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Brainstorm Health: Health Care Gig Economy, Digital Pill Concerns, Obamacare Signups

Greetings, readers! This is Sy.

Nomad Health co-founder and CEO Dr. Alexi Nazem says he wants to bring the gig economy to health care. His company’s set out to do so by allowing doctors and nurses (in certain regions) to team up with hospitals that need medical professionals on a short-term, freelance basis. And now, Nomad is taking the digital health-gig economy hybrid philosophy a step further by expanding into the world of telemedicine and virtual doctor visits.

“We want to be the one place that every doctor in America goes for gig work,” Nazem, who has described his firm as an Airbnb-style solution to the very real problem of health care worker shortages in the U.S., told Fortune in an interview.

Nomad announced on Tuesday that it’s launching a first-of-its-kind online jobs marketplace for doctors who want to contract out their services—without having to move physical locations thanks to videoconferencing technology. The expansion is an natural evolution of the company’s current model, which hooks up doctors and nurses in certain specialties like internal medicine, emergency medicine, and psychiatry with hospitals across the country in need of more medically trained bodies (and without the use of third party brokers).

Various legal hurdles like acquiring the proper malpractice insurance is taken care of by Nomad on the back end; the telemedicine push unites Nomad with more than 10 of the top telehealth providers in America (including industry giant American Well), the company says, and will center on fields like dermatology, urgent care, and psychiatry.

It’s a very millennial-driven concept. Younger generations of physicians and nurses are far more interested in remote work and short-term employment opportunities they can taylor around their own schedules compared with the old guard, as Nazem notes. The hope is that such a system can partially mollify a projected doctor shortage of 40,000 to 105,000 physicians, relative to America’s health care needs, by 2030—especially if existing regulatory barriers to medical accreditation and telemedicine services across state lines eventually fall.

Read on for the day’s news.

Sy Mukherjee


The flip side of the digital pill. Yesterday, I covered the milestone Food and Drug Administration (FDA) approval of a digital pill, created with technology from Proteus Digital Health linked with Otsuka’s best-selling schizophrenia and bipolar disorder medication Abilify. This treatment can be tracked digitally after you’ve ingested it (and patients can give their health care providers and personal care givers permission to access that medication). But while it’s an exciting technological breakthrough, it’s also caused trepidation among some mental health professionals who are concerned by the prospect of a treatment with potential “Big Brother”-esque implications that could actually scare off patients. “Imagine a paranoid man who takes digital Abilify, dislikes the experience, discontinues medication, and when the next episode of psychosis emerges, fails to seek help because he hated being spied on. Awareness of doctors’ capacity to monitor may discourage some people from seeking treatment in the first place,” writes Peter Kramer, an emeritus clinical professor of psychiatry at Brown University, in a commentary for Fortune. “Mentally ill patients want autonomy. The capacity to look in on daily behavior may complicate relationships between parents and their adult children with schizophrenia.” (Fortune)


Sanofi, Novo Nordisk get into Inozyme rare disease startup. European pharma giants Sanofi and Novo Nordisk are getting in on a $49 million funding round for Inozyme Pharma, a startup focusing on rare disease treatments. The firm hopes its Series A cash jolt will help it expand on a tech platform licensed from Yale, which aims to help babies who develop extremely rare and deadly diseases stemming from mineral imbalances that affect bones and soft tissue. (FierceBiotech)


Nearly 1.5 million people have signed up for Obamacare plans while GOP pushes for individual mandate repeal. The Centers for Medicare & Medicaid Services (CMS) reports that nearly 1.5 million Americans have signed up for individual health insurance plans under Obamacare since the open enrollment period began on November 1, including 800,000 signups in the second week of enrollment. That’s a significant improvement over where things stood one year ago–but it remains an open question whether the pace will be enough to make up for a severely curtailed open enrollment period this year. Meanwhile, top GOP lawmakers have indicated they’re willing to add a repeal of Obamacare’s individual mandate—which requires most Americans to carry health insurance—to tax reform legislation, which could potentially throw a wrench into that complicated legislative effort. (Reuters)

Legendary health economist Uwe Reinhardt passes away. The widely venerated Princeton health economist Uwe Reinhardt has long been known to colleagues and health care geeks round the world as one of the most eloquent, intelligent, and passionate academic voices in the medical field. Reinhardt, a German immigrant whose research has influenced U.S. health policy and informed readers of the New York Times, passed away on Tuesday, reportedly peacefully and surrounded by family. I’ll let The Incidental Economist‘s Austin Frakt take it away on the man’s legacy.


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Produced by Sy Mukherjee

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