Jun 12, 2023Liked by Arpan Parikh, MD MBA FAPA, Amit Parikh, MD
Very thought-provoking, and hard to disagree with a comprehensive approach to patient care. But I feel like you never came back to the business side of things -- and that, in my experience, is the real driving force for early-stage companies to focus on point solutions rather than generalist platforms. The major stakeholders (healthcare systems, payers...) make it way more challenging for startups to innovate with a generalist model than if there's unique innovation for a specific therapeutic area and/or narrow patient population.
But I'm in total agreement that point solutions have limited utility. And it's scary, because we've seen so many flash-in-the-pan startups have immense success with a single condition, only to flounder when trying to pivot into a more comprehensive platform. I hope M&A activity isn't the *only* way for some of the specialized startups to grow into more comprehensive offerings, but if that's what has to happen, then at least the patients will benefit from those synergies in the end.
Jun 14, 2023·edited Jun 14, 2023Liked by Arpan Parikh, MD MBA FAPA, Amit Parikh, MD
Great post. A few observations:
1. The idea of a navigation/referral platform for moving from general -> specific providers seems like a perennial idea that never really seems to get mainstream traction. I've seen this from the side of working with a specialty provider (Bicycle Health) and we would love for such platforms to exist. There are some: Included, Ribbon, Quartet, Solera, but so far for us none have led to any meaningful amount of patient referrals. Maybe others see something different?
The direct patient value prop of these navigation services I believe is fairly weak, so the main customer would need to be either the payor or the provider. I don't believe basic navigation is a burning need for payors/providers either. Instead access to in-demand resources tends to have more market pull (eg. mental health networks like Headway/Alma/etc).
Maybe the solution is to offer a generalist mental health provider as the navigation layer instead of a more generic platform.
2. While point solutions do add a layer of complexity, they should also offer improved experience and outcomes for their specific protocols and niches. It's hard to draw the line in what defines a "point solution" as too specific, since those two counteracting forces exist. I suspect the only way to figure that out is to build out point solutions and navigation services at the same time and see where the line lands!
Though therapists are often encouraged to find a niche, most of us have been generalists out of the gate. Is that really changing significantly? I can't find numbers, but I have to think that a huge portion of therapists still start out in Community Mental Health or similar settings. There is no doubt in my mind that specialized services are not well understood by most of those seeking care. And why should they know about such things? If my stomach hurts I go to my PCP. Maybe I learn what a gastroenterologist is and struggle to pronounce it, maybe my PCP can handle it. We use diagnoses and an alphabet of treatment modality acronyms daily, but most people seeking help are not thinking in those terms. They just want help with what's bothering them and are likely to conceptualize it in general terms like not sleeping well, being cranky, having relationship problems, crying more, worrying all the time, etc. A good generalist is a good diagnostician who educates their patient. I have to agree that the end game sure looks like excellent generalist platforms that develop specialty care resources through training, acquisition, or partnership.
Great post⚡🌶️and lots of food for thought! Having worked in the ADHD and BH space for a decade, I agree, it is best if the patient journey starts at the PCP but if it can't start there, it should come back to that point.
Like most things the incentives need to align in order to make an impact when it comes to referrals and outcomes. There are ways to measure, it is about piloting, improving and advancing, I HOPE!
Very thought-provoking, and hard to disagree with a comprehensive approach to patient care. But I feel like you never came back to the business side of things -- and that, in my experience, is the real driving force for early-stage companies to focus on point solutions rather than generalist platforms. The major stakeholders (healthcare systems, payers...) make it way more challenging for startups to innovate with a generalist model than if there's unique innovation for a specific therapeutic area and/or narrow patient population.
But I'm in total agreement that point solutions have limited utility. And it's scary, because we've seen so many flash-in-the-pan startups have immense success with a single condition, only to flounder when trying to pivot into a more comprehensive platform. I hope M&A activity isn't the *only* way for some of the specialized startups to grow into more comprehensive offerings, but if that's what has to happen, then at least the patients will benefit from those synergies in the end.
Great post. A few observations:
1. The idea of a navigation/referral platform for moving from general -> specific providers seems like a perennial idea that never really seems to get mainstream traction. I've seen this from the side of working with a specialty provider (Bicycle Health) and we would love for such platforms to exist. There are some: Included, Ribbon, Quartet, Solera, but so far for us none have led to any meaningful amount of patient referrals. Maybe others see something different?
The direct patient value prop of these navigation services I believe is fairly weak, so the main customer would need to be either the payor or the provider. I don't believe basic navigation is a burning need for payors/providers either. Instead access to in-demand resources tends to have more market pull (eg. mental health networks like Headway/Alma/etc).
Maybe the solution is to offer a generalist mental health provider as the navigation layer instead of a more generic platform.
2. While point solutions do add a layer of complexity, they should also offer improved experience and outcomes for their specific protocols and niches. It's hard to draw the line in what defines a "point solution" as too specific, since those two counteracting forces exist. I suspect the only way to figure that out is to build out point solutions and navigation services at the same time and see where the line lands!
Great post!
Though therapists are often encouraged to find a niche, most of us have been generalists out of the gate. Is that really changing significantly? I can't find numbers, but I have to think that a huge portion of therapists still start out in Community Mental Health or similar settings. There is no doubt in my mind that specialized services are not well understood by most of those seeking care. And why should they know about such things? If my stomach hurts I go to my PCP. Maybe I learn what a gastroenterologist is and struggle to pronounce it, maybe my PCP can handle it. We use diagnoses and an alphabet of treatment modality acronyms daily, but most people seeking help are not thinking in those terms. They just want help with what's bothering them and are likely to conceptualize it in general terms like not sleeping well, being cranky, having relationship problems, crying more, worrying all the time, etc. A good generalist is a good diagnostician who educates their patient. I have to agree that the end game sure looks like excellent generalist platforms that develop specialty care resources through training, acquisition, or partnership.
Great post⚡🌶️and lots of food for thought! Having worked in the ADHD and BH space for a decade, I agree, it is best if the patient journey starts at the PCP but if it can't start there, it should come back to that point.
Like most things the incentives need to align in order to make an impact when it comes to referrals and outcomes. There are ways to measure, it is about piloting, improving and advancing, I HOPE!