THE FOUNDERS OF ZOCDOC.COM, Cyrus Massoumi and Dr. Oliver Kharraz, had just concluded the very first public demonstration of their medical appointment-booking app at the TechCrunch40 conference in September 2007 when they got a review that threatened to put the whole endeavor on life support.
“Honestly, it would just never occur to me to go to any site to pick a doctor,” said Guy Kawasaki, the Silicon Valley venture capitalist, early Apple employee and venerable start-up guru, smiling and chopping the air with a pen. “I mean, it’s just sort of too facetious.”
Emphasizing once more that he would never use such a service, he turned to a fellow judge on the panel, the entrepreneur and philanthropist Esther Dyson, and elaborated, “You’d go to a site and just, ohhh, you know, Lisa Macintosh went to Harvard, she looks cute, I’ll have her operate on my heart!”
The audience responded with belly laughs. “A heart condition, that’s a unique issue,” Mr. Massoumi, a bright-eyed, 35-year-old salesman whose first start-up, an e-commerce site called One Size Too Small, was not considered a success, said slyly. “But I can say that if you had a rash on your butt, you would use our site, because a) you wouldn’t want anyone to hear you make that call, and b) it might be after 6 o’clock, and maybe the doctor’s office isn’t open.”
Mr. Kawasaki’s turned out to be the minority reaction. Four years later, ZocDoc has 700,000 registered users and has raised $70 million from investors, including $50 million most recently from Facebook investor Digital Sky Technologies. The website, most often described as the “OpenTable for doctors,” has five million appointments available in 10 markets, including New York, San Francisco, Chicago, Washington, D.C., and Phoenix, and it’s hiring like mad. During a phone call with ZocDoc’s public relations director, Allison Braley, Betabeat was interrupted by what sounded like a foghorn. “Oh gosh, they’re blowing the horn,” she said, sounding shaken. “Every time we hire someone they blow the horn.”
On a recent Friday afternoon, Betabeat stood in front of an oversize $100,000 check signed Forbes.com & HP, which was mounted on the wall at ZocDoc’s teal-painted Soho headquarters. It represented a pile of prize money the company had received in December 2008. “It wasn’t until three months later that they sent us the actual check,” said Mr. Massoumi. The check came during the nadir of the recession, and the bootstrapping entrepreneurs, who moved to Harlem and Brooklyn after quitting cushy consulting jobs, considered making a hokey YouTube video of themselves taking the minifridge-size document into a bank to goose the payment.
Mr. Massoumi, at the time working for management consulting firm McKinsey & Company, had the idea for ZocDoc after he ruptured his ear drum during a flight from Seattle to New York. “I was working on a really high-pressure client, and partners from all over the world were calling me at odd hours of the night, so I just got really sick,” he recalled, sitting in one of ZocDoc’s sunny but basic conference rooms. “I had this sinus infection. So going up, it was fine, but coming down, when the air expands in your ear”—he clapped—“it’s like, incredibly painful, and in the end I ended up rupturing my eardrum and I couldn’t hear out of my right ear.”
Mr. Massoumi comes from a family of doctors, though he decided at a young age to be a “businessman” like his father’s friend, instead of an orthopedic surgeon like his father, because he was bad at science. But he knew he needed to see an ear, nose and throat specialist, so after landing, he pulled up his insurance company’s directory, which listed 191 practitioners in Manhattan in alphabetical order. “Being a type-A person, I figured I’m just going to start calling doctors, and I’m sure I can talk somebody in to seeing me same day,” he said.
But after discovering that some of the numbers didn’t work and waiting on hold with the ones that did, he was told repeatedly there was nothing available. “It was amazing. I’m like, I’m in pain! I want to go see a doctor! I can’t hear! And no one would see me.” The earliest appointment he could get was four days out.
After an “aha” moment in the middle of an aisle at Whole Foods a few weeks later, Mr. Massoumi met with his colleague and friend, Dr. Kharraz, 38, an exacting German who graduated magna cum laude from the Ludwig Maximilian University of Munich with an M.D. and Ph.D. in medicine, for lunch at the Eatery in Hell’s Kitchen. It’s possible to book the next available flight or the first open reservation at a restaurant—why shouldn’t a doctor’s appointment be the same way? he asked.
“I’m a doctor myself, so it never occurred to me that it might be difficult for people to find doctors,” said Dr. Kharraz. “I use my networks to get in and be seen in the last minute. But I heard the situation and, actually, when you look at the data, four days is still pretty good. It takes the average American consumer 21 days to see the doctor, and that’s completely unacceptable. You know? You need to be able to see the doctor when you’re sick.”
You’re right, he told Mr. Massoumi, we should quit our jobs and start this company. “It took me about 10 seconds to decide, which seems like a really long time,” he deadpanned.
