieve, according to people familiar with the matter. Its shutdown attests to the challenges of making sweeping changes to the U.S. health-care system and of bringing innovations to hundreds of thousands of employees around the country working at different companies, the people said.
There is also PillPack, which was sued for obtaining patient data, as well as having a history of selling software that mines patient medical records for information from doctors and hospitals.
They have been sniffing around the healthcare industry’s butt for a while and maybe they have bigger plans, but buying One Medical? This is just my opinion but what are you doing, Amazon? For $3.9 billion!!?? I predict this will fail as well. One Medical can’t even figure out how to describe themselves. They are a witches brew of a little insurance, a little concierge, a pinch of DPC, and VERY FEW doctors working there.
“Healthcare is high on the list of experiences that need reinvention,” Neil Lindsay, senior vice president of Amazon Health Services, said in a news release. “We want to be one of the companies that helps dramatically improve the healthcare experience over the next several years.”
I have an idea for Amazon. Why don’t you work with some of the smartest people in the REAL direct primary care industry to figure out a way to expand DPC? I know them. Ask me and I will point you in the right direction of the real success stories of our broken healthcare system: independent direct primary care doctors who have figured out how to improve the healthcare experience.
Until then, you just bought a dog, I mean, a DINO, and wasted your money.
Didn’t Amazon get burned on another medical venture a couple years ago?
The whores at the AAFP have given One Medical and Iora a lot of free, very laudatory PR over the years. I guess they’ll get on their knees for Amazon now.
For the last hundred and some years, the administration of medicine took place using medical principles, and thrived.
For the last forty or so years, the administration of medicine has proceeded along business and management lines, and has stagnated.
Medical principles were once called upon to administer the necessary elements for medicine. The time results were not unlike that of the post-Civil War days of the “Connecticut Yankee” and the boom of innovation in industry. Hone one’s skills to incisively comprehend a problem or opportunity, Apply scientific principles to problem solving rather than applying by rote administration the usual processes. Critically analyze the response, and adjust ones goals.
Not only did the technology of firearms and vehicles race along using these basic scientific principles, so did surgery, anesthesia, antibiotics and such. The results of effective innovation are cost saving in the process, as well as improvement of outcomes. If one is clever and creative in one’s thinking and practice, one will naturally reap a portion of the financial returns of one’s efforts. Improve medicine according to fundamental principles, and one will never starve.
But business-school superstitions have come to the forefront, cloaked in “scientific” garb. Without detailing these superstitions, all “industry” has fallen under the yoke of these superstitions, which add to the burden of efficient progress. The analogy to the Soviet Union is applicable. One could do anything one wanted in business and industry of the Soviet Union. Of course, the efforts must be consistent with Marxism-Leninism.
The shackles of superstition brought Soviet industry to a grinding halt. Finally, Gorbachev sought to remove some of the party-line idiocy from the business of the Soviet Union, which consequently fell apart completely. We can laugh at Marxist-Leninist absurdities, but insist that American Business be run according to American Business Principles. Medicine has for 30-40 years, and has also fallen apart completely.
Elements of the superstition include: All business may be run by general principles; therefore, the Executive Class can run any business equally by applying rigid and invariant rules cloaked in terms of efficiency and common sense. Businesses must turn a profit first; whether they return money to their investors by savings from innovation or fleecing the customer, there is no difference. All aspects of “product and services” can be dissected into elements of production – “A patient visit,” for example. Finally, every element of production can be assigned a measure of value that can be determined by someone who is wholly ignorant as to what the “element of production” entails.
The Executive Class scrutinizing the “medical industry” cannot see a difference between DPC and DINO. They think they are offering honest-to-God DPC, which is improved as always according to business principles. When one points out that they are NOT the same, they ask which business school you have attended, which of the shuffle of jobs you have had through the Executive Towers, how many jets do YOU have. They really are no different from the petty Party leadership in the various levels of Soviet administration; ranks and offices now found only in history books.
I do not blame “we physicians” for this, any more than you can blame the rabbit for being caught by the wolf. If money can be made from the “medical industry,” that is by definition an improvement of the industry. The only thing left is to dull the senses and bamboozle the minds of the “medical industry consumer” to imagine the false equivalence between what is real and what is puffery.
The waiting list to buy the East German Trabant, a two-cylinder automobile, was years long; far more than the waiting list for the top-class West German BMW. Sadly, the wildly popular Trabant is no longer made; the BMW is doing fine. They were manufactured by similar people, designed and planned by similar individuals with training and skills in automobile design and manufacture. The only difference between them was that one of them sucked massively, and everybody knew it, even the people who pretended that they were equivalent. That is the “sales job” which the modern “medical industry” is pushing on the public. The true disciples of
Marxism-Leninism– sorry, American business practice, see no difference between DPC and DINO. At the top levels, they truly believe. The next rung down, they are paid to look like they believe. And at the bottom, the “medical industry consumer” is terrified into silent anger, occasionally shooting up a clinic.The superstition of the American Business Practice kills. And we are swept up in the lies of Taylorism to pretend we believe otherwise. Here are some references on Taylorism here, and here. What do you think?
I don’t know how much debt they have. But nonetheless they just paid the equivalent of $10 million per physician practice. 10 million.
So according to VC rules, the enterprise will pay $100 million per physician across its lifetime. I’m waiting for my lifetime $100M but I’m not close yet.