The co-founder of an online marketplace where patients can find doctors, Goldhill talks with Chief Healthcare Executive about his journey and how the industry needs to evolve.
David Goldhill brings a different resume from typical leaders in the world of healthcare.
Goldhill spent years in the entertainment industry. He served as president and CEO of the Game Show Network and president of TV at Universal Studios. He views that as a positive in terms of focusing on consumers and their preferences.
Now, Goldhill is the co-founder and CEO of Sesame, an online marketplace where patients can find doctors for telehealth appointments. Consumers can search for primary care doctors and physicians in dozens of specialties. Patients can shop for one-time visits from $39 or can subscribe for memberships, with visits starting at $19.
“Doctors, clinics, other providers, list their services, describe their services, fix a cash price, and consumers buy them,” Goldhill says. “There's no third-party payment. There's no approvals. There's none of the complexities that we've seen in the traditional healthcare system.”
“And the idea is that by having a traditional consumer marketplace in healthcare, we not only can get transparency around some of the things that are difficult to understand as patients, but we get competition around prices, competition around service definitions, interesting packages, interesting availability, all the things that our third-party payment system has deprived us uniquely in healthcare.”
In an interview with Chief Healthcare Executive®, Goldhill talks about his career path, his hopes for Sesame, and why healthcare lags other industries in ease of access.
"Healthcare is beginning that long journey from being a highly regulated, very rarely used industry, to our most common and largest consumer service," Goldhill says. "If we don't have a different set of economic arrangements in healthcare, we're going to continue to spend way too much money and get way too little."
"Sesame is a chance for me and my partners to try to put some of those ideas in practice," he says.
(See part of our conversation with David Goldhill in this video. The story continues below.)
While the entertainment industry is very different from healthcare, Goldhill says his work in that field provides him with an important perspective on competition and giving consumers what they want.
“I do think it's very valuable to come to healthcare from the perspective of having done something else,” Goldhill says. “Because I think it creates awareness that many of the things that we assume and take for granted in healthcare aren’t really true when you compare it to other industries.”
“When you've come from industries that are really competitive, what you see is that people are extraordinarily, extraordinarily creative, innovative and trying to get customers and trying to get people to use their product to watch their show to watch their movie,” he says.
Conversely, Goldhill says the healthcare industry’s ability to innovate is stifled because payers - government programs and commercial insurance - limit their ability to offer novel services and treatments. As he says, if the product doesn’t have a code, it can’t be sold.
“You've taken probably our most naturally creative, best educated service providers, one million doctors, and you've said to them, you're gonna follow these rules, and everybody else in the economy gets to innovate and create,” Goldhill says.
Goldhill says his journey into the healthcare world began when his father died of a hospital-acquired infection. In 2009, Goldhlill later wrote a widely read article for The Atlantic, titled, “How American Health Care Killed My Father."
Goldhill serves on the board of directors of The Leapfrog Group, an organization which releases regular reports on patient safety in hospitals. He says the group’s ability to offer data on hospital safety has “had a powerful impact on getting hospitals to change their behavior.”
Goldhill says traditional delivery methods of healthcare aren’t succeeding. At the same time, he doesn’t envision Sesame as ushering in “the Jetson era of healthcare.”
“It's about making it a bit better for the people who really need it to be better today,” Goldhill says.
‘Ease of use’
So far, Sesame is seeing impressive growth. More than 100,000 patients have used Sesame, the company says. Patients can search for primary care, pediatrics, women’s health, dermatology and a host of other choices.
“We have new doctors joining every month, new services added every month,” he says.
With many Americans paying rising deductibles and spending more out of pocket, Goldhill sees Sesame being an intriguing option for patients.
“Coming to the Sesame marketplace is going to give you an enormous amount of choice around the type of provider, the way the services are provided, time in which you could be served, and of course price,” Goldhill says. “And so there's an enormous amount of demand.”
Prices on Sesame tend to be lower than traditional insurance, Goldhill says, but he says the site’s ease of use has also proven to be a big draw, according to patient surveys. He says that’s “one of the biggest surprises for us.”
“About half of the people say just the ease of use is the reason they use it,” he says. “So even though the prices are much, much lower than you'll see anywhere else, we attract a significant number of people just because it's so easy to find.
“And then of course, it's also really easy both to find a doctor's availability and the times you want, and very easy to get a real sense of that particular provider's expertise, bedside manner, and reputation for follow through.”
Consumers are going to drive more changes in healthcare, Goldhill says. Patients are doing more research on doctors and hospitals. Successful businesses that are focused on consumers are making it easier for them to get what they need, such as Costco or Walmart offering lower prices on certain items, he says.
“What makes an industry consumer-driven isn't that the consumers do the work. It's that the sellers do the work to find the consumers,” he says.
“They are chasing you. You're not walking in and doing a lot of work,” he says. “In fact, once you cross their thresholds, their doors, you're confident they've done the work for you of shopping. That's how a consumer-driven industry really works. We're obviously very far from that in healthcare.”
As for the physicians on Sesame, many of the doctors are on the marketplace during their off hours, or on days where they may have less business.
Sesame isn’t providing care but is serving as a marketplace that can help doctors find more patients, and consumers find clinicians, Goldhill says. In a way, he says Sesame is going “back to the future.”
Sesame is “about empowering the individual clinician, giving them a way to find patients that makes sense for their practice, and patients to find them,” he says.
In addition, with providers competing for customers in a transparent marketplace, Goldhill has seen prices decline on Sesame. Doctors are getting high marks from patients and are demonstrating flexibility and creativity.
“All of the things that people in healthcare tell you are impossible, happen on Sesame,” Goldhill says. “Because the reality is, it could happen throughout the entire healthcare system if we allowed it.”