Doctor on Demand bets big on telemedicine, mental health by adding 300 shrinks

San Francisco startup Doctor on Demand is looking to expand the reaches of telemedicine, using the emerging medium to address significant issues of access and stigma for mental health. Today, Doctor on Demand announced it has hired 300 psychologists and psychiatrists across the country to provide a host of behavioral health services, augmenting its primary-care […]

San Francisco startup Doctor on Demand is looking to expand the reaches of telemedicine, using the emerging medium to address significant issues of access and stigma for mental health.

Today, Doctor on Demand announced it has hired 300 psychologists and psychiatrists across the country to provide a host of behavioral health services, augmenting its primary-care telemedicine offerings that patients and consumers access through its video visits across 46 states.

Simultaneously, Doctor on Demand also established a partnership with UpSpring to provide lactation consultants who will similarly use video visits to help new mothers on questions and problems with breast feeding.

Both developments underscore the widening opportunities of telemedicine. Yet hurdles do remain to full-scale adoption, notably whether it’s a covered benefit and varying state regulations.

Nevertheless, Doctor on Demand is forging ahead with what it sees as a vital area of opportunity with mental health.

Since being founded in 2012, the company has raised $24 million in venture capital from  Venrock, Shasta Ventures, Andreessen Horowitz, Google Ventures, Lerer Ventures, and angel investor Sir Richard Branson, and athena health CEO Jonathan Bush. TV personality Dr. Phil McGraw and his son, Jay McGraw, are also co-founders with CEO Adam Jackson.

Chief Medical Officer Dr. Pat Basu noted that the personal and mobile nature of a video visit can allow for a more personalized and private experience with what is often a difficult decision to seek help. Visits are conducted by downloading an app on either a smart phone, tablet or laptop.

“It is a huge need,” Dr. Pat Basu said. He cited a CDC study that shows over half of all Americans are going to experience some form of mental or behavioral health issue, yet only 40 percent will receive treatment. “I think this is something that is really applicable to a broad range of people, whether it’s depression, anxiety, relationship issues or stress.”

A number of factors are behind the aforementioned statistic, among them cost, patients not knowing where to seek help, not having access to a psychologist or stigma. Doctor on Demand, which offers its video visits both direct-to-consumer and to large employers, is betting it can offer an accessible solution with its model.

“It certainly lowers the cost and certainly increases the convenience,” Dr. Basu said. “And in a lot of ways it will decrease the stigma. This really gives you a chance to do this from home.”

For direct users, the cost of a video visit with a doctorate-level psychologist is $50 for a 25-minute session and $95 for a 50-minute session.

“Those are significantly less than what most people are used to paying for therapy,” Dr. Basu said.

The company also works with numerous large employers, often self-insured, who offer the services as a covered benefit for employees. Comcast is among the bigger examples, Jackson said. Lost productivity and other more minor issues can also arise from ignoring mental stress, such as gastrointestinal problems or anemia, providing as much impetus to detect or prevent problems early as in primary care, from both an employer’s and individual’s standpoint.

“Employers very much know that this is a major issue,” Jackson said.

Stress and other mental health issues often exacerbate other medical conditions like obesity and heart disease, or spur unhealthy behaviors like smoking, according to the CDC, in turn driving up healthcare costs. Even among individuals who don’t have clinically diagnosed issues, there are still major gains to be achieved by widening access, according to Dr. Basu.

“I think there’s a fairly large swath of Americans who are not clinically depressed, but they can really benefit,” he said. “There’s a lot of evidence in the mental health world that video therapy is just as clinically effective as in-office therapy. It makes sense. We don’t have to be as hands on.”

All 300 psychiatrists and psychologists are board certified and credentialed in the same manner as the company’s 14,000 primary care physicians, Jackson said. The company operates similar to that of an independent physician association, overseen by Doctor on Demand, in each state that it operates in.

With the lactation consultants, there is less demand nationally but it’s nevertheless an attractive niche . The consultants don’t need to be certified on a state-by-state basis either, so the area is comparatively easy to pursue while also providing a key service for an engaged audience of new mothers.

UpSpring Lactation Consultants are International Board Certified Lactation Consultants and are trained to provide support and manage common breastfeeding concerns or issues affecting the mother or baby.

“Breastfeeding doesn’t always come easy to new moms,” said Julie Jumonville, co-founder of UpSpring. “It’s not just physical, it’s also mental and at times very stressful. According to the CDC, 79 percent of moms initiate breastfeeding, but those rates drop to 40 percent at only 12 weeks.”

The cost of a video visit with a Doctor On Demand-UpSpring lactation consultant is $40 for a 25-minute session and $70 for a 50-minute session. Its primary care and non-emergency video visits run $40 a piece.