Eyeworld

EW NEWS & OPINION 20 June 2016 Insights Jack: (glances briefly out the window and then fixes on Mike's eyes) The primary care house call startups like Heal, MedZed, and Pager are not suitable for ophthalmology. Think cost side of the ledger. Your staff? Millennials love flexibility and are less loyal to a job than their parents. Temp and on-call jobs are grow- ing, conventional jobs declining. A tech, say one doing tests, sets his hours and is paid a fee for each test performed. You could offer a bonus based on patient satisfaction. Salary, benefits, vacation and sick days, Jack: (eyebrows raised, gray eyes intent) Not really. Sam's nurse is an employee. With Uber, you feed the entrepreneurial beast within. Politi- cians have no clue how to regulate this model because its workers are neither employees nor indepen- dent contractors. The whole thing's in flux. Uber's business model is a smartphone app platform feeding a competitive cost advantage. Mike: Hmm. OK, so how does this work in an ophthalmology practice? the Industrial Revolution. In today's digital age, it's called the gig econ- omy. The silicone chip and GPS make the magic. If you have a car, a smartphone, and free time, you can earn some serious change when you choose. Flexibility is its own reward. I wish I could've picked when I wanted to take weekend call. Mike: (Frowning ever so slightly) Their model is under attack. Law- suits, unions, municipalities, even the Feds threaten their existence. But too many Silicone Valley VCs think that there's gold in providing services for people who have money but no time. My kid picks up mad money on Sunday working for Instacart. She loves to grocery shop. Why not get paid for it? Jack: (brightening, a devilish smile on his lips) We practiced in ophthalmol- ogy's golden age and got out when the getting was good. Time and money? Why not uberize medicine? Mike: Isn't that what the walk-in clinics at Sam's Club did? A 1-act play in which 2 seasoned ophthalmologists banter about the gig economy A clean, well-lighted place, a Philadelphia coffee shop. Upstage, traffic noise is heard beyond 2 large storefront windows. Behind 3 tables, patrons parade to the counter for their drinks. Neat and casual, 2 men, both of an age when life no longer astonishes, sit at a table. Jack: (looking out the window with- out purpose or intent) I went to the Phillies game yesterday. Good game. They won, but the traffic! I ubered down but took the subway back. I felt sorry for the guy in the Mets cap. He took some abuse. Mike: (a smile punctuates pronounced crow's feet) Ha! Serves him right for wearing a Mets cap. This may be the City of Brotherly Love, but it does have a reputation to uphold. Uber? Smart move. How much did it set you back? Jack: Not sure. I didn't check my email. (pulls out an iPhone and taps on the screen) $7.50. While it's up, I'll give the guy 5 stars. He said he was a post-grad at Penn. He's going back to Egypt to set up the government's computer security system. Imagine, my driver's a PhD. Mike: (looking earnestly at Jack) Beats working construction in Scranton like I did my first summer of med school. Uber's interesting. It's a met- aphor for the profound choice, time or money? Even the super rich aren't spared. Uber exploited this dilemma to a market cap of $40 billion. Jack: (leaning forward, both hands on his cup) Their business model isn't new. Piecework was a mainstay of Paging Dr. Uber by J.C. Noreika, MD, MBA J.C. Noreika, MD, MBA " It's all about providing a service a paying customer wants when and where he wants it. Uber proved that people will spring for that. "

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