First Opinion Connects New Moms with Mom MDs via Text

TILDEN - First Opinion

It was the middle of the night and I’d just nursed my son back to sleep. I was having of one of those “he’s so perfect” moments, when it hit me that his head was flat on one side. Or was it the light?

I put him down and tore into the living room to grab my computer. I shook my husband awake, yelling, “Flat head! He’s got flat head!” He grumbled and went back to bed. Meanwhile, my shouting woke up the baby.

I pulled up dozens of recent photos, none of which offered clarity. Without reassurance, I Googled, “BABY FLAT HEAD.” Seemingly a million photos of babies in head-sculpting helmets filled my screen. I panicked.

I emailed my pediatrician (2:04am), to which I received a prompt “Out of Office” reply. I went back to Google - this time with ice cream. When my husband woke up four hours later, I was still awake, sweating and staring at my computer screen.

Sadly this was not an isolated event. I had similar anxiety over spit up (one “episode” flew straight across the room landing on our dog), late teething (will my son look like an eel forever?), late walking (maybe he’ll just be the guy still sniper crawling into high school?), poop color, cradle cap, and fevers. You get the picture.

In 2014, First Opinion launched as an app for new moms to text doctors 24-hours a day. Founder and Chief Executive Officer McKay Thomas, inspired by his own wife’s experience, thought moms could use a trusted source to reach out to day and night.

He was right. Today, the company says it is logging around 5,000 patient consultations per week. Six months ago, that number was 400.

Thomas doubled down on moms. Not only are they First Opinion’s biggest users by unit volume, Thomas says they also represent 80 percent of the company’s global doctor network (and 90 percent of its doctors are women). 

“We can’t take our eye off moms,” Thomas said to me in an April interview. Although First Opinion is open to everyone, moms tend to want much more frequent contact with doctors, according to Thomas.

“During the third trimester and the first few months following birth, moms are chatting [with our doctors] sometimes daily,” he said.

There are many telemedicine companies out there (Teladoc being the market leader), but First Opinion is unique in that it continues to offer a free way for patients to talk to a doctor through what it calls a “companion” service. This helps to save time and money as patients can figure out whether their issue is even worth paying for, Thomas said. A companion doctor could be located anywhere in the world, but average response times are less than 60 seconds, according to the company.

Having an initial screening process helps to solve what Thomas believes is one of the biggest problems in healthcare – access.

Wait times to see a doctor are increasing nationally, government data shows. Patients have to wait on average 22 days to see a doctor, up from 19 days in 2009, according to the Centers for Medicare and Medicaid Services.

Long wait times for office appointments drive patients to the emergency room with no where else to turn. Over 70 percent of ER visits in the U.S. are unnecessary, a recent study done by Indiana-based healthcare consultants Press Ganey found.

Thomas said patients needing follow-up help are connected through his service to a licensed doctor in his or her area. The new doctor is given an overview of the issue, saving time when the user connects.

After asking a few clarifying questions, a local doctor can diagnose the problem and prescribe what is needed quickly, sometimes in five minutes or less, Thomas told me. Prescriptions can be called into a patient’s local pharmacy or even delivered within a few days.

Today, First Opinion is a full-service health technology company aimed at optimizing the doctor-patient experience. Patients can use the app on the go on their mobile device or speak to a doctor on their desktop in the comfort of their own home.

But telemedicine isn’t for everyone, of course. Patients don’t always have the undivided attention of their doctors – the concept promotes multitasking on both ends. And a photo or video can’t always get a complete picture of an issue, some experts say.

Angie Jelin, M.D., a maternal-fetal specialist at Johns Hopkins in Baltimore, said she worries about the quality of care patients receive when it’s not face-to-face.

“I worry especially about physicians who are at home helping patients,” she said. “The person who has hands-on experience is more qualified to counsel a patient.”

While some physicians have concerns about device-enabled care, Thomas feels First Opinion’s mobile app better enables a relationship between a doctor and a patient versus desktop-only platforms.

“The relationship on a desktop is more transactional,” Thomas said. “You’re looking to get something very specific out and leave.” With texting, however, patients can ask follow-up questions or continue a conversation at any time.

In addition to convenience, Thomas believes his app offers greater efficiency for doctors.

“With a traditional video service, there has to be a scheduling alignment and a doctor can only do one thing at one time,” he said. With the First Opinion app, doctors can sometimes do shifts in a hospital and message patients during downtime, Thomas said. Full time First Opinion doctors can do several consultations simultaneously. 

“We call it asynchronous communication,” Thomas told me. “And it works especially well for busy patients and doctors alike.”

Telemedicine as an industry, while rapidly growing, is still very young. In person physician office visits still totaled over 900 million in 2014, according to the CDC.

“It’s dawn and most of the country hasn’t even gotten out of bed yet,” Thomas said.

Answers 24-hours a day in 60 seconds or less? I’ll likely be texting a doctor tonight.


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