A DOCTOR WITHOUT AN OFFICE

Let us be the latest but certainly not the last blog to spill a few pixels over Jay Parkinson, M.D., of Brooklyn. The good doctor and scarily accomplished photographer (see his work as a shutterbug here and here) has an offer to take care of you for $500 a year. And most of the time, you’ll be meeting online.
Parkinson, 31 and freshly licensed, has got no office, though he’s looking into renting a room. You’ll get two face-to-face visits a year (at your apartment, office or other mutually convenient place) and unlimited “e-visits,” his word not ours, for help with your health. Those e-visits could be IM chats, emails, or Web video sessions.
There are some catches. You have to apply online to be a patient (see his Web site here) and that system won’t be up and running for a few days. Also, you’ve got to be young and in lower Manhattan or hipster Brooklyn (not an oxymoron for those of you outside NYC, believe it or not, but the neighborhoods of Williamsburg and Greenpoint).
A friend tipped us to a post on Gawker about Parkinson, who was also noted on Boing Boing and Apohenia and who knows where else.
We IM’d Parkinson (pictured). He responded, well, instantly, and then we had a brief conversation by phone about what he’s got cooking. Here are highlights.
How did you get the idea to do this?Well, I’m not a typical doctor. I get along fine with other physicians, but I didn’t enjoy the hospital or clinic environment. I’m a photographer as well. I shoot for Men’s Journal and stuff like that.
Are there any special hurdles to running your practice this way?No, not really. You have to have your New York State license. The e-visits are more for things like acne, allergies and follow-up labs. Things that aren’t life-threatening. There’s no way in hell I would prescribed narcotics online. It’s a kind of telemedicine. People have traditionally used it for access [for care in rural areas]. I’m looking at it as a way to practice convenient medicine.
Is your service cash only?
If somebody has insurance, I’ll charge them less and provide them with receipts. You can get cheaper care. But you can’t get it immediately, nor will you get care where people will help you spend your money wisely. I’ve spent the the last two or three months calling physicians associated with the best hospitals in New York City and getting their prices. I called one radiologist and found he’d do a chest X-ray for $75 and another would charge, say, $300. For cash-paying patients the prices are all over the place. I’ll make referrals based on quality and price.
What’s your online process for taking a patient?
I have a few questions that I ask whenever patients contact me. Name, age, that sort of thing. If they’re over 40, I’m not going to see them. The disease profile changes after that. If you’re under 40 you have the same disease profile as an older child, adolescent or young person that I saw during my preventive medicine and pediatrics training. I’m not going to deal with people who have old-people diseases.
How many patients do you think you’ll take on?
I want to keep this small. About a 1,000 patients. It fails in its mission if it’s a large corporate thing.
Without an office, how will you pull this off?
I run this entire thing off my iPhone and a laptop. I can access any patient records from my iPhone. Patients can make an appointment on my Web site and it’ll text me and I’ll go see them. This is, to me, what’s missing from medicine: personalized attentiveness. Going to someone’s home allows you to get to know them ridiculously well.