Best Practices: Qwell
The primary care physicians and startup founders on leveraging technology to improve patient and doctor experiences.
Bertie and Rachel Bregman both trained as family medicine doctors, met in their residency at Beth Israel Hospital in New York City, and began their careers at Columbia University working as faculty members. Twelve years ago, they decided to open their own high-touch primary care practice, Westside Family Medicine, which has since grown to three locations. This past July, they launched Qwell, a service designed to provide a more guided online experience for patients looking for a doctor, and for doctors wanting to refer patients and build their professional network. Read on to learn about how they grew their first business and what their plans are to do the same with Qwell.
Rachel: We started Westside Family Medicine (WFM) when the transformation to electronic medical records was in its infancy. We were early adopters; we wanted to be fully digital — which, believe it or not, at that time was not an obvious choice. Since then, we’ve adopted new technologies that help us better serve our patients while avoiding additional administrative burdens. We were always tech-forward in a field that’s not always thought of as being tech-savvy. In terms of patient relationships, we pride ourselves on taking care of the whole patient, like old-style family doctors. The combination was a bit unusual when we first started, but it was really popular with our patients and led us to grow fast. We started with one office on 110th street, near Columbia, then expanded to 70th street and West End. Then we doubled our size at 110th Street, and eventually made it across the park to the Upper East Side on 87nd Street.
Bertie: Our motto for Westside Family Medicine is: where vintage care meets modern medicine. We always try to be as tech-forward as we can without losing that personal touch. We want to give our patients that small town family doctor feel.
What was the spark that led to Qwell?
Bertie: At WFM, one of the engines of our growth was online booking. We started with Zocdoc, but decided to leave when their business model changed. We realized that there was an opportunity to create an alternative to the status quo by building a platform that could function as a medical home for the patient, where they could be directed to a group of doctors who know and trust each other — all this, while still having the convenience of online booking.
Rachel: As family medicine doctors, we’ve always been comfortable being the focal point for many different types of doctors. In primary care, it’s really important to make sure that your patients are getting the right specialty care when they need it. While we were seeing a large market for online patient booking, we were also seeing a lack of guidance. We designed Qwell to create a better patient experience and to build a network of highly trusted doctors. When patients are getting better care, doctors are happy. With Qwell, we’re looking to create a holistic system that takes into account both the doctor and the patients’ needs.
Bertie: The idea for Qwell grew out of our personal experience. When our friends and family needed medical care, they wouldn’t go online to look for a doctor, they’d call us and ask who they should see. Online, there is a lot of information, including all sorts of different review systems, but very little true guidance. We wanted to recreate the experience of having a doctor in the family — where you can be guided to a doctor who other physicians recommend and trust, which is where our motto came from: like having a doctor in the family.
How does Qwell work?
Rachel: We are both patient and doctor facing. Patients can search for a specialist and book online. Our doctors can do doctor-to-doctor referrals for their patients in real time. If you’re a patient in a doctor’s office that uses Qwell and you need to see a specialist, your doctor can go into Qwell, find someone she recommends, and in many cases book you an appointment. Bertie sees patients every morning and is routinely booking patients through the system. As providers, this gives us peace of mind because we know that our patients are all set up to visit the right specialist. Plus, the other doctors are happy we have sent them patents. In the current system, something like 50–60% of referrals go uncompleted. Most of the time, specialists never even know that you’ve sent them a patient because they don’t end up in their office.
For doctors, it’s really important to create the doctor-to-doctor network and make connections. Our reputation is built by how we take care of each other’s patients. It’s extremely important for doctors to have that level of connection, and with Qwell they can do that in a meaningful way.
We also have a feature called Qwell Concierge, which is a hybrid of telemedicine and a concierge service. For a small fee (the platform is free otherwise), patients can get simple medical needs taken care of with a virtual visit, or they can use Qwell Concierge to ask questions or to get more personal guidance. This can be anything from deciding which doctor to see to figuring out whether they need to see a doctor at all.
Bertie: Another use of Qwell Concierge would be if you have a specific symptom and you aren’t sure what type of specialist you need to see. Qwell Concierge can help guide you and direct you to the right doctor. It can also schedule an appointment for you right then and there.
How do doctors join Qwell?
Bertie: In order to get on Qwell as a provider, you need to be recommended by another provider. There is a baseline quality control that’s built into the system in that you have to be trusted by other providers already on the platform. It’s an iterative process; it expands in an organic way because once you’re on the site, you can add any doctor that you trust and recommend.
Rachel: For doctors who are new graduates or new to New York, we have a simple application process to curate and vet them if they don’t have a doctor willing to nominate them at first.
What kind of providers do you have on Qwell?
Rachel: As family medicine doctors, we were trained to take a complete picture of our patients’ lives, circumstances, and health. That is not restricted to just traditional medicine. We are taught to be open to different types of modalities. When we built Qwell, we purposefully included all types of providers. We have different categories for integrative medicine and wellness. It’s an area we want to build out more because many patients are really benefiting from that type of care. There aren’t many platforms that combine the two. We actually just signed on our first chiropractor, and we also have a lot of nutritionists. Patients are happy to see that those fields are not sidelined.
What’s next for Qwell?
Rachel: We hope to allow visitors the ability to choose a primary care provider whom they know, have heard about, or are interested in to help guide their visit. Once you’ve gone into the system at a practice, you would be associated with that practice. For any future times that you go in to look for another specialty, you’ll be preferentially matched to specialists that your primary care doctor knows and already sends patients to. The physicians who appear higher on the search are the ones who are recommended by your other doctors. From there, you can choose by location, insurance, etc. We don’t allow for pay-to-play, where doctors pay more to be at the top of the list.
How do you see Qwell fitting into the future of healthcare?
Bertie: We want to be able to store medical records and for these to be easily accessible. We want to create a medical home that starts with the patient and extends to the doctors to create a small town doctor experience for the patient. We want their care to be less fragmented, so that one hand knows what the other hand is doing.
Rachel: One of the things we love about the way we thought about and built Qwell is that we have already started to spread out of the Manhattan area because every time a doctor joins Qwell, they bring their network that invariably includes physicians from outside the city. It’s very gratifying to see that kind of network effect in action.
Vital Signs
Favorite NYC restaurant:
Rachel: I Sodi in the West Village (it’s a combined favorite).
Favorite type of exercise:
Bertie: I run in Central Park and do yoga at home.
Rachel: I like Yoga to the People, and I play tennis in Central Park.
Favorite family activity: Definitely, skiing. Our kids are all downhill ski racers, so every winter weekend we go upstate with the family.
A piece of technology that you can’t live without:
Bertie: Waze, I don’t know how I survived before it!
Where does the name Qwell come from?
It means “the source” in German, which was meaningful to us because we want Qwell to be the source of great medical care.
Learn more about Qwell here!
Know an innovative practice in NYC? We’d love to hear, introduce us here!
