This week we sat down with Dr. Rachel Roth, founder of Healis Health, a platform described as the “AirBNB” for physician practices. She shares her story of building a telemedicine company created by physicians, for patients and physicians.
1. Tell us about yourself and your story.
Firstly, thank you for this opportunity. My journey in medicine is similar to many physicians. Medicine is something that I’m passionate about. Since childhood I knew that it was in my future. My medical school experience at the Cleveland Clinic was uniquely inspiring but soon after being exposed to the practice of medicine on my hospital rotations, I began feeling demoralized by the pervasive inefficiencies, toxicities, and unaddressed social determinants of health. I felt that our efforts fell so short of what patients needed to achieve health and watched my peers and myself sacrifice our own wellbeing continuously. I had my first son in medical school and struggled with the separation from him especially in infancy.
Unsure whether or how to continue, but determined to find a way to improve the system and care that patients received, I chose family medicine and continued to Seattle to complete my residency. There I worked in pilots of alternative access models, early DPC. I also learned what it meant to be a physician in this day and age. Managed care, quality incentives, billing & coding, RVUs, MOC, admin bloat, the increasing complexities that sat in the room with my thinking while I tried to be fully present and thoughtful around the actual medicine. A few days after graduating residency, our young family took all our miles (we had little money) and booked a one-way flight through Spain to Israel. I felt deeply the need to recover and re-center. We planned to stay a few weeks or even a month, but we stayed for years.
2. What inspired you to start Healis Health?
The founding of Healis Health was serendipitous. I did not set out to found anything, but rather to create for myself a telemedicine practice that allowed me to create work-life balance, have freedom and autonomy, and to connect with patients fully and as much as they need to achieve health – inspired by the success of the DPC (or direct care) movement.
A good friend from residency was talking about moving internationally and we were discussing the limited options that exist for US doctors working abroad. I suggested that she and I partner up and create a practice together. We thought we would look for another one or two doctors who might be interested in starting a group practice, thinking we could get better traction and coverage as a small group rather than a solo practitioner. I floated the idea on Facebook, in the Hippocratic Adventures Physicians Group, and stepped away from my computer for a few minutes. By the end of the day, 500 physicians had responded with their interest. Starting a company was not something I had planned to do, but the responses all looked so familiar: they told stories of burnout, obligations to family being overridden by work, feeling of disempowerment, and doctors planning to leave medicine because they could not compromise their care anymore. It was clearly a need – a movement – so I did my best to step up and organize.
3. What were the first steps you took?
We called the group, “Physicians United.” This captured the essence of our mission. Subsequently we rebranded for the patient-facing platform as Healis Health (easier to spell and recognize), but the collective action of the group name remains. We then established it as a physician-only space and eliminated the charged word “provider.” I put together a very lean practice model with as little admin as possible, and no CMS or insurances, and shared it with the group. Every physician set their own practice scope and pricing and we collaborated to choose certain basic platform price points. I went through the paperwork to establish a formal company and invited doctors to invest in the company – if the group succeeds, we all succeed.
With this seed money, we built a website, set up our malpractice policy, managed the legal documents and hurdles, and set up payment collection and the EMR/telemedicine tech. During this process, multiple doctors jumped in to help, including my colleague and medical school friend, Dr Samir Thaker, who has an impressive resume in tech and consulting, and our only non-physician Pamela Ferman, who has brought her experience serving on healthcare boards, running a credentialing and licensing business, and serving in the role of VP for Physician Outlook. With a team and the pieces in place, we were ready to pilot the project.
4. What has been your biggest challenge?
Our biggest challenges are two-fold. Firstly, funding. In studying other companies we see that they often fail because they are expected to scale too quickly and not organically, and also because ultimately the business interests take over and shift the mission to profit-above-all. We are here to do something different, something long-lasting and physician- and patient-centered. Thus, we are looking for investors who are mission-aligned while also understanding that to succeed, the business must succeed. Secondly, reaching patients is difficult. Other companies take their millions and advertise. We are supporting our doctors in their outreach to patients, which takes time. Our growth is slow and steady, but we do feel the pressure to get this lifted off the ground for everyone’s benefits.
