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Dr Mahnaz Hashmi spoke to EMJ with great excitement about the recent trend of clinicians stepping out from their day-to-day role of treating patients and becoming entrepreneurs, developing innovative solutions to healthcare problems. “Previously, you became a consultant for a few years then you either became a manager, or an educator, or you go into private practice,” she explained. “And actually, now this seems to be another route that you can get into. Hopefully in your day-to-day clinical work you’re not just improving the outcomes and care of the patient in front of you, but you can try and do something on a bigger scale that maybe impacts on the health sector in a bigger way.”
This phenomenon is displayed by the development of a new online service called Medstars, co-created by Dr Hashmi, that enables patients to find and choose the ideal specialist clinician for them in private healthcare in the UK. Part funded by the UK’s National Health Service (NHS), Dr Hashmi, along with co-founder Dr Barry Lambert, expect that a similar service along the same principles may be brought in for the public health system in the future. This is why Dr Hashmi believes there are potentially significant long-term benefits that innovations such as this could have for public health services like the NHS, as well as in the private sector.
Drs Hashmi and Lambert both work as consultants in the NHS, based in the city of Birmingham, UK; Dr Hashmi is a psychiatrist while Dr Lambert is a paediatric anaesthetist. The pair were inspired to create the service because of what they believed to be poor regulation in the private health service, leading to a lack of transparency in pricing and expertise for patients. They were therefore determined for their website to not simply be an amalgamation of as many healthcare professionals as possible, but to be composed entirely of hand-selected, verifiable clinicians from a range of specialisms, allowing for concise but informed options for patients using the service.
“We wanted to set up an online platform that was free for the patients to use to help them navigate private healthcare, so not a huge database of thousands of doctors and anyone who does private practice, but, with regard to each particular field of expertise, really starting to gather together an online community of people who are genuine and verified experts in those fields,” said Dr Hashmi. “And keeping the numbers fairly limited, because too much choice isn’t choice really, to enable patients to navigate the private healthcare market more effectively.”
This vision led to the launch of the pilot website in 2015, initially covering the regions of the West Midlands and London only, before the service officially began to encompass the whole of the UK in November 2017. This new, innovative service is something that the NHS is keeping a keen eye on; they have directly invested in Medstars because the same principles of the system in the private sector could potentially be transferred into the public domain, where similar issues exist surrounding navigation for patients. In particular, the data Medstars is gathering about patients’ needs and priorities and the possible future development of artificial intelligence systems to improve the navigation that takes place, could well prove to be of significant value for the NHS.
Dr Hashmi explained how the experience of the pilot changed the focus and priorities of the service they were seeking to create. Rather than a practice management system, with the ability to book, pay, and schedule appointments, Drs Hashmi and Lambert discovered that clinicians and patients alike had rather different priorities of what they wanted from such a service. From the clinicians’ point of view, the most important aspect was for their particular expertise to be clearly differentiated from others who worked in the same field but who did not have the same specialisms. For patients, much more important than being able to pay for and book appointments online was the ability to find the right physician for their particular ailment. It was at this point that the co-founders decided to unscramble their strategy, and build a system designed to prioritise what their users wanted in the most simple, hassle-free way possible. “We said OK let’s strip it back and go back to the core of what we do, which is about helping patients navigate the private healthcare system to get to the right person. So that’s what we learnt, and we’ve rebuilt the website so it’s much more focussed on that,” added Dr Hashmi.
Transparency in Choice
She also believes that one of the most important unique aspects of the Medstars service is the thorough selection process in place that clinicians have to go through to be included on the site, and the very personalised and detailed clinician profiles presented. They firstly try to ensure that there is an even spread of clinicians across specialisms, and not too many focussing on particular conditions, providing clear, coherent options for patients. The doctors on the site also need to adhere to Medstars’ values and standards to be included. Therefore, transparency is of the upmost importance in this respect.
“What evidence is there that they are genuinely specialist experts in the particular thing that they say they are an expert in?” asked Dr Hashmi. “Because most people don’t want to sell themselves as a general gastroenterologist for example, they want to say I’m a gastroenterologist and an expert in gallstones. So what evidence is there if you’re saying that? Are you just saying that because there’s a big market for gallstones in the private market? Or are you saying it because you’ve genuinely got some specialty expertise, and post-graduate training and qualifications that make you an expert in that? So I think that the level of rigour that we apply to understanding our clinicians is really important.”
Another fundamental part of the service is the emphasis on promoting the human side of the interaction between doctors and patients. A highly detailed profile of each clinician, argues Dr Hashmi, enables patients to be better qualified to select the doctor who they will form the closest personal connection with: a vital aspect of the doctor–patient relationship. “What we really wanted to do was understand who our clinicians are as people and really try and communicate that on our website,” she elucidated. “We have this thing called a personal pitch where we talk about their hobbies, their interests, things that usually get lost at the end of their CVs as they don’t really talk about it, but actually I think patients do want to know. You know it’s the surgeon who’s going to do a life-saving operation on me; who are they, do I get on with them, will they be really curt and brusque with me, or are they charming and engaged?”
Medical Concierge Service
Medstars also provides a thorough, clinically-focussed medical concierge service for patients who require more guidance about the specialist clinician they are looking for. This is in the form of a telephone consultation with a senior doctor who drills down and discovers the priorities of that patient, be it geography, timeframe of appointment, or price etc. Using this information, 2–3 suitable clinicians are identified from a search of clinicians from across the UK, not just from Medstars, for the patient to choose from, before an appointment is made. “Basically, all the patient has to do is have a conversation with us, choose from the shortlist, and then we set up the appointment and they go off and turn up to it,” explained Dr Hashmi.
With the model still in its early stages, the founders are very receptive to feedback and experiences of their users. Indeed, they are actively contacting patients who have completed an appointment through Medstars to understand the areas in which the service can be improved.
Innovations in Healthcare
Medstars is undeniably an exciting and innovative development, indicative of current trends towards new and unique healthcare services that many healthcare professionals are starting to engage in. Dr Hashmi believes that this reflects the fact that modern-day patients are generally better informed and aware of what they want from their healthcare providers than in the past, largely due to the vast information available to them. She also pointed out that such innovations, by enabling patients to undertake their own research and preparatory work outside of a GP surgery, can end up playing a crucial role in complementing and enhancing the excellent, but often resource-limited care provided by more conventional bodies like the NHS.
To access the Medstars website, click here.