United States

ZocDoc CEO: 'Today there are 30 million new patients. What's next?'

October 1, 2013: 3:48 PM ET

A Q&A with Cyrus Massoumi, the founder of the fastest growing medical appointment booking service in America

By Ryan Bradley, senior editor

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FORTUNE -- Six years after his burst eardrum and subsequent scramble to see a doctor led him to start ZocDoc, the medical appointment booking service, Cyrus Massoumi's company is growing like mad -- 2.5 million patients use the service each month, which services population centers that account for 40% of the U.S. population. And the company opened offices in New Delhi and Phoenix, secured more than $95 million in funding, and launched a new feature, Check-In, an online medical form that can be used by doctors across specialties. "Everything we do," Massoumi says, "relates to the interaction between patient and doctor. That's our sweet spot, that's where all our innovation should go." He spoke to Fortune senior editor Ryan Bradley. Edited excerpts:

FORTUNE: Check-In, it's an online form for patients to fill out before they visit the doctor. I notice you avoid the term Electronic Medical Record. 

MASSOUMI: They're different. It's a personal health record, not an EMR. If you look at what Google (GOOG) did before it shut down Google Health, or what Microsoft (MSFT) is doing with Health Vault, it's getting people to go online and fill in their information.

And it doesn't need to be HIPAA compliant.

Right. And there are lots of things you can do to the patient's benefit. HIPAA protects patients, but there are a lot of things you can't do. You can't, for example, use any of that data without explicit consent from all the patients in the dataset, even if you're not using their names. Now, imagine if you're looking for ideal candidates for clinical trial. In mining that data you can do things in the patients' interests. If I had a chronic ailment I'd want someone to have access to that.

The problem is that if I'm a healthy person, what is going to incentivize me to go into Google and enter my whole medical history. That's why Google Health failed. So you're offering something different -- a service?

It's very much tied to: I'm going to the doctor, I'm doing this anyway, I might as well fill out this form before I get there and have it travel with me from office to office. Over 40% of the people offered the ability to Check-In are checking in. We believe we now have one of the largest personal health records in the country.

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So now you have this database. What are you doing with it?

Well, it will help guide us to what we should build on top of our service.

What do you mean?

We see ourselves, as a business, as your personal health ally. So this information allows us to send you better information. Remembers about how you probably should get your teeth cleaned, go to your physical -- we already were doing some of that, but now we can get very precise. When you're a young child your mother takes care of everything, but what happens afterwards? Who reads through the CDC recommendations to help you? And it can get much more sophisticated over time. Patients wanted this, by the way. This feature was the No. 1 most requested product.

So the first problem you tackled was one of access, and you are doing that. Appointments are easier, and this gets at this huge problem in health care where people wait to go to the doctor until the last minute, if at all, and end up in the emergency room, which is terribly expensive. Say that in 20 years ZocDoc is the interface ...

It will be.

 ... is there another phase, one that doesn't require a visit to the doctors office, but absolutely requires some level of interaction with a health professional? Your dad's a doctor, my dad's a doctor, we grew up with this in our house, basically. Do you see yourselves evolving to fill that void?

You're asking about telemedicine.

Yes but I'm trying to avoid the word telemedicine. 

I can't go into specifics, but, look, indulge me for a minute: In consumer healthcare, you've got four major categories: electronic medical records and the cloud, telemedicine, cost-transparency, and online appointments. Recently I sat in front of our 400 employees, and I asked the room -- "Who has all their medical records aggregated in the cloud, raise your hand." No one. "Raise your hand if you have had an appointment with a doctor over video-chat, on the Internet"  -- remember, this is in front of one of the fastest growing medical tech companies in the world. Not a single hand. "Raise your hand if you really care today if a doctor is $5 cheaper" -- you really only care if they're in network or not. "What about booking an appointment over the Internet?" Everyone's hand went up. Now, in the future, wouldn't it be great to do all this stuff -- of course! But we're focused on the access problem for now.

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Is that because it helps solve other problems, too? Take the shortage of doctors ...

We talk about the hidden supply. We take online travel booking for granted, but imagine if you had to go to each individual plane, call it up, see if a seat is available. In travel, it sounds ridiculous, but the shortage of doctors people expect in this country can be completely solved by this hidden supply.

But air travel is based around hubs. And here we are, in New York, we've got a lot of doctors in a not very large area. What happens to ZocDoc when you're not in cities?

People everywhere in the country book health care appointments the exact same way. In New York, we wait 19 days; national average is about 20 days. We started in the largest metropolitan areas, but what we realized is that a lot of times doctors have locations in multiple areas -- a practice in the city and another in a small, rural town. Everywhere we've launched, it's worked. And the problems with doctor wait times, by the way, aren't just true throughout America, but the world.

Every time I leave the country, I go to the doctor in the country I'm visiting. I'm healthy everywhere but Germany, by the way.

What?

They do ultrasounds for routine physicals, and apparently my liver is a few centimeters too big.

They must see that all the time in Germany. Swollen livers.

They have all the same problems, doesn't matter if you're in the U.K., Canada, France, anywhere where patients have a hard time finding a doctor, ZocDoc should exist.

How do you solve the last, arguably most expensive and certainly most in need segment. That is, the poor, uninsured, who can't see doctors because they work two jobs and are only now maybe going to be able to be insured?

Well, thankfully, the cost of technology and mobile, you'd be surprised how pervasive it is becoming. We've seen 500% growth in our mobile app year over year, as the cost of technology comes down. Having access to the Internet is like the new TV. I do believe technology is becoming more pervasive. It is a large problem, and it's one we're trying to do better. Hopefully one day health care will be accessible to everyone, but unfortunately it is not, even today, and I don't have a great answer to your question.

That is one of the most honest responses I've heard to that question. Thanks. But what about today, now that there is increased access. 

There are going to be 30 million new patients and no new doctors. How do we solve this? When Massachusetts instituted its plan, now you may need to wait up to 30 days there. I think the need for a service like ours -- well, it means that we're needed even more. It's going to be harder to find a doctor across the country, it's inevitable.

But it seems like in solving one problem you're creating a new one, in that patients will just go to see whoever is available, not necessarily their doctor, or specialist.

That's actually not what we see empirically in the data. We're trying to make your health care relationship with your doctors tighter. We don't tell you to get an annual skin screening with any dermatologist, we tell you to go to your derm. You're right that if there's an illness you need treatment for immediately, it might not work that way. But the majority of appointments booked we find are for preventative care. We find that people maintain those relationships. If you like your doctor, you stick with her.

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