5. What has surprised you?
I am continuously surprised and heartened by doctors’ commitment to this project. Every time we come to a hard place, a difficult conversation, an unknown, or a compromise, I reach out to the group and inevitably receive a robust response in support of whatever it takes to make this succeed. At one point I polled the group to ask how many would stay active if they didn’t get a single patient for a year: 100% of doctors said would remain. We have doctors with their own practices who do not even need the support in our group, because it means so much to them to see it succeed. For their colleagues, their patients, future doctors, and the future of medicine. It is a remarkable energy.
6. What has been your most effective way of raising awareness about your business?
Word of mouth among physicians. For patients, we are still figuring out what works. Grassroots growth and neighborhood practices – the personal, human aspect – is still our most powerful tool.
7. How is Healis Health different from other telemedicine companies?
In so many ways. I’ll name a few. Doctors are autonomous: they set their own hours (and can change them), scope, fee schedule, most everything. Their opinion matters. They have access to the administration and say in the organization. The doctor-patient relationship is primary and they can take their patients with them if they leave. They are not locked into a contract and there are no non-competes. They work from wherever they are, even abroad. There is no cost to join, and their percent payment into the pool supports growing their practice. It also has both primary care and specialty practices. We cross-refer and cross-consult to each other when that is in the best interest of the patient, and can do peer-to-peer consulting as well. It is a full health ecosystem designed in support of physician and patient wellbeing.
For patients, Healis uniquely offers them choice of doctor, and continuity with a doctor that comes to know them personally. We don’t believe in band-aid medicine or the revolving door of never knowing who you will see. It also removes barriers to access, so that patients can see a doctor within a day or two, and can consult with specialists outside of their own state in some circumstances. Perhaps most importantly there is no insurance required, so for those millions who live without any insurance coverage or with “bad insurance” ie high deductibles, this is an incredibly affordable and accessible solution that offers top level care.
8. For a physician looking to join your company, what should they know?
You do not work for Healis, it works for you. Healis covers everything you need to practice. Malpractice, EMR, electronic prescribing, legal documents for patients to sign, everything. It is integrated with labs (discounted for patients) and imaging. You can have any kind of practice you can imagine. As doctors ourselves we will do our best to support your success. We endeavor to be fully transparent as we consider you an equal member of the team.
The biggest hurdle to starting your practice then is building your panel. We help you with step by step guides and printed materials, but in our experience practice, growth is gradual. This can be done remotely or in-person/locally. I share this with everyone so that they understand what work will be expected of them when they join and how the experience will be. It is a long-term investment in yourself and not a quick-money side-gig.
9. How can a patient receive care through Healis Health?
Patients land on our website www.healishealth.com where they can search by state, or for a particular physician or specialty if they know who or what they are looking for. They can choose to sign up with a doctor of their choice for a monthly or annual membership in which they have unlimited access, or a one time consultation. Patients then communicate directly with their doctor by SMS (which texts into the electronic medical record) or by setting video or phone appointments. All visits are virtual, but the relationships and connection build with their doctor is real. Their prescriptions are sent electronically to their local pharmacy and refilled automatically as long as they are members.
10. Is it all worth it?
The creation of Healis Health by Physicians United is attempting something that has never been done. It is nothing less than reclaiming the doctor-patient relationship and putting it back where it belongs – at the center of healthcare.
It is difficult, and not every day feels like a success. But every time I want to walk away, I feel the support of the hundreds of physicians who believe in this mission and who are committed to seeing it succeed. I think of the many patients whom I have treated knowing that without insurance they would fall through the cracks in the system and not be able to care for their health. And I think of the future of healthcare in the US, with these patients and doctors needing to connect directly, to live their lives healthfully. It is all worth it.