man sick in bed on laptop with telehealth doctor
PlushCare allows users to search for doctors and schedule appointments via video chat, with any prescriptions or follow-up also being done digitally. — Getty Images/YakobchukOlena

Developments in the health care sector had been simply going the way of many industries in the 21st century: As in music and media to movies and retail, disruptors are making it easier than ever to provide their goods and services via the internet.

PlushCare, a nationwide telehealth startup that acts almost like a Netflix for primary care health providers, where doctor-patient visits are held via video chat, is among those disruptors.

Now within the context of the COVID-19 global health crisis, telehealth has gone from a new convenience to a public health imperative, moving the Silicon Valley-based startup’s business model into the national spotlight.

Here’s how PlushCare works: Users can search through an assortment of doctors, choose one that they like and schedule an appointment, even for that same day. The consultation is held via video chat, with a text chat function for follow up questions or future concerns.

Telehealth is booming and plenty of similar competing platforms (Teladoc, DoctorOnDemand, 98point6 among them) exist to expand access to care and keep patients out of the emergency room or urgent care center, some of the most expensive bills for insurance companies to foot. What sets PlushCare apart, according to co-founder and CEO Ryan McQuaid, is the kind of relationship it encourages between doctor and patient.

“I think [telehealth] was a great innovation, but it was very much a transactional relationship,” he told CO—. “We believe that the future is a digital relationship with a primary care provider.”

Dial-a-doctor

Platforms like Netflix, Seamless, Amazon and Spotify have raised consumer expectations sky high for frictionless, convenient experience into other sectors — even ones that haven’t yet been disrupted.

“Previously, healthcare organizations could sit back and wait for patients to come to them,” Arielle Trzcinski, senior healthcare analyst for Forrester Research, told CO—. “Now, if consumers find that their current provider doesn’t meet these new demands, there are an abundance of alternatives to turn to — telehealth, Walmart, CVS Health to name a few.”

McQuaid touts the credentials of its doctors, who also come referred to PlushCare via word of mouth. For doctors, the incentive to practice online is largely based around the promise of remote and flexible work hours, an unfamiliar concept for many working in hospitals and private practices.

They’re also able to expand access to primary care. According to McQuaid, an estimated 50% of Americans do not have a primary care provider; and among those who do, it takes about 24 days to get an appointment, he said.

Though online doctor services may seem oriented toward cash-strapped, nomadic millennials, McQuaid notes that PlushCare’s customer base is surprisingly diverse, with an average age of 40. The promise of a doctor visit on your schedule, avoiding waiting rooms and travel time, appeals to users across the country, in urban areas as well as the 55 million Americans living in rural “primary care deserts.”

"From a general population health perspective,” McQuaid says, “telehealth is incredibly valuable.”

From a general population health perspective, telehealth is incredibly valuable.

Ryan McQuaid, co-founder and CEO, PlushCare

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 screenshot of plushcare telehealth service
Ryan McQuaid, PlushCare's CEO, found that an estimated 50% of Americans do not have a primary care provider. One of his goals with PlushCare is to expand that opportunity. — PlushCare

Telehealth steps up to fight COVID-19

Amid the coronavirus pandemic, “This moment will forever establish virtual care as a viable alternative to in-person care,” Trzcinski said, predicting it will drive not only adoption but long-term enrollment in telehealth platforms.

McQuaid emphasized the opportunity for PlushCare to step up during a time of social distancing and shelter-in-place policies.

“The CDC has specifically called out and even recommended telehealth,” he said. “Even for patients that need to see a doctor but aren’t having COVID symptoms, we’re able to keep them out of the waiting room, which is filled with germs, and we’re able to keep them from potentially infecting healthcare providers.”

With hospitals facing unmanageable waves of sick patients and struggling to test all those who request it, McQuaid believes startups like his have an important role to play in driving healthcare innovation. The company, like several others in the direct-to-consumer health space including Maven and Ro, is working on developing its own at-home testing kit for COVID19, labs for which are integrated with PlushCare’s digital platform.

He promises the commitment to a concierge experience will extend throughout the patient’s experience. “It’s not just, ‘Let’s send you a test and good luck,’” McQuaid said. “[It’s] ‘Let’s get you connected with a doctor, let's get you a test ordered, and we’ll be here for whatever questions you have along the way.’”

Though it empowers patients to take their health into their own hands, Trzcinski warns of the importance of patient education around how to use it. “We need to see more activity around self-triage to bring awareness and understanding of when virtual care is appropriate to not only drive patients to it as a convenient alternative, but as a safety net to prevent misuse.”

 ryan mcquaid headshot
Ryan McQuaid, co-founder and CEO, PlushCare. — PlushCare

Funding for the future

As digitization continues to concentrate more consumer activity in the home, and certainly if epidemics continue to ravage the population, the opportunity for telehealth only grows.

Prior to the pandemic, McQuaid and his team planned for massive growth, taking on funding in order to double the size of the company. A $10 million investment from GGB Capital has PlushCare in good company, among other startups including Slack, Airbnb and Hotel Tonight.

The company is taking inspiration from another successful health startup. One Medical, a primary care provider, charges members a $200 yearly fee for same- or next-day appointments, digital services and integration, and an overall concierge experience.

But, Trzcinski notes, legacy healthcare players are also paying attention to the startup space. "Many legacy healthcare providers are launching their own telehealth service, and from our research we see this is an effective strategy,” she told CO–. “There are many tactics [healthcare organizations] can deploy to respond to this growing trend and ensure relevance in the future.”

McQuaid returns again to the parallels between his company and Netflix, highlighting the progression from mom-and-pop video stores, to Blockbuster franchises, and now today’s spectrum of home-streaming options.

“I think in medicine you’re seeing the same evolution,” he says. “The future is digital care.”

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Published April 13, 2020