EW NEWS & OPINION
June 2016
21
Jack: OK, how about surge pricing?
That type A accountant who abso-
lutely must have the first afternoon
appointment on Monday. That'll
cost him $25. He's in and out, and
the hour saved waiting later makes
him a couple hundred bucks at his
office. Or, don't want to go to the ER
on a Saturday night for that corne-
al abrasion? Sure, I'll open up the
office. There's a $100 convenience
fee. Push back? (Laughing) Maybe,
but 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. And it's
not just Uber. Airbnb, SoFi, Etsy,
Instacart, and Luxe are based on dig-
ital peer-to-peer exchange. Too soon
to tell if this validates Schumpeter's
notion of creative destruction. But
Instacart's latest round of funding
raised $220 million. Somebody
thinks something's changing, but no
one is sure just what.
Mike: (collecting his backpack beneath
the table) Blessed or cursed, we cer-
tainly do live in interesting times.
Jack and Mike get up to leave; the
stage, lit only through the windows,
darkens. EW
Editors' note: Dr. Noreika has practiced
ophthalmology in Medina, Ohio since
1983. He has been a member of ASCRS
for 35 years.
Contact information
Noreika: JCNMD@aol.com
withholding, worker's comp, health
care, maternity leave, 401K all go
away.
Mike: (taking a deep breath) Staff-
ing is the biggest cost center in a
practice.
Jack: (softly chuckling while sipping at
his cup) And the biggest headache.
This pool of techs can be shared
across locations, even practices.
You'd need enough to meet demand,
but they'd figure out how the work
gets done. The more they do, the
more they make.
Mike: How else?
Jack: (brushing crumbs off the table
absentmindedly) Remember, time
and money. Provide a service for
folks who have too little of 1 and
enough of the other. How about a
patient concierge service? Grandma
has a doctor's appointment and
granddaughter Jessie's got to meet
a client, same day, same time. Like
a hotel shuttle, patients get picked
up on routes coordinated with office
schedules through smartphone
logistic apps. The drivers are retirees,
own their vehicles, have insurance
and good driving records. It's not
free. The driver captures a portion
of the fare and tips are appreciated.
Different practices might share the
same service.
Mike: (with a wry smile) You've been
thinking about this. What else has
Uber taught you?
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