“Bang Head Here.” This message was printed above a large black circle, push-pinned to a practice’s front desk the day Zocdoc’s user research team visited to better understand their patient engagement challenges. If this is not a representative sign of the state of America’s independent medical practices, I don’t know what is.
I can relate. Throughout nearly a decade of medical training, I spent tens of thousands of hours becoming an expert in things like peak airway pressure, nerve conduction velocity, and ion channels. But I never received a minute of training in managing the disjointed operational maze that increasingly saddles providers: installing scheduling portals, verifying insurance coverage, collecting patient intake forms, getting patients to rebook when it’s time, getting paid, and more.
Like most physicians, I went into medicine to care for patients — not to be a healthcare bureaucracy wrangler. However, a study found that physicians only spend roughly one-quarter of their day on direct clinical face time with patients – another study found they spend over four hours daily completing EHRs. It’s no wonder that provider burnout is on the rise. According to a survey co-authored by the AMA, at the end of 2021, nearly 63% of physicians reported symptoms of burnout, up from 38% in 2020. This is largely attributed to “system inefficiencies and administrative burdens.”
A $30 billion healthcare SaaS market promises to solve many of these administrative pain points. But as a doctor who has experience with these SaaS systems, my observation is that far too many fall short of their aspirations — especially when it comes to software that needs to work not just for providers, but also needs to effectively engage the patients they serve.
When I look Now that I am leading a technology company, I look outside of healthcare to learn from business-to-consumer SaaS solutions, Shopify and Square are gold standards that seamlessly power customer engagement for millions of businesses globally. While they sell to businesses, they understand that the primary user must be the consumer — because if they don’t work for consumers, they won’t deliver any value to their paying customer: businesses. This consumer-centric focus delivers streamlined, easy-to-use product experiences that make it effortless — some might even say magical — for customers to transact. With Shopify, customers can confirm their identity with a text message, they don’t have to re-enter static information like their billing info or shipping details, and they can expect this uniform experience across millions of merchants.
This same magical experience should exist in healthcare, but it does not. Patients are expected to log in to disparate systems to schedule visits. They need to fill out the same insurance info and medical history over and over. And each new practice brings a novel Kafkaesque, broken experience.
This is largely because patient engagement solutions seem to have forgotten that while their paying customer is the provider, their core job is to engage patients. Counterintuitively, these tools are designed primarily with the practice in mind, which makes them unintuitive and hard for patients to use. As a result, patients fail to engage with these clunky tools: they often don’t complete their bookings, and when they do, they’re not providing the information needed ahead of their visit. This creates more administrative work for practice staff, who spend their days playing ‘scheduling Tetris’ and chasing patients for critical information.
But even with a provider-first focus, we’ve heard from our network of providers that their patient engagement solutions are not intuitive or easy for them to use, either: they’re hard to set up, hard to incorporate into the office’s bespoke systems and workflows, and hard to navigate. At the heart of this subpar practice experience is the business model of these tools: they benefit from the complexity by upselling additional features and customizations that promise to make things better for the practice — but don’t. As a result, these tools cost practices thousands of dollars only to have many of these offerings create more work for their office. This all serves to exacerbate the system inefficiencies and administrative burdens these patient engagement solutions promised to vanquish.
While private practices used to dominate healthcare, they are now a dying breed. Fewer providers are hanging up a shingle and venturing out on their own. According to an AMA study, less than half (49.1%) of patient care physicians work in physician-owned practices, while nearly 3 in 4 doctors work for a hospital, health system or corporate entity, which represents a 20% increase since 2019.
We should all be rooting for America’s private practices to thrive, as studies indicate they provide better patient outcomes, result in fewer readmissions, play a pivotal role in primary care, and more. There’s too much at stake to allow them to wither. But the status quo is not tenable. Providers running a private practice today seemingly need not just an M.D., but also a Ph.D. in administration and patient engagement. But they shouldn’t have to become experts on any of this, nor should they have to invest in costly software developers or IT teams to figure this out for them.
Like the SMB segment outside of healthcare, providers deserve consumer-first, user-friendly software that they can easily plug in to seamlessly power patient engagement. This will help them to get out of the business of contending with healthcare’s administrative quagmire and get back into the business of caring for their patients.
About Oliver Kharraz, MD
Oliver Kharraz, MD, is CEO and founder of Zocdoc. Oliver is the most recent doctor in a 300-year family tradition. Throughout his wide-ranging career, Oliver has accrued comprehensive experience affecting change and building efficiency in large-scale healthcare organizations using information technology. Prior to Zocdoc, Oliver was an Associate Principal at the global management consulting firm McKinsey & Company. During his seven-year tenure at McKinsey & Co., Oliver developed and implemented new patient utilization models for the national health services of several governments and major hospital chains.
In 1994, Oliver built and sold his first business – a forerunner of early internet software. He later became a resident doctor at the clinic of Ludwig Maximilian University in Munich, where he earned an MD and a Doctorate in Neuroscience. Oliver also has a Masters Degree in Philosophy from the Jesuit College of Philosophy in Munich. He is also a member of the Council on Foreign Relations. Born in Germany, Oliver immigrated to the U.S. during his work for McKinsey & Co. He currently resides in Brooklyn, NY, with his wife and their twin daughters.