Health Tech | Streamlining Your Physician Network An Interview with Nate Gross of Doximity

By Shiv Gaglani

If you are a cardiologist, there's a 50% chance you're already using an online physician network called Doximity. We had the opportunity to speak with co-founder Nate Gross, MD, a graduate of Emory University School of Medicine and Harvard Business School, about his company and why hundreds of thousands of physicians are using it.

What's the story behind Doximity?
Doximity launched in 2011 with a vision to make physicians' lives easier. Working as a junior member of the care team at Emory and Grady Hospital, I was tasked with communicating between providers, often having to search frantically for their contact information, and then faxing over orders or records. That experience gave me a strong desire to help doctors communicate more efficiently.

I was fortunate to share this desire with a phenomenal group of experts in technology and physician-centric design. Jeff Tangney, my co-founder and our chief executive officer, brought quite a track record of making doctors' lives easier, since he was co-founder, president, and chief operating officer of Epocrates. His focus has always been on delivering relevant information to doctors at the exact time they need it. We work alongside our wonderful physician members to make it a useful service, and today over 40% of US physicians use Doximity.

How does Doximity accomplish its goal of making physicians' practices more efficient?
At the core of Doximity is our master directory of all US providers. We make it easier for doctors to find and reach each other. You can look up any provider by name, specialty, location, research, training location, and more. For example, say you're a primary care doctor with a patient who speaks broken English. You can find a cardiologist on Doximity who speaks your native language. Doximity then allows you to seamlessly and securely communicate with the provider, whether it's a digital fax for a referral, a phone call to discuss a case, or a secure message.

Miscommunication is a leading factor in medical error, which the Joint Commission estimates is the fifth leading cause of death in the United States. Two-thirds of the time when a specialist sees a patient, he or she does not have the complete—or, in some cases, any—patient records. There's little that can be done to get the records at the point of care, and this often leads to repeated tests which is one reason health care costs are so high.

To improve this we've developed a secure, convenient way for doctors to communicate, making referrals more precise and closing the feedback loop. We built our platform to be backwards-compatible with fax, which means that our users get a free fax line to receive, sign, and send faxes on their mobile devices. In this way, records and orders can easily be sent between clinicians, even if the receiving or sending party is not a Doximity user.

Physicians also use Doximity to stay up to date on the literature. We scan all the medical literature to build each physician a personalized digest that says, "This month here are the five articles you need to read to be current and up to date in your niche." And they concurrently earn all their CME credits without the hassle of filling out paperwork.

How many cardiologists are on Doximity?
This is of particular interest to me because I've been reading CardioSource for years and was involved in research on percutaneous valve replacement. Today, roughly 52% of all US cardiologists use Doximity, up from 44% at the beginning of this year.

That's impressive growth! Can you discuss the physician verification process to ensure that everyone on Doximity is actually a doctor?
Doximity uses a three-step verification process that essentially replicates bank-grade security. It's essential that doctors on our network be verified so that they can feel comfortable referring patients and sharing information. Your Doximity login is secure enough to be used as a "universal passport" to log into 80 other services, including Amion shift scheduling and US News & World Report.

Since it is free for a physician to create a Doximity account and use the services, how does the company make money?
Our business model is centered on career opportunities and expertise introductions. For example, a cardiologist working in California may find an opportunity in a neighboring state that pays them three times as much and offers a quality of life that is more similar to what they had in mind.

Cardiology is a specialty that has seen a tremendous shift in employment patterns since we started Doximity. Nearly two-thirds of cardiologists were in private practice, but now closer to two-thirds are employed by hospitals. While there are certainly nice aspects to being employed, many doctors feel less in control and may find that the first hospital job they took was not necessarily the best one. Being on Doximity allows them to transparently view their options, and, to this end, we hope to change the market so that physicians are masters of their own destiny again.

What is the most interesting thing you've learned since you helped found Doximity?
We're always humbled by how hard our physician members work, so it's important not to give them "one more thing to do," but rather help them save time on their existing workload so they can be more productive and spend more time with their families. To navigate this system, whether it's helping our members maximize their career potential or communicate across fragmented systems, we've had to intimately understand the incentives of all stakeholders involved. For instance, rather than trying to kill the fax machine altogether, we've learned it will take years to replace the 15 billion pages of fax that are sent in the US health care system annually, and instead we should design convenient ways for physicians to digitally manage their fax load from their phones and iPads.

Shiv Gaglani is an MD/MBA candidate at the Johns Hopkins School of Medicine and Harvard Business School. He writes about trends in medicine and technology and has had his work published in Medgadget, The Atlantic, and Emergency Physicians Monthly.

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