March/April 2008

THE PENN STATER

well-dressed young man with tousled hair recently struck up a conversation with a barista at a Brook-lyn coffee shop. The barista had seen the man quite often in recent weeks, and she asked him what he didfor a living, and that was all it took, the man would say later, for him to sense an open-ing. He said he was a doctor, and then he took it a step further: He asked the barista if she had health benefits.In this day and age, and given this woman’s job, Dr. Jay Parkinson figured theanswer was obvious. And he was right: She did not. In fact, it could be argued, giventhe unconventional trajectory of his career to date, that Parkinson’s marketinginstincts may exceed his instincts in medicine. He has made his name by approachingaconventional problem—the costly, inefficient, and impersonal monstrosity that ismodern American health care—in an unconventional way. This was why he asked thequestion in the first place. And this was why

Parkinson ’02 MD Hershey

returned later, during the barista’s break, and personally laid out his methods and philosophy. He told her about his newprimary-care practice, Hello Health, which had recently opened a few blocks away, onBerry Street in Williamsburg, next to a liquor store and several bars, in a district of Brooklyn that has earned a reputation as the epicenter of New York’s young, culture-obsessed “hipster” crowd. Parkinson told the barista that Hello Health charges a $35monthly membership fee, and a flat fee for appointments: $100 for a simple visit, $150

inventive

medicine

Can a hip, tech-savvy 33-year-oldBrooklyn doctorfix what ailsAmerican healthcare? Jay Parkin-son doesn’t seewhy not.

BY MICHAEL WEINREB ’94 ComPHOTOS BY NOAH KALINA

March/April 2009

THE PENN STATER

for issues of moderate complexity, and $200 formore time-consuming issues. For a smaller fee—as little as $50 in some cases—she could get con-sultations by more unorthodox means, likeinstant message, video, and e-mail (sending aphoto of a suspicious-looking mole, forinstance). She’d have access to cheaper genericdrugs and more affordable specialists. She couldmake all of her appointments online, a rarity inan industry where nearly all business is still doneon paper. And she didn’t need insurance, because Hello Health doesn’t accept it.Parkinson walked the barista through themath, until he convinced her that he would takecare of her much more cheaply than any doctor who subscribed to the traditional methods of the American health-care system and insuranceindustry ever could. For a young and relatively healthy person, Parkinson argued, the cost of monthly membership and one or two annualconsultations or visits is a fraction of what she’dpay through an employer-offered health plan.“Thirty-five dollars a month—that’s like fourhours she has to work,” Parkinson says, describ-ing the encounter. (Yes, the barista signed up.)“But we’re going to take care of her, because shehas problems.”Here, laid bare, is the essence of Parkinson’senterprise: People have problems, and many of those peopleare either unwilling or unable to pay for health insurance todiagnose or remedy these problems. Because of that—becausehe harbors such disdain for the methods of insurance compa-nies, the frustrating limitations of their physician networks,their seemingly arbitrary means of determining what will and won’t be covered—and because he sees how rising costs (formalpractice insurance, or for maintaining endless mountainsof paper records) have forced primary-care physicians to takeon an absurd number of patients just to maintain salaries inthe mid-to-high five figures—he has chosen to rebel.In the past few years, Parkinson, 33, has been refining hismethod of skirting the system, of integrating the Internet intothe practice of medicine and making a profit at the same time.In September 2006, he started a one-man practice withoutthe expense of an actual brick-and-mortar office; he ran itentirely through his iPhone and MacBook laptop, advisingand diagnosing patients by e-mail, text message, and video-conference. He did not accept insurance. If a patient neededmedication, or an X-ray, he would comb the city for thecheapest options, gradually building a network of empatheticpharmacies and specialists along the way. If his per-sonal attention was required, he made house calls. Along the way, both because of his unusual approachand his leonine good looks, Parkinson became some-thing of an online celebrity. He was profiled and inter- viewed in both newspapers and influential blogs, earn-ing himself several nicknames (including Dr. IM, as in“instant message,” and Dr. Skinny Pants, a reference tothe retro-fashion trend among the hip-ster crowds), as well as a great deal of attention, both wanted and unwanted. At one point, the catty gossip Web siteGawker linked to the Flickr.com pagefor Parkinson’s amateur photography hobby, which included a photo of thedoctor, sans shirt.Parkinson claims to have “neverreally thought of myself as part of that”hipster culture, but there was littledoubt that his approach was targetedto such an audience—the young, the healthy, the urbanuninsured, many of whom rely heavily on the Internetto guide their decision-making. Targeting such a nar-row audience made him an easy target for naysayers; but then, don’t millions of Americans lack affordablehealth care? Hasn’t the new president made digitizingthe nation’s medical records a pillar of his plans forhealth-care reform? Parkinson’s practice might only reach this small corner of Brooklyn, but his premise—the benefit of a smarter, less institutionalized, moretech-savvy approach to health care, for patients anddoctors alike—could apply to

