Specialty Care: This Launch Feels Personal

When the phone buzzed I recognized the area code and switched on the speaker so my wife could hear. We looked at each other across the car we were driving in and listened as the head of neuroradiology at Stanford Medicine told me — told us — I had a tumor the size of a small plum growing into my brain stem and that I needed treatment ASAP.

Time stopped. As soon as I heard the word tumor, my first thought — and my wife's too, I could tell — was of our three young children. I remember wondering, as the doctor walked us through the details, whether I'd live long enough for our 6-month-old to remember his dad.

On the inside, I was panicking — and yet, even in that moment, I felt incredibly lucky to have a diagnosis I could trust. And I knew I was better positioned than most to spring into action and get the info I needed and the care that was right for me and my family.

Four years earlier, I'd started a company called Grand Rounds to provide virtual expert medical opinions for people navigating complex diagnoses and difficult healthcare decisions. Instead of making people get on a plane and visit a specialist in person (which for a long time was the only option), we matched people with leading experts across the U.S. and helped them get answers and assurance on next steps.

I've gotten to know lots of healthcare entrepreneurs over the years, and many of them — including my Grand Rounds co-founder, Dr. Rusty Hofmann — were originally motivated by a health scare in their personal life or a run-in with the dysfunction in our healthcare system. Those stories aren't uncommon. What is uncommon is starting a company and creating a service that ends up saving your own life.

The sequence of events that led to the phone call from the radiologist started a month earlier, in the spring of 2016, when I woke up one morning to discover I couldn't hear anything from my right ear. It was odd, and alarming, but no cause for panic (yet). I made an appointment with my primary care doctor, who said my ear was probably just clogged and referred me to an ear, nose, and throat (ENT) specialist.

That all seemed reasonable, but when I looked up the specialist, I saw her subspecialty was in swallowing, not hearing. That was a red flag. Had my PCP actually heard me? I suddenly found myself in the same shoes as the patients our company was designed to help.

So, I engaged the Grand Rounds team. After vetting the 700,000 doctors in our database at the time for the relevant expertise, they connected me with an ENT specialist in San Francisco who ultimately ordered the type of MRI that found the tumor.

The weeks that followed were among the most stressful in my life. The brain surgery I needed is performed just 3,000 times in the U.S. each year (for comparison, there are about 2.5 million joint replacements). With the support of the clinicians at Grand Rounds, I spoke with 15 surgical teams across the country and ultimately settled on one at Stanford, who operated on me for more than 13 hours.

Thankfully, the tumor was benign, but I had to re-learn to walk and it took months for my facial movement to return to normal. If I hadn't had access to the right expertise and the right specialists — if I'd bounced around the system without an advocate as so many people do — the diagnosis could have taken much longer and the outcome could have been very different. Possibly fatal. I permanently lost all hearing in my right ear, but my 6-month-old is now a happy second-grader, and I can hear him just fine with my other ear. 

I've been thinking a lot about this lately as we get ready to launch our Specialty Care Clinic. Included Health (as the company is now called) has come a long way from second opinions, and we now provide virtual primary care, mental health care, and navigation and advocacy services, in addition to second opinions (and many other things). We've had lots of launches, but getting into virtual-first specialty care — at scale — feels different, and more personal, like coming full circle.

Specialty is where the tough and scary stuff happens. I know what it feels like to get the phone call. I know what it's like to share the news with your family and friends, to wait for the pre-authorization, to lie awake at night wondering if it's the right surgeon, or the right approach. I saw what my wife went through.

I don't wish the experience on anyone (and many people have experienced far, far worse). But if it does happen to you, or your loved ones, I want you — everyone — to have access to the same level of care and support that I had. You shouldn't have to be the CEO of an expert opinions company to get the help you need. Healthcare shouldn't be based on luck.