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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me



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Millennial Health Care Delivery

Millennial (mə-lĕn’əl) adj.

1. Of or pertaining to the millennium, or to a thousand years
2. Generation of Americans younger than 29 in 2007 with unique social, cultural, and market identity

* This is a companion piece to an article called Millenial Patients that will appear in MDNG shortly *

The highlight of last months Health 2.0 conference was the segment in which three enterprises physicians discussed their next generation practice models. We heard from Enoch Choi, MD at Palo Alto Clinic who has a traditional, but technology enabled practice; Jordan Shlain, MD of San Francisco On Call which provides a cash only mobile practice; and from Jay Parkinson, MD who has attained the most notoriety through his unique approach, clinical skill set, and artistic flair. These services are representative of a growing number of similar practices that serve as an example of another important concept to consider in preparing for next generation health care. Millenial patients will demand a new range of services, many of which currently do not exist within the current medico-industrial insurance construct. In fact, the provision of niche services which have traditionally fallen outside the concept of traditional health care may prove to be the biggest opportunity to impact care delivery.

This conceptual framework can be understood within the technology description of The Long Tail. First described in the popular press by Wired Magazine Editor Chris Anderson in 2004, it is basically descriptive of unique markets wherein distribution and storage costs approach zero and therefore the provision of small numbers of less popular items actually is more profitable than the provisions of large number of popular items. The math works out as such that the area under the “long tail” part of the curve is as big or bigger than the area under the curve to the left. This long tail represents all the niche, specialty offerings that can be purchased so that when aggregated, the niche market opportunity is bigger than the mainstream.

The anatomy of the long tail shows that most patients consume a relatively small number of core health care related services. These have been provided in a prescribed way for decades and have address most basic health care needs. However, as science and technology advance, there have been, and will continue to be new, more efficient, and hopefully effective treatment options. Over time these new therapeutic options themselves become more personalized and specialized in order to address the needs of niche target populations. The number of personalized services will ultimately outstrip the traditional health care service offerings.

Long Tail Anatomy

Remixed with the expectation of obtaining permission from Wired Magazine Issue 12.10, October 2004

But niche products are not for everyone. Most people have gotten and can continue to get traditional health care services. However, newer technologies that create new value propositions might fill an entire set of health care needs just as well, or perhaps even better. The personalization of medical services allows them to be consumed “wherever the consumer is” along the health care delivery continuum based on their unique value equation. So while not everyone will want to speak live with a physician for $1.99/minute, there are certainly some who will, and they can be recruiting into the next generation health care system via health care delivery offers that occurs within the long tail of healthcare.

Sliding Down the Long Tail of Health Care Services

* Remixed with the expectation of obtaining permission from Wired Magazine Issue 12.10, October 2004

Millenial Health Care System

We are entering an unprecedented period of accelerated discovery and change within health care. Millenial patients are beginning to demand a higher quality of service and a more meaningful relationship with their provider consistent with their experiences in other sectors of the market. Millenial providers will create service offerings that will address these specialized needs and help deliver appropriate health services within a personalized context. This “partnership of care” will need to be supported by the very best technology, products, and services associated with the pricing, quality, and effectiveness information required of a value-driven system. When these elements become transparent and aligned with appropriate fiscal incentives, the US Health Care system will approach the efficient, next generation health care system that can continue to serve our countries health care needs well into the new millennium.

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