What can health care learn from Uber?

I just spent the past few days in Boston for my daughter's college orientation (last one for the Wheeler family!).  I decided, with my wife's permission of course, to run my own experiment.  I was interested to know whether Uber was less expensive than a typical taxi cab fare (my hypothesis was that Uber was cheaper, but I really can't say why I believed that to be the case).  The conditions in the two experimental groups (group 1 - Uber, group 2 - taxi) were fairly identical - a one-way trip from our hotel to the college campus, same pick-up and drop-off location and similar time of day (we actually took two separate trips approximately 1 hour apart - don't ask why!).  Contrary to my original hypothesis, the costs were about the same, including the tip.  So based on this experiment, it really doesn't matter whether you take Uber or a taxi.  There is a big "however" here... 

The convenience of using the Uber app far outweighed any advantage to taking a taxi.  I was able to use the app to arrange for our pick-up.  I knew how the Uber driver had been rated by previous users.  I knew my charges in advance, as well as the estimated time that I would reach our destination.  Finally, I didn't have to worry about paying the driver, as my credit card was automatically billed by the app itself.  Contrast that with the typical experience with a taxi.  First, and perhaps most importantly, unless you are in an area where taxi cab drivers frequent, you have to search on the Internet and find a telephone number for a taxi cab company and call to arrange pick-up.  Even if you are at a public venue, you either have to flag down a taxi driver yourself or pay a tip for someone from a hotel or airport to flag one down for you.  Second, you have no ability to see how others have rated the taxi cab driver or know in advance how much the taxi fare is going to cost.  Third, you have to either pay in cash (the method that seems to be preferred by almost every cab driver I have used) or use a credit card (I doubt that most taxi cab companies have the latest and greatest IT security systems, so using your credit card brings the additional risk of credit card fraud). 

In all fairness, there was one incident over the last couple of days when we could not connect with our Uber driver.  The driver cancelled our appointment and charged us a penalty fee of $5.  However, with a quick explanation on the Uber app's "help" button, I was able to avoid the $5 penalty (although we ended up having to go "old school" and have the hotel bell hop call us a cab).  On the other hand, when we needed to be picked up at the college campus to go to the airport, there was not a taxi in sight.  It was raining, which may have been one reason why we could not find a cab (see great article here).  The convenience of Uber proved itself again.

So what is my point?  During our flight home, I pondered to myself and thought that there is a lot that health care can learn from Uber.  First is the issue of convenience - on this point, Uber beats out the taxi cab companies hands down.  We are seeing a similar phenomenon in health care with the increase in so-called retail health care clinics.  These clinics are typically staffed by nurse practitioners or physician's assistants and are located in pharmacies or grocery stores.  As far as convenience goes, it's hard to beat the proximity to patients' home as well as the hours (usually after the normal work day) that these clinics are open.  While one could certainly argue that the care provided at these locations is not as good as the care provided by a patient's own primary care physician (the two biggest complaints from primary care physicians that I have heard are that they overprescribe antibiotics and that there is no continuity of care), most studies suggest otherwise.  Moreover, as far as continuity of care goes, the shift towards team-based care, even in the primary care setting, often means that you don't necessarily always see your primary care physician (you may see one of his or her partners, or even one of the practice's nurse practitioners or physician's assistants). 

Second is the issue of price transparency.  When you use Uber, you know in advance how much it is going to cost you.  Again, in most cases, the retail clinics provide a fairly comprehensive listing of their charges for a number of different visit types.  Unfortunately, most primary care practices and hospitals still do not provide this degree of price transparency (certainly not BEFORE the care is delivered). 

Third is the issue of driver ratings.  How much better would it be if patients were able to rate their providers based on friendliness, courtesy, how well they explained the care that was going to be provided, and how much time they spent with the patient?  Many health care organizations are heading in this direction, including my current organization.  Anecdotally, we and others have found that transparency around individual provider-specific experience ratings typically results in a better patient experience over time (most physicians will use these ratings to improve their delivery of care).

Finally, from a technology perspective, Uber clearly beats out taxi cab companies.  I think health care is heading in that direction, but we still have a long way to go.  I remember watching the cartoon, "The Jetson's" when I was a child.  Whenever Elroy was sick, he would be seen virtually by his pediatrician (see picture below).  It is hard to believe that we are seeing more of these kinds of "virtual visits" through telemedicine in health care today!

Suffice it to say, there is a lot that we, in health care, are learning and can learn from a company like Uber (with the notable exception of how their CEO runs the company, of course).  What does all of this have to do with leadership in health care?  Easy - as I have suggested in a number of previous posts, we as health care leaders can learn a lot by going outside our own industry.  There is a lot for us to learn from other industries.  The parallels are there, if we just simply take a look.