Uber managed to be a marketplace that allows people to be more effective at buying taxi services. I see no reason why should be impossible for someone to create a new marketplace that provides a more effective way to buy medical services or legal services.
You would need to run the system at a jurisdiction that gives some freedom, but it’s worth keeping in mind that most Westerns jurisdictions provide at the moment enough freedom for acupuncturists and homeopaths being in business.
You wouldn’t start by going directly after mainstream medicine but with more alternative providers like hypnotists.
A hypnotists who can cure an allergy in a few hours of work would benefit a lot from a central website funneling him clients that know that he can actually cure patients reliably of their allergies. A highly effective hypnotists is going to make a lot more money when he’s payed by the outcomes he produces instead of him being payed by the hour.
I believe that there are enough people currently who can produce great outcomes for their clients but who don’t have any way to trustworthly inform prospective buyers about their skills and distinguish themselves from the noise empty marketing promises that a startup who provides a marketplace where those people could sell their services would be viable.
Vassar speaks in The legend of healthcare about how much value a person who provides the mirror hand treatment for amputees can provide to patients. If a person in a city specializes in doing the mirror hand treatment and could advertises their services to the patients who need them via such a marketplace the person could create an obsene amount of value while being able to charge prices that reflect that the buyer knows that this is his way to stop the immense pain.
in a way that’s a lot simpler for humans to handle and doesn’t serve as a giant tax on people who don’t have graduate-level probability skills.
I don’t think you need high level probability skills on the buyer side. If a website lists treatments and says treatment A has 60% chance of curing you and costs 500$ while treatment B has 80% chance of curing you and costs 1000$ that doesn’t need graduate level math.
Unfortunately, you need some statistics skills on the provider side but teaching healthcare providers the ability to make accurate predictions about the effects of their intervention, will likely lead to them making better treatment decisions.
Taxis are Playing on Easy Mode. Taxi rides are easy to evaluate and hard to fake, mostly reliable and mostly fungible, if they mess up the costs are low. Providers don’t make predictions or put in bids, in fact they agree to do any task assigned to them and take the system’s price for it. There are no sacred values at stake, and while nasty regulations often raise prices, we’re talking about a different order of magnitude of regulatory issues and costs. It’s certainly a good sign that taxi markets can work, if they didn’t we could likely safely say that the medical/legal proposals were dead on arrival. But it doesn’t make me confident. And my experience at MetaMed says that people don’t want the thing you’re pitching here, even if they’re wrong to not want it.
In terms of the tax on skills I was referring to providers needing those skills, more than consumers. Consumers have the far easier job, although it is still too hard for most people, since most cases won’t see one thing dominate on all fronts.
You can pay a lot of money (high 4 figures or 5 figures) and then we give will research the best treatments for you and there’s no promise of effectiveness.
It’s my impression that people usually don’t want to pay for information directly. People are not willing to pay for a ConsumerReports report before buying a new washing mashine. On the other hand people are quite willing to read Amazon reviews about what’s the best washing machine and make their buying decision based on that information. They are also willing to go to the WireCutter and let them get their affiliate commission (even through most of the people likely don’t think about the commission).
I think the success of various expensive alternative medicine treatments suggests that people are quite willling to pay money for treatments that they hope will help them with a medical issues for which they currently don’t have a solution.
If a person starts answering a questionaire about their pain, it’s straightforward to be able to funnel them to the person who does the mirror hands for amputees.
In Germany the person who does mirror hands for amputees would need to spend ~1 year for an education as a “Heilpraktiker” to be allowed to heal people and then a bit of time to learn how the mirror handing works and how to estimate the probabilities.
It’s a quite different skillset then the expensive skillset of doctors.
As far as the skillset of making good predictions about treatment success goes, I think it will help in many cases with the clinical decision making. David Burns (who was one of the people who popularized CBT) wrote a bit about how important testing and calibration is in his essay of why he now advocates TEAM instead of CBT. Working with calibration does require additional skills that are a barrier but it pays off. Working that way while being supported by software will be easier then with photocopying sheets the way Burns does.
