Third Place Health Care

By Evan Falchuk

Media reports on misdiagnosis continue to mount.

A recent study on patients with Alzheimer’s found that half had been misdiagnosed.  Half.

Another headline blared “4 out of 10 patients being misdiagnosed.”  The article encouraged patients to “see another doctor” if they are worried about their diagnosis.

You know what it makes me think about?

Starbucks.

Why?

Because the way Starbucks revolutionized coffee drinking shows a way forward for health care.

Starbucks realized that since our lives focus on two places – home and work – most of us don’t have a “third place” to go.  A place where we can be free of everyday distractions and take care of ourselves.  Starbucks set out to create that “third place,” by making its stores comfortable, inviting places.  It works.  “Third place” makes customers’ lives better – and Starbucks has almost 20,000 stores to prove it.

It’s time for a kind of “third place” in health care.

Health care focuses on two places, too: the doctor’s office and a hospital.  Both places are difficult for patients.  Patients complain of not getting enough time from their over-worked doctors, and studies of things that go wrong in hospitals are equally disturbing.

There really isn’t a “third place” to go to in health care.  Somewhere that you can step outside of the difficult process of being sick.  Somewhere you can get a quiet, clear perspective of what is going on.

Now, some people are lucky and can turn to relatives or friends who are doctors to provide some of that “third place” experience.  But most people cannot.  At Best Doctors, we’re creating the experience of a health care “third place.”  We do it by taking the time to review each case, have doctors think about what’s happening, consult with experts, and share advice.

In 2010, we found incorrect diagnoses in more than 20% of cases of the cases we reviewed.  We found incorrect treatment plans in more than half of cases.  These data match independent studies of misdiagnosis and faulty treatment.

Consider Rosa (not her real name), a 45-year old woman.  She had been having trouble with her thyroid, and after a biopsy came back “inconclusive,” she endured months of treatments that didn’t seem to help.  As part of her benefits package at work, she had Best Doctors and so she called.  She was worried, but mostly she was frustrated that she couldn’t get answers to what was happening to her.

We collected her records, reviewed them, and identified the important issues in her case.  We consulted with an expert in the thyroid problem the doctors thought she had.  He said the “inconclusive” finding on the biopsy and the lack of response to treatment were worrisome signs of cancer.  He recommended she have her thyroid removed.

Roslyn shared this information with her doctor.  The doctor agreed, and she had surgery to remove her thyroid.  It turned out that the thyroid was riddled with cancer.  It was a missed diagnosis that could have threatened her life.  Today, Roslyn is doing very well.

Stories like Roslyn’s are familiar to anyone who has faced illness, and is one of the ironies of modern health care.  We have the best trained most capable doctors in history, and yet it can be harder than ever to get the right care.  The increasing demand for what we do speaks to the need consumers feel to find health care’s “third place.”

  • "Medicine is learned by the bedside and not in the class room. Let not your conception of manifestations of disease come from work heard in the lecture room or read from the book: see and then research, compare and control. But see first."
    - Sir William Osler, MD
    The Father of Modern Medicine
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