The steady “Uberification” of modern life continues, and with it have come companies that provide “Uber style” medical home visits for patients.
KNOK began operating in Portugal in December 2015. A patient can call a GP and a number of other specialists through an app. This lets you see a map which shows which doctors are online at any time of the day and what their current geographical position is. It is also possible to call a doctor through their website. If a doctor receives and accepts a consultation request, he or she is guided by the app to the patient’s home via GPS. The patient can see the doctor’s progress on the app and the estimated time until arrival.
On a Saturday morning in November, I received a Whatsapp message from the KNOK team asking if I was available to do a home visit. Finally, after many months of being registered on the app, my first consultation was happening.
So what are my early thoughts? The most obvious edge that this kind of service provides is high accessibility to primary care doctors, as a patient can literally have a doctor at their doorstep just minutes after using the app.
Lisbon is Portugal’s largest metropolitan area and has the greatest shortage of GP’s in the whole country. There aren’t many public primary care services available during the weekend. Those that exist do not offer home visits and many people may be reluctant to take their children or elderly parents to the emergency department of the local hospital.
The other edge that this kind of service offers is the possibility to choose a doctor, which doesn’t usually happen with other private providers of medical home visits, where one has to go with whoever is covering the rota on that day. Even in the public healthcare system it is often difficult to be able to pick a GP, and assignment is more often based on availability rather than choice. Based on the information available on each online doctor’s individual profile, it is possible to choose a doctor based on gender, qualifications, language skills, or rating (doctors are rated by patients between one and five stars). All this information allows patients to choose who they think is the most suitable doctor. Being rated is something new and somewhat nerve-wracking to me, since patients do not rate doctors in the Portuguese public system, but I am aware it is commonplace in places like North America and seems almost inevitable in an era where we rate everything and everyone from hotels to supermarket cashiers.
I didn’t feel as time-pressured, because I didn’t have to see other patients immediately afterwards, which is usually the case with the public system or other private providers I have worked with. This allowed me to dedicate as much time as I felt I need to examine the patient without worrying that I was taking too much time. Moreover, I did not have to be the one to process the payments. With this app, payment is made online by the patient before the consultation thus making the process much safer and freeing the doctor of that burden.
I enjoyed my first experience as an “Uber-doctor” and the 15% average weekly growth is possibly a sign that patients are enjoying the service too. Whether and how it will ultimately drive change in the way society uses healthcare services as well as in the overall healthcare system only time will tell.
Tiago Villanueva is Assistant Editor, The BMJ and a locum GP in the Portuguese National Health Service. He also works as a freelance GP for KNOK Healthcare.