everyone

.Indeed, though Parkinson acquired about 300patients in that first practice, he had always dreamed of something bigger than a one-man medical practice. Hefigured he couldn’t change the entire health-care sys-tem, but maybe he could change a piece of it. He alsofigured all the media attention would allow for furtheropportunities. Again, his entrepreneurial instincts were correct.Parkinson abandonedthat initial stab at anindividual practice and partnered with the Canadianfirm Myca to launch Hello Health. He has an officenow, and shares the practice with three other doctors, but the digital accessibility and anti-establishment phi-losophy (not to mention marketing savvy) he started with three years ago remain intact. A link on the prac-tice’s Web site—hellohealth.com—reminds potentialpatients that, “Once upon a time, going to your doctor was simple. Then things started to change … we nowhave to contend with … insurance premiums … deduct-ibles, HMOs, OTC drugs, specialists.” Hello Health,goes the pitch, is the friendly neighborhood doctor youmay or may not remember from your youth, only now with an iPhone in that black bag.For a doctor who was all about play-ing David to the Goliaths of thehealth-care industry—he regularly rails against insurance companies, BigPharma, and ineffectual governmentat blog.jayparkinsonmd.com—hook-ing up with a private health-technol-ogy company raised eyebrows. A med-ical trade magazine put him on thecover with the headline

Jay Parkinson Sells Out?

Parkinson would claim that what he has done is nothing like selling out. Myca, hesays, is a privately funded company that acts essentially as an R&D firm for his ideas; it has a team of softwareengineers working to improve the Web site and HelloHealth’s ability to provide services outside the tradi-tional insurance-based system. But Parkinson insiststhat the creative concept remains very much his own.He says he is filling a niche, offering affordable healthcare to those who can’t get it any other way.But he also recognizes that the people he’s marketinghimself to are looking for a different kind of experiencethan what their parents or grandparents might expect.The personal barriers between doctor and patient, thegruff bedside manner, the hurried visits—those thingsdon’t work with a generation that lives an increasing per-centage of its life online and no longer sees inappropri-ateness in blurring the line between personal and profes-sional. This is why the doctors Parkinson has hired so farat Hello Health list their hobbies and favorite books onthe Web site alongside their bio. And it seems to have worked: Parkinson claims one of the docs has gotten sev-eral patients who requested him because he named

The Big Lebowski

as one of his top films.This philosophy, one would assume, is also why HelloHealth’s first office (there are plans to open others indifferent New York neighborhoods eventually) feels asmuch like another Williamsburg coffee shop as it does amedical practice. It can be disconcerting to walk into adoctor’s office and immediately come face-to-face with

Last May

Parkinson’s prac-tice might onlyreach one cornerof Brooklyn, buthis premise—lessinstitutionalized,more tech-savvyhealth care—couldapply to everyone.

UNPRETENTIOUS:The HelloHealthstorefront feels as much like a coffeeshop as a medical practice.