Inspired with Alexa von Tobel
00:13:31 · Jeremy Gurewitz
[00:13:31] S0: Yeah, for sure. So we do a basic intake. So we actually have a team of physicians. So people, you meet with a physician. They confirm your diagnosis. They confirm your eligibility for advocacy in accordance with kind of, like, the rules and regulations for advocacy. And then once you connect with an advocate, that's your advocate. And so you work with the same person longitudinally. And that's one of the things that we've found is super, super valuable is you're building this relationship with someone. They know who you are. It's not like you're calling a random phone number and, you know, you're getting all these people. You have to explain what's going on. You have your advocate. So that's kind of like the first piece that I think is really worth calling out. Once you're with an advocate, you have an initial conversation, you explain what's happened, what you're going for. And then one of the most important things, and this is kind of like we talk about in Solace all the time, is we have a no homework ethos. So in healthcare, one of the things that makes it so painful for people is like you go somewhere and they're like, here's this 27 step thing that we need you to do. And that's not how we operate. The advocate works on behalf of the patient. So you meet with them. And then once you share the situation, then the advocate gets to work. And it can be ranging from something super simple. Like oftentimes we hear, can't get access to a provider. I can't get access to the right doctor. Something simple, but like this happens all the time. And certainly even in New York finding a primary care physician incredibly difficult. And like especially if you go down the list of specialists or even if you're not sure right way to go, that's actually a very difficult thing. And that's the most simplest thing. It then kind of progresses significantly. Sometimes we have people who are handling chronic illnesses and they haven't been able to find the right way to manage it, or they're having challenges on medication management side, or they need to understand the care plan. And then obviously, in many scenarios, people are dealing with life or death situations. Perhaps you've just been diagnosed with cancer, perhaps there's an ongoing serious illness and you're being asked to make a very critical medical decision.
00:15:29 · Jeremy Gurewitz
And so while obviously the advocate isn't your doctor, the thing the advocate does is help you understand the situation, try and get you the best information possible, and help you lay out some of the different pathways that might occur if you're being asked to undergo different type of treatment protocols. We also have kind of all sorts of... Sometimes I call advocacy deals with the sum of all edge cases. And like we have one... This is just one example that I've sometimes shared with people where we had a patient that came in and they needed a kidney transplant. And so they were in the hospital and they were joking with a friend and said, couldn't wait to have a beer when this is all over. And a nurse overheard this and wrote in the chart that this guy was an alcoholic and he got kicked off the organ transplant list. Oh my gosh. And so imagine if you're in that situation, you're a regular person, you're very sick, clearly you need an organ transplant list. Like you get this notice, like how do you even deal with that? Very, very difficult. And so luckily, came to Solace, connected them with an advocate and went through this incredibly cumbersome process to change the chart. Changed the chart in the hospital and then it turned out, well, that's great. That still doesn't get you back on the list. So then they had to engage with the National Organ Transplant Registry, took a month, got him back on the list, but it was actually now they're on at the end of the list. So no, that doesn't work. This kidney is going to pass away. And so another month passed and eventually got him back on the place on the list, ended up getting a kidney, ended up saving his life. And so while that's an extreme example, there are countless cases where bureaucracy, poor processes end up resulting in far worse health care outcomes for people than they would otherwise get. And health care advocates solve the problems that people face.
00:17:07 · Alexa von Tobel
[00:17:07] S1: Jeremy, said almost differently, you at Solace are helping people in the scariest days and hours of their life. Yes. I have chills even just thinking about it. I mean, it's the scariest minutes of people's life where the decisions that they are making really matter, and most people getting health diagnosis aren't doctors themselves. Right? And why is the system so broken there? Can you lay... And and and I really don't fully understand this answer. Why is it so hard to get the right care at such a critical time where it's literally life or death dependent?
00:17:50 · Jeremy Gurewitz
[00:17:50] S0: Yeah, there's like a very, very long answer to this. I don't want to take up this entire conversation with that. So I'll try and boil it down. So I've spent a lot of time now studying The US health care system as part of the work here at Solace and trying to understand it. Without going into the full history of US health care, if I had to boil it down, what... What's occurred is there is oftentimes a bunch of well meaning regulations and rules that end up resulting in very, very limited ways in which providers feel they're allowed to do things. There are also structures and and and not meant to be political, but just like in terms of how the rules have been set up where there are basically local monopolies everywhere. And you can look throughout The US health care system. There's consolidation. There's been limited things. And I think, you know, what we see in historically is when you have monopolies there and you combine the monopolies with the very tight rules and regulations, it ends up being that there's no real incentives or ability for people to create a better outcome. And so you end up having all these cumbersome steps. You have all of these processes, and there's no real incentive to make things better. And so that's the challenge, I think, that's occurred. We could go into any particular detail about why a particular rule is the case when you look at even just, for example, getting health care records. There's a very, very long list. And truly, the rules go into the thousands of pages about how health records are generated, the way in which they're allowed to be generated. So so we've actually connected to... They're called, like, health information exchanges. We're we're connected to one of them that allows us to get health records. In normal databases, if you have someone's name or whatever, there's like an ID or there's a way to connect someone to their record. In The US health care system, you're actually not allowed to have that for various reasons. And so if you have someone's information, you have to search for them geographically. So which is the most... Software, would never say, okay, we're gonna look for this soft database search geographically. So I think that makes no sense. But that's just one example, one niche example of searching for health records.
00:20:16 · Jeremy Gurewitz, Charlotte Ross
And the health care system is full of rules that have good intentions but have kind of combined over time, combined with the limited nature of competition and supply that's resulted in these really, really challenging places. [00:20:31] S2: And one of the things that we've loved about you from the beginning is you've come into this, you don't have a healthcare background. Obviously, you have your personal story, your brother's a doctor, you're a savant when it comes to topics. But it's not like you kind of grew up in the healthcare system. You're coming at this from a real consumer angle. And I think with that, have an ambition of building a marketplace that's like an Uber or an Airbnb, but in health care. Can you talk a little bit about just the advocate side of things? Obviously, before Solace, advocacy was like this niche thing. And now you're really creating a path for these people. Tell us about who they are and like how this population is growing and where do you think it kind of will become, you know, what it will become in like ten years from now?
00:21:22 · Jeremy Gurewitz
[00:21:22] S0: Yeah, for sure. So before Solace, you know, there were folks that were calling themselves healthcare advocates, the most passionate, wonderful people. Got to meet a lot of them. And when we first started Solace, had conversations with many of them to convince them to give us a shot and work with us. People generally with health care backgrounds who have dedicated themselves towards solving this exact issue and are experts in this. As we've grown Solace, what we found is there's an incredible supply unlock where there are tons of nurses who really want to be health care advocates. And they are, in fact, in their day to day. I think so many people, if you've ever been in a hospital or a place, incredible nurses do incredible work. And so we found that there's a lot of nurses who want to be health care advocates. And so we bring them on the platform. We have kind of a training program that kinda catches them up with kind of some of the things that they'll be working on. And, yeah, we we connect them with patients. And so I think it's just a fantastic opportunity for nurses who want flexible hours, who wanna work for a super mission oriented company, and to be able to work remotely is something that I think is just incredibly exciting for them.