A Conversation with Dr. McFadden and Geoff Matous

Following our recent collaboration with Buoy Health, Wellinks President and Chief Commercial Officer Geoff Matous sat down with Buoy Health’s Chief Medical Officer Dr. Adrienne McFadden to dive deeper into how it will make care more accessible and affordable to the millions of people who need it.

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Geoff Matous

I think there’s a cool similarity that the founder of Wellinks, Dr. Ralph Finger, shares with you—the background of being an ER doctor. When we first started the company, we would talk a lot about how his experiences as a clinician translated, for better or for worse, into his experience as an entrepreneur. We saw an incredible ability to context shift with ease, go from one thing to the next and pick it up really quickly. He not only wanted to context shift quickly, but also quickly master everything. Can you tell me a bit about your background and experience? How have you seen themes from your clinical experience apply to your strengths now in being a business leader in health care and shaping it at this level?

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Dr. McFadden

Whether it was naive or audacious, I really was committed to transforming the health care system for the better from a very young age. It really felt like it was a system of the have and have nots. I didn't want to exist on this planet, and then leave this planet, without having made some impact on that.

It’s funny, because I recently gave a lecture to my old residency program about the survival skills developed in the ER that translate really well outside of clinical medicine. I told the residents that one, we have strong people skills. We have to build trust and empathy in a really short timeframe, which is a skill that develops and is nurtured overtime, but we wouldn’t survive as an emergency physician if we couldn’t do it. Those soft skills are invaluable in the business world.

You talked about context switching—I consider it more project management. We are able to shift our focus, to understand the limited resources available, and figure it out. We’re kind of like MacGyver that way. Clinicians are also amazing contingency planners. We're always thinking three steps ahead—if this, then that—and we're naturally crisis managers. In the startup world, these will both be invaluable skillsets.

And lastly, you have to drive the narrative and communicate clearly. You have to be an advocate for the patient, but get everyone aligned, while focusing the conversation so you’re not trying to boil the ocean in one 30-minute visit.

Overall, the biggest thing I would say my clinical experience gives me is perspective as a person. If it's not a life-or-death situation around me, I'm not going to panic. I think I got that perspective from being in the emergency department.
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Geoff Matous

After your experience as an emergency physician, you spent some time in policy, and then moved into the payer world where you were working a lot on health advocacy and bringing high quality care and support to underserved communities and Medicaid beneficiaries. What drove the transition to Buoy?
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Dr. McFadden

Part of it was my curiosity that I alluded to earlier. I just have been very curious about this world for a long time, and I think that curiosity was really nurtured when I was working with the Medicaid populations, because a lot of the technology and disruptions that we're seeing could really have impact in the Medicaid world.

I was really attracted to Buoy’s founding principle of empowering patients, and not only the ones who are part of this huge healthcare machine. Being able to feel like you're providing them with digestible and actionable information so that they can make better decisions for themselves about how to access healthcare was really appealing tome. We talk a good game in healthcare; we talk about patient-centric or consumer-centric innovation. But really everybody talks around the patient, and is not necessarily talking to, or with, the patient.

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Geoff Matous

How do you think about underserved and vulnerable populations that might not have access to high-speed internet to get into a symptom checker or might not be employed by the same employers that are purchasing products through a marketplace? How do you see Buoy addressing those populations today? And then what's your vision for how that evolves in the future?
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Dr. McFadden

I think a lot about this. What we're doing well now is accessibility, at least from a proximity standpoint, by offering services via the internet or a mobile phone. Also from an accessibility standpoint, we’re offering our services for free if someone can get to us online. There’s no charge for them to use our symptom assessment tool or to utilize the clinical content on our platform. It’s free for them to browse the care options and solutions that could benefit them based on their symptoms. I’m proud of how Buoy is delivering that kind of access.

Broadband access has always been a passion point of mine, and it is certainly not yet fully accessible particularly for people in rural America. Access through mobile devices is helpful, though, as we know a large majority of the population is using those. As we’re rolling out our marketplace, I think about how we’re able to reach rural communities, economically underserved communities, and other marginalized communities through the power of mobile. They’ve never had a “world is your oyster” healthcare experience, and historically have been limited by what’s proximal, and that’s usually a clinic or a hospital. Now having access to specialty solutions and care that wouldn’t be available where they physically are, it feels like we’re opening a whole new world for these populations.

When I was sort of a baby in medicine, we always used to say “people are misusing the emergency department.” “That's inappropriate use, why are they going for a common cold at three in the morning?” As I became more in tune with the individuals and the people that were coming into my ER, it was very clear to me that a lot of people just had context in their life driving that decision. They were working two jobs. They didn't have an ability to get childcare, so they were waiting for their partner or their spouse to come home. Three o’clock in the morning was really the only hour that they actually had to spare to go take care of their health. Having digital solutions available to them now means they don't even have to leave their home to be able to do that and can still take care of themselves and their family the way they want to. I think this marketplace to me is just sort of really honoring the context of people in their lives and allowing health care to be integrated into the livelihood of everybody versus having to make additional efforts to access care.

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Geoff Matous

In the context of COPD, our focus at Wellinks, that rings incredibly true. We’re working to expand access to things like pulmonary rehabilitation, specialty pulmonary care, therapists and coaches, and self-management support. If you live in a rural area and are referred to these services in-person, you might dropout of that program and not complete it if it’s an hour away and transportation is a challenge. Virtual programs have a huge opportunity to solve for many of those challenges.

