200710jayp.jpgRecently Williamsburg doc Jay Parkinson unleashed his revolutionary idea onto Brooklyn -- a doctor for the uninsured, medical advice through emails, and the return of the housecall. The word spread fast and now much of the world is looking his way to see if he can change the way healthcare is provided.

How did your non-conventional idea come about and become a reality?
I don’t really fit in very well to the traditional doctor mold and don’t have a lot of doctor friends. Many of my friends are youngish like myself, involved in the creative industries, and don’t make a hell of a lot of money. They’re often coming to me for medical advice trying to save the absurd amount of time and money it takes to see a doctor when not insured or under-insured. Many of my friends make too much money or are otherwise disqualified from obtaining low-cost health insurance. Most of the time, they would IM, email, or video chat me. I thought it would be a great idea to treat this demographic -- young, uninsured or under-insured, wired, health conscious, and those who are sick of paying too much to wait four hours for a five minute doctor visit. Many people in this age group have acute illnesses and injuries that need timely treatment. Timely doesn’t seem to be in the vocabulary of the modern healthcare system unless you consider paying $2,000 for an ER visit “timely.” I figured I could develop a high quality medical practice based on very accessible low-cost, nearly immediately available house calls, for people who have been priced out of the absurdly expensive traditional health insurance plans. Of course, this type of practice couldn’t survive in a place that wasn’t as densely packed as Brooklyn and lower Manhattan. I’m obviously very mobile and very wired. My schedule is integrated on my website via Google Calendar. My patients can see an open slot, text me with their desired appointment time, and I’ll come see them...even if it’s the next hour. My entire practice, including my electronic medical record, runs on my iPhone. My practice depends on instantaneous communication and mobility.

Aside from offering the uninsured masses healthcare, you also offer housecalls and consulting via IM, email and video conferencing. Do you think you'll run into a lot of electronic patient/doctor scenarios where you'll need to see the patient in person?
Nothing can replace the value of seeing a patient when making a diagnosis. When someone signs up for my service, I make an appointment to come to their house and perform a physical exam, talk with them about their health history, discuss how to use my service, and ways to optimize their health. After this first meeting, I will still almost always visit the patient in person at their home or work. However, there are some diagnoses that are just so obvious I won’t need to go see them. Acne, depression, allergies, and a growing list of other conditions are successfully being managed in a rapidly emerging field called Telemedicine. At the same time, say someone falls on their wrist and thinks it may be broken...most people would go immediately to the ER and get an X-ray. Say it’s not broken...they just spent $2000 on a negative X-ray. If you are my patient, you would call me and describe what happened. I’ll ask you some questions to assess the injury and then send you to a radiologist I know who charges $80 for an X-ray. If it’s not broken, hot damn you just saved $1920. If it is, I’ll be on the phone with orthopedists finding one who can see you in their office to cast your wrist for $400.

I use IM, email, and video conferencing as a supplement to a person’s care to follow up on patients I saw recently and to manage how well a treatment is working. It’s one of the most fulfilling things in the world to wake up in the morning and read an email from a patient I treated yesterday that says she’s feeling so much better.

You've traced your publicity from Noah Kalina's Flickr account to the NY Post in just ten days, did you expect that kind of attention so fast?
I knew I was doing something that had the potential to be revolutionary. One thing that makes me so angry about the healthcare system is a concerted, widespread policy of keeping their prices hidden from the public until you receive your bill a month later for services already rendered. I’ve called a few thousand physicians, radiologists, ERs, and pharmacies to get their prices they charge for certain services and tests. Healthcare prices are absolutely unregulated and the prices vary tremendously. For example, the cost of a brain MRI (same quality facilities mind you) ranges from $500 to $1750. This is absurd. If you are unlucky enough to have chosen the one that charges $1750, you just made a $1250 mistake. I hope that the general public becomes aware of this issue and forces the Industry to be more up-front with their prices. There needs to be more of a free market system in healthcare services and tests. I hope that, through this media exposure, I’m able to raise the issue enough to force the healthcare industry to stop taking advantage of people who are willing to spend anything just to get back on their feet.

But, yes, the offers I’ve gotten from the media and entertainment industry has blown me away. They don’t teach you how to find an entertainment lawyer in medical school.

How many patients do you currently have? Are you feeling a little overwhelmed with the recent response?
I’m feeling more overwhelmed with the media response. Keep in mind, the demographic I’m trying to treat are essentially pretty healthy people. The healthcare industry calls them the invincibles. Young people unfortunately don’t see the value in having their own doctor until they absolutely need medical care. I’m waiting for people to get sick who have heard about me either through the internet or word of mouth to sign up for my service. Once they do experience what it’s like to have such an accessible physician, they’ll understand what they’ve been missing for so long. I promise. Everyone I’ve treated so far thinks it’s the best thing since wheels on luggage.

