Canada's taxpayer-funded health care system has many benefits, but its painfully long wait times to see a doctor isn't one of them. This is where innovators like Felix Health see the potential for disruption.
The seven-month-old firm offers the first "asynchronous" health care service in the country, where a patient and a doctor don't need to meet in person to discuss a diagnosis.
Instead, a patient creates an account with Felix and fills out a 15-minute questionnaire. A doctor in Felix's network reviews it and makes a decision on whether to fill out a prescription, which is sent to a pharmacy for pickup or for shipment within 48 hours.
"It is a great experience where the patient is only dealing with one service provider the whole way through, and it creates a level of care that is extremely consistent, predictable and safe," Kyle Zien, Felix's co-founder and chief executive, said in an interview.
Felix is the latest among a slew of startups looking to shake up a single-payer system that some U.S. Democratic presidential candidates, including Sen. Bernie Sanders, I-Vt., are seeking to emulate. Many are taking a direct-to-consumer approach to health care to eliminate cumbersome wait times or offer medical support in remote areas with few doctors.
Some have received funding, with Felix raising $568,000 (U.S dollars). Montreal-based Dialogue Technologies received $30 million last month in a funding round led by a Canadian pension fund and a German investor.
Maple Corp., often considered the pioneer in the recent wave of telemedicine startups in Canada, raised $3 million in March 2018 from a group of investors including MaRS, a Toronto-based innovation hub.
In a 2017 study by the Commonwealth Fund, a U.S. foundation focused on health care research, Canada ranked the worst among 11 high-income countries on doctors' same-day responses to patient questions, wait times for emergency room care, specialists and elective surgery.
Focused only on lifestyle issues such as acne, hair loss, birth control and erectile dysfunction, Felix is like the "Uber for doctors," where the next available physician can issue a prescription, Zien says. The company plans to add more treatments such as HIV prevention, smoking cessation and wrinkles — ailments for which an in-person physical appointment isn't necessary.
Felix's focus on lifestyle disorders also builds on the idea that Canada's health care system prioritizes the sick and often overlooks less critical needs. It's the same model used by a number of U.S. upstarts selling sexual wellness drugs and baldness treatments, such as Hims Inc. and Roman Health Medical LLC.
In addition to convenience, the startups offer privacy and discretion to patients who may feel embarrassed discussing these issues in person.
All this convenience comes at a cost. Felix charges patients for a doctor's consultation, typically about $30, plus the cost of prescribed medication. Most provincial insurance plans in Canada only cover in-person doctor visits, so patients using virtual care must pay or seek coverage from their private or employer insurance plans.
"When you look at the value of my time, I would pay $50 [Canadian] each time if the value of the service is good," says Gina Giouroukos, a retired police officer who recently used Maple to consult a doctor for fever and strep throat.
For the doctors, these services create a new conundrum: While many would like the freedom and flexibility that telemedicine offers, they worry about the safety and efficacy of a diagnosis without meeting a patient.
"Most doctors have significant hesitation about telemedicine and are concerned it is unsafe for patients, and that there is no continuity of care," said Kelly Anderson, medical director at Felix.
She adds that most of these concerns arise from lack of experience with telemedicine platforms. Many doctors in the country have been slow to adopt technological changes even as they're overworked and see up to 50 patients a day. Canada's lower adoption of medical technologies makes it one of the most expensive universal health care systems among developed economies, research by the Fraser Institute shows.
"We're going to see telemedicine coming in Canada, whether physicians like it or not," Anderson said. "It's better for physicians to be involved in shaping the safety practices and making these telemedicine avenues the best that they can be rather than sitting on the sidelines and being nervous about them."