The ‘Doctor in the Family’

My dad is a physician, and my aunt —?a personal hero of mine — was an ICU nurse and professor of nursing. I know the value of having someone with healthcare expertise in your corner. Someone who can offer advice, open doors, and help loved ones get the care they need — what a privilege for far too few people.

Extending that privilege to everyone was the vision behind Grand Rounds, the company I founded with Dr. Rusty Hofmann in 2011 to give everyone access to clinical insights and personalized care, whether they have a doctor in the family or not.

More than a decade later, our business has grown into Included Health, and the surrounding landscape looks a little different. Yes, navigation and advocacy remain central to what we do, and yes, being the doctor in the family for our members is still what drives us — but the role has evolved. Here’s how:

1. Artificial intelligence

While human judgment should always play a role in healthcare, data has sharpened our judgment; meaning, as "the doctor in the family," we now also have a PhD in data science and access to 35 billion #HealthData points (and counting).

As part of our expert medical opinion offering, for example, we harness large data sets and software to go beyond personal connections and institutional relationships. When we hand-select experts for our members, we open the type of door a doctor in the family might, but that door is based on analysis of claims data and provider outcomes. We let data lead us to the most experienced and proven experts — to those best positioned to get people on the right care path for them.?

It’s amazing how #HealthAI has supercharged the process, leading to a change in diagnosis or treatment plan 67% of the time. Today, our provider matching system spans primary care, psychiatry, therapy, and more, in addition to specialized experts, and is powered by 300 machine-learning algorithms. This means we can engage members early and often — in some cases even before they come to us for help.

2. Health equity

Just like AI, our understanding of health disparities and health equity has grown exponentially. People of color, the LGBTQ+ community, and other groups that have faced persistent barriers to accessing high-quality care each have a unique set of challenges in healthcare, and they need and deserve tailored support.

As "the doctor in the family," our approach is built around specific needs and preferences of these communities. Whether those needs are clinical (e.g., finding a provider who’s an expert in gender dysmorphia) or preferred (a provider of the same racial/ethnic background and/or understands LGBTQ+ issues), or administrative and financial, we are looking to support people in the ways that lead to the best results and feel best.

#HealthcareNavigation and #PatientAdvocacy like this is one of the most important tools we have to make the healthcare system effective for everyone. We can’t control who has a doctor in the family, but we can increase access to informed expertise on a national scale.?

3. No ask too small

At Included Health we like to say there's no such thing as a "little" healthcare problem. For any given person on any given day, a surprise $100 medical bill — or even an unexpected $10 copay — might not seem like a crisis, but if you can't pay it, and it means you can't afford essential care or medications, it can become a major event in your life.? We believe admin support and advocacy is every bit as important as access to world-class experts, because the little stuff can snowball fast.?

The healthcare system has become so confusing and overwhelming; it’s not enough to have a doctor in the family. People need more than a single trusted person to call for occasional medical advice or guidance. They need a team of healthcare-everything experts who are ready to help 24/7 with any obstacles, big or small.

So, while having a doctor in the family remains a privilege for far too few, in reality people need and deserve so much more than that.