Uber managed to be a marketplace that allows people to be more effective at buying taxi services. I see no reason why should be impossible for someone to create a new marketplace that provides a more effective way to buy medical services or legal services.
You would need to run the system at a jurisdiction that gives some freedom, but it’s worth keeping in mind that most Westerns jurisdictions provide at the moment enough freedom for acupuncturists and homeopaths being in business.
You wouldn’t start by going directly after mainstream medicine but with more alternative providers like hypnotists.
A hypnotists who can cure an allergy in a few hours of work would benefit a lot from a central website funneling him clients that know that he can actually cure patients reliably of their allergies. A highly effective hypnotists is going to make a lot more money when he’s payed by the outcomes he produces instead of him being payed by the hour.
I believe that there are enough people currently who can produce great outcomes for their clients but who don’t have any way to trustworthly inform prospective buyers about their skills and distinguish themselves from the noise empty marketing promises that a startup who provides a marketplace where those people could sell their services would be viable.
Vassar speaks in The legend of healthcare about how much value a person who provides the mirror hand treatment for amputees can provide to patients. If a person in a city specializes in doing the mirror hand treatment and could advertises their services to the patients who need them via such a marketplace the person could create an obsene amount of value while being able to charge prices that reflect that the buyer knows that this is his way to stop the immense pain.
I don’t think you need high level probability skills on the buyer side. If a website lists treatments and says treatment A has 60% chance of curing you and costs 500$ while treatment B has 80% chance of curing you and costs 1000$ that doesn’t need graduate level math.
Unfortunately, you need some statistics skills on the provider side but teaching healthcare providers the ability to make accurate predictions about the effects of their intervention, will likely lead to them making better treatment decisions.
Taxis are Playing on Easy Mode. Taxi rides are easy to evaluate and hard to fake, mostly reliable and mostly fungible, if they mess up the costs are low. Providers don’t make predictions or put in bids, in fact they agree to do any task assigned to them and take the system’s price for it. There are no sacred values at stake, and while nasty regulations often raise prices, we’re talking about a different order of magnitude of regulatory issues and costs. It’s certainly a good sign that taxi markets can work, if they didn’t we could likely safely say that the medical/legal proposals were dead on arrival. But it doesn’t make me confident. And my experience at MetaMed says that people don’t want the thing you’re pitching here, even if they’re wrong to not want it.
In terms of the tax on skills I was referring to providers needing those skills, more than consumers. Consumers have the far easier job, although it is still too hard for most people, since most cases won’t see one thing dominate on all fronts.
When I understand the MetaMed pitch it’s:
You can pay a lot of money (high 4 figures or 5 figures) and then we give will research the best treatments for you and there’s no promise of effectiveness.
It’s my impression that people usually don’t want to pay for information directly. People are not willing to pay for a ConsumerReports report before buying a new washing mashine. On the other hand people are quite willing to read Amazon reviews about what’s the best washing machine and make their buying decision based on that information. They are also willing to go to the WireCutter and let them get their affiliate commission (even through most of the people likely don’t think about the commission).
I think the success of various expensive alternative medicine treatments suggests that people are quite willling to pay money for treatments that they hope will help them with a medical issues for which they currently don’t have a solution.
If a person starts answering a questionaire about their pain, it’s straightforward to be able to funnel them to the person who does the mirror hands for amputees.
In Germany the person who does mirror hands for amputees would need to spend ~1 year for an education as a “Heilpraktiker” to be allowed to heal people and then a bit of time to learn how the mirror handing works and how to estimate the probabilities.
It’s a quite different skillset then the expensive skillset of doctors.
As far as the skillset of making good predictions about treatment success goes, I think it will help in many cases with the clinical decision making. David Burns (who was one of the people who popularized CBT) wrote a bit about how important testing and calibration is in his essay of why he now advocates TEAM instead of CBT. Working with calibration does require additional skills that are a barrier but it pays off. Working that way while being supported by software will be easier then with photocopying sheets the way Burns does.