Instagram has figured out I run a healthcare company.
It sends me ads meant for in-person offices: “Are your patients talking too much in visits? Here are some strategies for moving them along.”
Somebody built a product whose entire purpose is getting doctors to treat patients more like factory cogs. Unfortunately, this is common in the industry.
Healthcare has forgotten the product is care.
American families pay $27,000/yr for health insurance.
Twenty-seven thousand dollars a year. In some parts of the country, that's a year’s rent. Imagine if every family had free rent instead of having to pay for health insurance. Bernie Sanders would cry tears of joy.
Employers regularly pay over $20,000 to health insurance companies beyond employee premium contributions. But your employer doesn't actually pay that. You do, in wages you never see. Insurance is taking more and more money out of your paycheck every year, money that your employer could be paying you.
And your health insurance doesn't even cover you. The month you switch jobs, take a sabbatical, or start a high-deductible plan… how are you going to pay for the $300 clinic visit?
After six years working in healthcare, I've come to appreciate how much work it takes to write even the simplest prescription. The doctor needs to:
Understand what you're asking for and why. You want to be healthy, not just get a pill.
Collect the facts: what you say, what the chart says, what the last blood test says. Sometimes the data disagrees. Oftentimes there are gaps in the records. The doctor needs to ask the right questions.
Check that the diagnosis (if you have one) still fits and figure out the best treatment plan (even if the plan doesn’t change, justifying that it shouldn’t change).
Safety checks: dosing, kidney and liver function, and anything else to be wary of.
Decide which drug, how much, what form, how many, for how long. Sometimes, plan a follow-up.
Write the legal record. Every prescription is a legal decision a doctor can be sued over, so they have to document their medical decision making. This is a big deal.
Send it to the pharmacy and make sure you can actually get it: in stock, at a price you can pay, and manage any substitutions or pharmacy fulfillment issues.
Practicing medicine has a lot of steps. This is why doctors are so busy and have whole teams to support them. Things get even more complicated when a lab is missing, when the drug is higher risk (any antibiotic counts), or when a pharmacy drops an order for a patient on their last day of medication.
We’ve made healthcare affordable
The big lie in America: healthcare is expensive. Actually, it’s health insurance that is expensive. Building outside the health insurance system, directly serving patients, using the best technology available, helps us serve patients drastically cheaper and faster than what the health insurance oligopoly permits.
Temi is building new infrastructure for practicing medicine so the doctor can focus on the most important thing: the final prescribing decision for each case. Today, we’ve cut the human cost of safely prescribing medications 30x, profitably writing scripts at $15/fill.
We are better because we’ve cut out insurance while building on AI infrastructure. So why doesn't everyone do this?
It’s hard in multiple dimensions. Prescribing a broad range of medications takes advanced clinical skill. Building a health system from the ground up needs legal, compliance, data security, software, AI, customer support, and pharmacy operations in the same room. Our team is world-class in all these competencies.
Playing the long game isn’t for everyone. Fast money comes from marking up drugs, which is why every telehealth brand is secretly a pharmacy. The safe money comes from billing insurance, which is why it feels like the system was never designed for you. Temi is building what healthcare should be: accountable to each patient on the merits of our service and care quality.
Jaded people don't believe it's possible. They've decided American healthcare is doomed. They are wrong. We are making American healthcare the most effective and most affordable in the world.
We want all of healthcare to believe in doing things right. It’s the only way to make real change.
An anonymized patient story
Mary. 11:52 PM.
Days of medication left: 1.
A 52-year-old caretaker types "lisinopril"
We call her to confirm her blood pressure history:
"I've been on it nine years. My mom has dementia, so I moved back in. I can't take a morning off to sit in a waiting room and answer the same five questions."
We deliver a 90-day supply approval to the pharmacy in minutes.
The next morning, we noticed the pharmacy still hadn't filled it. We called them to nudge things along, then let Mary know her medication was ready for pickup.
"Wow. I didn't know healthcare could be so simple. Thank you."
On one hand, I'm furiously disappointed that our patients are surprised by how good our care is. Good healthcare should be the norm. On the other hand, I'm deeply appreciative of how much our work matters to them. It fills me with the conviction that we’re turning a new chapter for what people expect out of their care providers.
The real job is care
Hot take: the clinical part of healthcare isn't the hard part anymore.
What's actually hard: ensuring every patient feels cared for.
The biggest job of a family doctor was always assurance. Listening, understanding, guiding. The best doctors, like coaches, steer their patients to be the best versions of themselves.
There should be no such thing as talking too long with your doctor. Patients need someone who is there to listen.
We personally listen to every patient's story. We make sure every patient is cared for. We remember the details of each patient's life. Our challenge ahead is scaling our operations from the hundreds of patients we’re serving today to thousands and eventually millions of patients tomorrow.
It’s what we need to do. We are rebuilding healthcare to serve everyone, starting with prescription access cheaper than your copay.
Be Your Best