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At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.

An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.

Patients delay medical care, hospitals lose billions

by jerry on May 31, 2020

In March, many hospitals cancelled scheduled procedures to make room for potential COVID-19 patients. Those cancellations, in conjunction with Americans' fear of getting infected at hospitals (and perhaps other reasons), have led to a dramatic reduction in hospital procedures. The Kaiser Family Foundation released poll results showing that about half of the public indicated that they skipped or postponed medical care because of the pandemic. It is perhaps not surprising, then, that CNBC reported that hospitals are collectively losing billions of dollars per month (the American Hospital Association estimates $50 billion per month). Such financial losses will undoubtedly have significant repercussions to hospital operations.

In March, many hospitals cancelled scheduled procedures to make room for potential COVID-19 patients. Those cancellations, in conjunction with Americans' fear of getting infected at hospitals (and perhaps other reasons), have led to a dramatic reduction in hospital procedures. The Kaiser Family Foundation released poll results showing that about half of the public indicated that they skipped or postponed medical care because of the pandemic. It is perhaps not surprising, then, that CNBC reported that hospitals are collectively losing billions of dollars per month (the American Hospital Association estimates $50 billion per month). Such financial losses will undoubtedly have significant repercussions to hospital operations.

Many businesses -- not just hospitals -- often run on thin margins and are not necessarily built to withstand large financial shocks. It is also unclear when society will return to "normal" or what "normal" in the future will look like. Coming out of this pandemic, medical care might look different from what Americans had gotten used to.

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Pandemic reshapes California's health policy

by jerry on May 23, 2020

Inaugurated in 2019, the current governor of California had ambitions to change the landscape of health policy of the state, including expanding insurance coverage and even rolling out a white-label generic pharmaceutical program. As with many other states, the pandemic changed many plans. Kaiser Health News wrote about the current governor having to scale back the agenda that he had earlier promoted.

Inaugurated in 2019, the current governor of California had ambitions to change the landscape of health policy of the state, including expanding insurance coverage and even rolling out a white-label generic pharmaceutical program. As with many other states, the pandemic changed many plans. Kaiser Health News wrote about the current governor having to scale back the agenda that he had earlier promoted.

The pandemic -- in conjunction with the subsequent shelter-in-place ordinances -- has had a tremendous impact on state and local governments: not only are people working less (and the governments receiving less in tax revenue), but more people need financial assistance and are seeking out programs such as Medicaid or unemployment benefits. It would have been interesting to see how certain programs would have played out, but for now, one person quoted in the article summarized the current dilemma: "Do we invest in prevention when the house is burning down?"

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Valuing human life in public policy

by jerry on May 17, 2020

As much as we would all like to think that the value of a human life is beyond measure, trade-offs are inherent in a system with limited resources, if for no other reason than the possibility that a few million dollars spent saving one person's life might actually be put to use saving more than one life elsewhere. The New York Times published an interesting piece that reviews different dollar amounts that the US government has used to value an individual's life: $885,000 (in today's dollars) in 1972 to near $9 million today. The piece also mentions The World Health Organization's guidelines regarding cost-effective treatment and touches upon the idea of a quality-adjusted life year (known in academia as a QALY).

As much as we would all like to think that the value of a human life is beyond measure, trade-offs are inherent in a system with limited resources, if for no other reason than the possibility that a few million dollars spent saving one person's life might actually be put to use saving more than one life elsewhere. The New York Times published an interesting piece that reviews different dollar amounts that the US government has used to value an individual's life: $885,000 (in today's dollars) in 1972 to near $9 million today. The piece also mentions The World Health Organization's guidelines regarding cost-effective treatment and touches upon the idea of a quality-adjusted life year (known in academia as a QALY).

To a large extent, today's public policy controversy about the timing of when to open up the economy has public policy implications that relate to the value of human life. Lift the restrictions too early, and more people may get infected and die. Lift the restrictions too late, and people may find themselves without ability to buy food and governments might not have enough tax revenue to pay for a number of social programs.

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Hospitals facing declining revenue amidst pandemic

by jerry on May 10, 2020

Ironically, in the middle of a public health crisis, most hospitals and other medical care providers are facing a steep drop in demand for their services, rather than than being overwhelmed. NPR reports on healthcare workers being laid off or having reduced hours. Many scheduled services were indefinitely postponed, and many people who might have visited have decided to stay away for fear of being infected.

Ironically, in the middle of a public health crisis, most hospitals and other medical care providers are facing a steep drop in demand for their services, rather than than being overwhelmed. NPR reports on healthcare workers being laid off or having reduced hours. Many scheduled services were indefinitely postponed, and many people who might have visited have decided to stay away for fear of being infected.

The economy is an interconnected web, with many services organizations expecting a relatively steady flow of customers or clients. The current shelter-in-place ordinances have disrupted many retail businesses, and that also turns out to include healthcare providers.

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EHRs prove less useful than hoped

by jerry on May 03, 2020

As part of the American Recovery and Reinvestment Act in 2009, Congress designated $36 billion to encourage doctors to upgrade their medical records systems to be electronic (known as electronic health records, or EHRs for short). The extra funds indeed encouraged many providers to adopt EHRs, and one of the aspirations was that researchers would be able to use information from various different clinics and hospitals to make better progress. In order for an EHR to be certified as eligible for the customer to receive funding, the EHR had to undergo a certification process which included interoperability requirements such that data from one system could be meaningfully interpreted by other compatible systems (e.g. weight recorded in one system as structured data would be similarly interpreted as structured data in another system). Kaiser Health News reported that such dreams of interoperability for the sake of science has proven elusive during this pandemic.

As part of the American Recovery and Reinvestment Act in 2009, Congress designated $36 billion to encourage doctors to upgrade their medical records systems to be electronic (known as electronic health records, or EHRs for short). The extra funds indeed encouraged many providers to adopt EHRs, and one of the aspirations was that researchers would be able to use information from various different clinics and hospitals to make better progress. In order for an EHR to be certified as eligible for the customer to receive funding, the EHR had to undergo a certification process which included interoperability requirements such that data from one system could be meaningfully interpreted by other compatible systems (e.g. weight recorded in one system as structured data would be similarly interpreted as structured data in another system). Kaiser Health News reported that such dreams of interoperability for the sake of science has proven elusive during this pandemic.

I imagine that part of the problem is that entering structured data (so that it can be meaningfully queried later on) is likely very tedious for providers. Doctors and others had been under a lot of time pressure to see a certain number of patients a day, and many likely resorted to non-structured data (e.g. textual notes). Given the daily pressures of seeing enough patients and documenting the encounters (which many doctors have not enjoyed) and weighing that cost against an abstract societal benefit of being able to make use of that data, it is not surprising that many doctors would revert to what is easier.

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