Daniel Carlin, M.D., pioneered JobSiteCare’s innovative concierge telemedicine model after a decade of experience in demanding healthcare environments. Dr. Carlin is a national leader in the field of telemedicine.
Russ Alan Prince: Dr. Carlin, we interviewed you in 2011 when you were at the forefront of concierge medicine with WorldClinic. You and your team then cared for high-net-worth families and senior executives. Bring us up to speed on your field and your new company JobSiteCare.
Daniel Carlin: Our first company, WorldClinic, was a concierge telemedicine practice that served mobile executives and high-net-worth families globally. Those clients wanted an accountable physician to care for them in close alignment with their globally mobile, anytime/anywhere lifestyle. We made a name for ourselves in that small but highly influential market.
In 2019, one of our WorldClinic clients asked us to bring our model of connected concierge medicine to their everyday workforce: 5000 individual construction workers operating at 31 sites and six different states. Their ask was two-fold: care for injured and ill workers right at the job site and improve their workers’ comp experience. Given our 20+ years of history in telemedicine, the first challenge was easy. What was truly unexpected was our success in enhancing both the workers and the employer’s worker’s comp experiences.
Prince: That’s quite a journey. You’ve gone from caring for some of society‘s wealthiest members to caring for hourly laborers and succeeded with both. How did you do it?
Carlin: We were fortunate in the timing around our development. Our WorldClinic experience taught us that success was driven by client renewals, and client renewals was driven by the client’s emotional processing of the care they received. The better they felt about the care they received, the less anxiety and fear they experienced, and the more likely they would renew each year with us.
This exact same emotional dynamic applies to injured line workers. The injured worker recovers faster by providing a fast, well-managed and fully informed experience. When that happens, the worker’s comp cost of their injury is diminished.
Prince: Can you tell our readers more about how the worker’s emotional processing of their injury plays a role in the recovery?
Carlin: The predominant emotions injured workers feel are fear and anxiety, primarily related to not knowing what lies ahead and how it will impact their ability to provide for themselves and their families. If timely communication and care are delayed, this state of anxiety worsens. The worker has few choices other than to turn to legal counsel to relieve this anxiety. By doing so, the length of the recovery will increase by 300%, and the cost of their worker’s comp claim will go up by 400%.
To avoid this fate, we’ve adopted what we call the Whole Worker care model. With the Whole Worker model, an injury is assessed and treated while integrating multiple non-medical factors, including the worker’s emotional state, social standing, economic conditions and personal values and beliefs.
Done well, the Whole Worker model builds a lasting bond of trust and collaboration between the worker and our providers. Once that kind of relationship is in place, great things can happen.
Prince: Can you give us an example?
Carlin: Sure. We recently had a telecom worker injure his ankle while unloading a truck. In an onsite video call, our doctor interviewed the worker and performed a guided exam of the ankle, which suggested a possible fracture. After elevating, splinting and ice bags, we arranged transportation to a nearby imaging center. In less than an hour, the x-ray was done, and it revealed an unstable fracture that would require surgery. From there, our care team searched the insurance carrier’s provider network and verified an available orthopedic ankle specialist. Our doctor called the orthopedist directly, and together they reviewed the case and the X-ray. The worker had surgery three days later. During those three days, our doctors called his supervisor to arrange the modified work duties he needed to say on full pay. We also spoke nightly with his spouse and oldest son.
In the context of the Whole Worker model, this patient felt authentically cared for. We set realistic expectations, shortened the time between his care events and, most importantly, continuously addressed his and his family’s concerns. It was, therefore, not a surprise that he did well in recovery and returned to full work duties six weeks later without a single day of full pay lost.
Prince: You are again working at the nexus of technology in medical care. What can our readers expect to see in the near future? And especially for our audience of entrepreneurs and business builders, where do you think this is all going long term?
Carlin: The Whole Worker model combining worker’s comp and concierge telemedicine will likely be adopted by the big insurance carriers in the worker’s comp and general liability markets. The fact that the model enables better outcomes while cutting overall costs is a double win, and I suspect it will spread quickly.
The longer-term picture is a bit murkier. The only absolute we have now is the near-universal dissatisfaction people have with the lack of access to a doctor. Though there are too many reasons to list here, we are seeing a response to this lack of access; employers are starting to hire individual and group medical practices like JobSiteCare to provide their workers with a responsive point of access to help guide and address their medical issues.
We have some supporting evidence. In 2019, less than 2% of our cases were individual employee illnesses; the other 98% were injuries incurred on the job. Today, 24% of our cases are purely medical illnesses and not work-related.
We fully expect this trend to continue. Workers will always need some sort of healthcare, and if the only easy place to access it is at work, the majority will use that resource. It is also an issue of productivity. Employers suffer substantial lost time due to workers leaving work for medical care. They also witness minor medical problems going unaddressed, creating major problems and downtime down the road.
Employers should pay close attention to this trend. If they can offer timely physician access to their workers, they will be more competitive in the battle to recruit and retain talent.
Russ Alan Prince is the executive director of Private Wealth magazine and chief content officer for High-Net-Worth Genius. He consults with family offices, the wealthy, fast-tracking entrepreneurs and select professionals.