Have you really been offered a tv show? Would you think about saying yes to such an offer?
I’ve been offered an ungodly amount. Books, TV series, a full feature romantic comedy from one of my favorite producers who produced some of my favorite movies (who actually personally called me). Yes, I would consider these offers. Especially if I could use some of the money I make from these ventures to make my service even more affordable.

Do you think your press schedule will now offer you less time to treat your patients?
I’m a multi-tasker. All of my press began three days before I “opened” my practice. In reality, “open” means, I enabled the link where people could sign up. As in every type of new business, it takes some time to build a client base. Fortunately, the press I’m getting is happening when my client list is small but growing.

What is the number one/most common ailment you treat?
That has yet to be discovered. But I have some hunches. All I know is that this entire experience in treating patients this way will allow me to save people a hell of a lot of money AND meet some very lovely people who are doing some interesting things with their lives.

What is the general age group and occupation of your patients?
I only see patients age 18-40. Generally, everyone who has contacted me so far has been freelancing creative professionals.

Do you keep certain hours or have a staff?
I do routine house calls with patients on Monday through Friday 8 am to 5 pm. I’ll definitely make some exceptions. It’s not really set in stone. It’s dependent upon the individual case.

Please share your strangest "only in New York" story.
I used to be friends with this guy who was the manager of a popular clothing store in Soho. He was the biggest David Bowie fan and told me how he listened to only Bowie for something like three years straight. He just wanted to immerse himself in Bowie. My friend was walking down the sidewalk in Soho one morning and heard someone whistling a Bowie tune. He turned around and saw David Bowie walking with his daughter on his shoulders whistling his own tune to her. I don’t know why, I just love that story.

Which New Yorker do you most admire?
Unfortunately I have to choose someone who recently died -- Jane Jacobs. The Death and Life of Great American Cities was a huge influence on the New York we know today and quite an influence on the design of my practice. New York can be such an isolating place because most of us just keep to ourselves on the sidewalks of New York. I think the modern forms of communication such as IM, email, and SMS are just as isolating. What if I could use these communication technologies to my advantage as a way to help people with their medical problems; make a meaningful change in a broken healthcare system; and get to know, in a very personal, real way, hundreds to thousands of New Yorkers.

Given the opportunity, how would you change New York?
I would make healthcare more affordable and accessible to young, uninsured or underinsured New Yorkers. I have that opportunity now and that’s what I plan to do. I saw a patient yesterday who was spending $63 a month on her monthly prescription from Walgreens. I knew of a place that was selling it for $42. I saved her over $250 per year because I’ve put the effort into doing the research. One person at a time, I will make sure they get affordable, high-quality healthcare.

Under what circumstance have you thought about leaving New York?
I only thought about leaving New York once. That was two years ago when I finished my residency at St. Vincent’s in the Village to do a residency at Johns Hopkins. Hopkins has a such a great name and is known as the best program in Preventive Medicine. My practice focuses on prevention in order to keep people as healthy as possible for as long as possible. I figured I could suck it up for two years in Baltimore and move back to New York the hour I finished my residency at Hopkins. I love this city. I don’t plan on leaving.

What's your current soundtrack to the city?
Ooooh. Good question. I know not everyone listed is from the city, but I figure that’s alright. They all have some sort of personal connection to NYC in my own mind.

Sonic Youth - Teenage Riot, Brian Eno - On Some Faraway Beach, Elliott Smith - Some Song, Gary Numan - M.E., The Hold Steady - Multitude of Casualties, Iggy Pop - The Passenger, Interpol - Untitled (from their only good record), John Phillips - Let it Bleed, Genevieve, Kiss - God Gave Rock-n-Roll to You, LCD Soundsystem - All My Friends, Liars - Grown Men Don’t Fall in the River Just Like That, Marah - Formula, Cola, Dollar Draft, The Modern Lovers - Dignified and Old, The National - All the Wine, Neutral Milk Hotel - Love You More than Life, The Stooges - I Wanna Be Your Dog, Super Furry Animals - Man Don’t Give a Fuck, TV on the Radio - Staring at the Sun, The Afghan Whigs - 1965, The Velvet Underground - Sunday Morning, Wilco - I Am Trying to Break Your Heart, !!! - Pardon My Freedom

What's the best subway line?
The L? It connects to everything.

Favorite headlines: NY Post or Daily News?
The Post is the shittiest newspaper in the entire nation.

Yankees or Mets?

Best cheap eat in the city.
Cheap is so damn relative. Cheap (as in stuff your face for $3): Big Enchilada on 12th and University. Cheap (as in good eatin’ for a good price): Itzocan Cafe on 9th Street in the East Village.

Best venue to see music.
Bowery Ballroom. The only thing I hate about summer in NYC is having to see a band at some horrible outdoor venue.

Photo by Noah Kalina.