On ZocDoc, users search for doctors by insurance accepted, location and specialty: allergist, dietician, urologist, general practice. The site pulls up a list of doctors, displaying a week’s worth of availability for each, so one can book the earliest available appointment if it’s urgent, or the highest-rated (or cutest) doctor if it’s not. The booking requires no payment up front, it’s possible to cancel online, and ZocDoc emails a friendly reminder before the appointment and a thank-you note afterward, encouraging patients to rate their doctors for bedside manner, wait time and overall impression. Doctors can choose whether or not to reveal their ratings.
But while reviews for doctors vary, patients who have used ZocDoc tend to gush about the service. “I have used ZocDoc to find a new dentist and a new primary care physician in the last year, and in both cases it was a fantastic experience,” said Chris Carella, a 33-year-old software developer who lives in the East Village. He registered on ZocDoc after a dentist he didn’t much like told him after multiple appointments that the pain he was experiencing was nothing. Using ZocDoc, he picked a highly rated dentist in his neighborhood who discovered he needed a root canal. “I now have two doctors I really like!”
ZocDoc’s real customers, the dentists, doctors and specialists who pay a flat $250 a month for the referrals (ZocDoc also allows them to add a button to their websites that lets users book appointments online), also tend to be enthusiastic about it. Dr. David Ritholtz, who founded and manages the Premier Dental practice in Lower Manhattan, was one of the first dentists to sign up. Indeed, Mr. Massoumi spent five hours camped out in Dr. Ritholtz’s waiting room, desperate to get the final sign-off on the partnership. The start-up was due to launch at TechCrunch40 in a matter of days and there weren’t enough dentists in its directory to make a scroll bar appear.
Dr. Ritholtz remembers none of this. He thought enabling a patient to make an appointment online and see a doctor’s profile—their schooling and level of experience—was a great idea. Like many in the medical professions in New York, he was just busy.
“I was just told by my front desk that we got in excess of 35 patients last month from ZocDoc,” he said. He estimates that the service refers a quarter to a third of all new patients.
“I’m a happy customer,” he said. “Please give Cyrus and Oliver my best. Ask them to call me. I’d love to do lunch with them one day or something like that.”
In addition to camping out in Dr. Ritholtz’s waiting room and being escorted out of the offices of three other physicians by security, Mr. Massoumi and his co-founders Dr. Kharroz and CTO Nick Ganju, 35, had to figure out how to collect insurance information directly from doctors—trying to get it from the insurance companies would have been even more onerous and prone to error—and make ZocDoc work with their myriad appointment-booking systems.
There are hundreds of practice management programs for doctors; ZocDoc says it syncs with all the versions that have more than a 1 percent market share. Doctors who use supported systems will see their appointments open up or get blocked online almost immediately, so a ZocDoc patient can slip in if there is a cancellation. Doctors who use an unsupported system—or rather, their receptionists—manually add and subtract appointments on a separate ZocDoc calendar, a stop-gap solution reminiscent of the kitchen fax machines behind the few-clicks it takes to get a Seamless delivery. The logistical nightmare of organizing and coordinating doctors, insurance information and software is probably the reason there wasn’t a ZocDoc earlier–consider that even Seamless, then SeamlessWeb, started in 1999–and competitors are just starting to emerge. “They solved the problem really well on the front end and it was a great experience for the patient, and then the sausage factory in the back-end sort of took care of itself,” said Unity Stoakes, co-founder of the local start-up OrganizedWisdom, a web-based patient management system for doctors.
Most doctors we spoke to had few complaints, although one dentist mentioned he wished ZocDoc would prevent patients from canceling at the last minute, and the Yelp-like rating system does make physicians a bit squeamish. “Most of the reviews are very positive, but I’ll give you an example,” said one Manhattan ear, nose and throat doctor, who did not want to be named for patient confidentiality reasons. “A patient comes in, fills out forms, sits down in the waiting room and gets seen immediately. How is it she can rate me as a four for timeliness?” He acknowledged this was a problem with “the entire internet,” adding, “People have an ax to grind for some reason.”
Betabeat decided to replicate Mr. Massoumi’s experience and make believe we had an agonizing ear infection on an August Friday afternoon. We looked up E.N.T.’s in Manhattan who accepted our insurance and started calling around. There were three doctors at Beth Israel; all their numbers went to the same automated message—“If this is a new patient, or if this is regarding a departmental administrative matter or an emergency, press option one”—which then went to voice mail. The next office was closed. In all, we called eight doctors, by which time, though our ears felt fine, our head was starting to hurt. The earliest opening was five days out. But there were multiple appointments on ZocDoc on the day of our imaginary ear ache, where booking an appointment takes about two minutes.
ZocDoc has the potential to expand into other segments of the multi-trillion dollar health care industry, including medical records and patient management. But first, its founders want to irreversibly change the way patients book appointments. And the efficiency achieved by solving “one small thing that’s a huge pain point for everybody,” in Mr. Massoumi’s words, could add up to billions of dollars saved by Americans a year, just by keeping patients with painful earaches and other calamities out of the emergency room.