The Doctor Will IM You Now

"Who's the youngest person in here?" asked Dr. Jay Parkinson, a 33-year-old doctor cum entrepreneur to a group of medical students gathered recently in New York-based Mt. Sinai Hospital's student lounge. A girl raised her hand. She was born in 1988. "That's how I start all my talks," Parkinson said, "but usually I'm talking to old people. They're just figuring out what Facebook is and all that crap that everyone already hates by now." The students giggle, a little uneasily. It's clear that the guy standing before them in skinny black jeans and a rumpled denim shirt is not the sort of speaker they're accustomed to seeing. Even the invite they received, via Facebook, is not the sort of posting typically seen around Mt. Sinai Med. "Hello Health is revolutionizing health care using our familiar procrastination technology," it said. "Beer and snacks will be served!"

A true believer, Parkinson announces, "We're here to share the gospel." And in the next hour, as he explains his ideas for reinventing the way Americans get primary care, Parkinson seems to do just that. One part doctor, one part tech innovator, one part salesman: the sum of those parts have made Parkinson the face of a new kind of health care. At his New York City clinic, his team of doctors uses dozens of means of communication—instant messaging, e-mail, texting, etc.—to communicate with their patients and each other. They are working on a platform that could allow doctors across the country to do the same. And they say that by streamlining health-care delivery, partly by refusing to deal with health insurance, they're improving how primary care is delivered, making it more appealing to young doctors and improving the medical system as we know it. But is the model really a revolution?

With all the social-networking jargon, it's easy to chalk up Parkinson's philosophy as just a hipster marketing tactic, but if he gets his way, his practice and forthcoming online platform could radicalize the way many doctors practice, the way patients pay and the choices that these students will make about their own careers.

Countless industries from publishing to retail sales have been revolutionized by the Internet: consider eBay, Craigslist, the Huffington Post and Amazon.com. Medicine is one of the last frontiers. By some estimates, less than 25 percent of American physicians use computers to record and track basic information about their patients. Parkinson thinks that even that figure is high. He believes the fact that medicine is so technologically inept is inseparable from the state of health care in America, where we spend double per capita on health-care costs than our closest competitor, and where, he adds, doctors are paid to practice more, not better, medicine. "I think we can do things better," he often says. "And I think we can do it cheaper."

Hello Health started in 2007 in Williamsburg, Brooklyn, ground zero of hipster U.S.A. Parkinson, a trained pediatrician with a master's degree in public health, wanted to practice primary-care medicine, but balked at the high overhead and the meager pay. He was hundreds of thousands of dollars deep in student-loan debt, and the $77,000 a year he could make as a pediatrician in Connecticut seemed a paltry sum. So, he did what scores of young entrepreneurs are doing in their own various ways: Parkinson set up a Web site. Potential patients could make an appointment by highlighting a time on his Google Calendar. They filled in their name, address and what was wrong with them, and Parkinson would show up at their homes. They paid later through PayPal. Within weeks, local blogs had noticed his tiny practice, he was asked to appear on "The Colbert Report," he got two book offers and film deals. "It was amazing," Parkinson recalls. "People are just longing for something better. We all know that medicine sucks." Then he got a call from a Canada-based software company, Myca, and Hello Health was born.

Today, the practice operates out of a storefront space in Williamsburg with a decidedly sleek aesthetic. The waiting space is about as different as you can get from the traditional doctor's office. There are no receptionists, no file cabinets; there aren't even any magazines in the waiting area. There are just a couple of doctors (the practice has three, not including Parkinson, who isn't practicing at the moment so that he can focus on his bigger projects), working on their laptops (made by Apple, of course) and tapping on their iPhones.

Patients, who pay $35 a month for membership, make appointments online, highlighting their time slot on a sliding bar. The first appointment must be face-to-face, but after that, patients can follow up with e-mails, schedule a time to video chat or instant-message with their doctor. Visits like those, that take place in real time, cost money, but e-mails and texts are free. And all their files, all their records, even notes about their appointments, are there on Hello Health's custom-designed Web platform, privacy protected and only available to the patient and his or her team.

Appointments run $150 for the first hourlong meeting, and $200 an hour after that. If a patient has health insurance, they can submit the receipt for doctor's visits and any tests or outside procedures they need to their insurer, but they have to handle all that themselves. As a result, about 50 percent of the few hundred patients are insured. Parkinson and his team recommend that patients pay for high-deductible catastrophic insurance to cover hospital stays, but rely on Hello Health for their day-to-day care. Catastrophic plans typically only cover health-care costs of more than $10,000 or so, but can cost as low as $100 a month for individuals, a fraction of what a comprehensive health-care plan would cost.