On the flip side, though, there’s maybe a quality concern we’ve seen lately when you have a ton of new care options and Google is the front door. Especially when those companies are in arms races to win paid search bid results for some conditions.

I appreciate the way that Buoy is focused on winning the organic search for a lot of common disease states by offering high-quality content. Ultimately, as a care seeker you must do some homework and evaluate clinical solutions that could be good for you, whether they’re coming from your employer, your plan, your family, your physician. What is Buoy’s approach to making sure that care seekers are getting the best-in-class solutions, so the world can really be their oyster (with a pearl, not just some dirt)?
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Dr. McFadden

A pearl! I love that. As you alluded to, trust is one of the most invaluable currencies in healthcare. We've taken a lot of time to build a system and services that will build trust with our users. Over several years, we’ve had practicing clinicians developing our educational content and vetting the services to make sure they pass muster. As our marketplace flourishes, we need to make sure that every solution and service we connect our users to will continue to be as trustworthy as we hope to be.

How do we do that? We really value adherence to evidence-based practices first and foremost. That’s the foundation of what we look for in any content or solution.

We also want them to share our commitment to quality and safety. At the end of the day, the Hippocratic oath I took is “do no harm,” and our solution partners have to honor that because it’s infused in everything we’re doing at Buoy. That’s central to our evaluation process when we’re thinking about partnership opportunities.

We also are committed to continuing to do this clinical evaluation and review throughout the partnership, as well, to make sure that the user's needs and experiences are continuing to be met in the way that we believe they should be.
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Geoff Matous

You’ve created a powerful dynamic in the combination of readily available, high-quality information and a collection of evidence-based solutions on the cutting edge of the latest clinical guidelines. As Chief Medical Officer, how do you think about achieving patient empowerment beyond getting them into the environment just described? And what are the challenges with activating those patients?
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Dr. McFadden

I think it's actually natural. The individuals that are coming to our pages are, by definition, already activated and engaged in their own healthcare. These are not folks that we're searching for the best sale on the latest fashion and happened upon clinical content. They were actually looking for specific information about a condition, a symptom, or other things that they were curious about, either related to their own health or the health of someone they love. And so, by definition they're already activated.

From our standpoint, it's helpful for us to empower them to keep them activated and engaged so they don't become overwhelmed by the ubiquitous and unfiltered information that can become paralyzing because they cannot make a decision about what to do next. Being able to give them relevant and actionable information allows them to continue on that journey of activation and engagement in their own health.
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Geoff Matous

In the COPD space, there are many patients who are not active in their care, but are very sick and could benefit from resources like ours. Do you see a role for Buoy to help reach those people who aren’t yet activated, or is that more a role for your partners or others outside of what you’re doing?
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Dr. McFadden

I think the answer is twofold. If you think about the journey of activation, it usually begins with a question: “what’s going on with me?” or “what could be going on with me?” There’s then an element of discovery to try and learn more about those answers.

Then, beyond getting that initial information, you have to act on it and move to “these are things that might make me feel better.”

Buoy is helping improve the first phase of activation by offering proximity between those questions and making it easy for people to identify the solutions for their unique challenge. And if you go through that journey and achieve those steps and get to a result you want, whether that’s improvement or completely recovering, you’re more inclined to come back and repeat that cycle knowing that you’ll experience benefits from each of those steps.

That’s why it’s so important for us to have partners and solutions that drive positive experiences for our users.If they don’t see any symptom improvement, have a bad experience, or are left confused, there’s probably going to be a break in the chain for them. They are then more likely to drop off. It’s really why we think of the marketplace as a convener of partners rather than “solution providers” because we have to have true partnership that reinforces the member experience.
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Geoff Matous
I want to look to the future and ask where you believe we’ll see transformative change in US healthcare. Also, what do you think won’t change, but probably should?
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Dr. McFadden
Bringing things full-circle, I’d like to close by talking about health equity.I don’t think it’s changing fast enough, but I do think we’re seeing incremental change. From my experiences across my entire career, I’ve seen how health equity is so multifaceted and influenced by things beyond health systems, health solutions, and healthcare providers. It’s driven by policy, socioeconomic factors, environmental factors.

Improving the circumstances in which people live will pay off dividends in the long-run for their health, their mortality, their morbidity, across every individual measure. But I don’t think we can make significant progress on that without a collaborative approach and until lawmakers and policymakers get on board fully with what it will take to accomplish that at a systemic level.

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Geoff Matous

I’m hopeful that through that kind of messaging and by building companies that can have an impact, we can accelerate some of that change. We are proud to be a part of that change alongside you. I do have one more question – about football. Buoy HQ is in Patriots’ territory but you’re in Tampa Bay. Are you fully a Buccaneers fan?

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Dr. McFadden

When you move to CHAMPA BAY … you have to be a fan!

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Geoff Matous

You’ll have to keep me posted on how the Tom Brady/Rob Gronkowski conversations go with the Boston Buoy contingent! This has been a pleasure – we are so excited to be launching this partnership with you. Thank you so much again for your time.

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Dr. McFadden

Likewise. We are looking forward to working together. Thanks so much, Geoff.