The Hollow Men of Hims

>The real tragedy is not that Hims exists, but that it works so perfectly. Every day, thousands of people choose their compounded weight-loss drugs over FDA-approved alternatives, their combination ED pills over established single-ingredient treatments, their algorithmic consultations over actual medical care. They make these choices not because the products are better, but because the entire experience has been optimized to feel more like shopping and less like confronting the mortality and vulnerability that define the human condition.

Strongly disagree with almost everything in this article, but specifically this. The reason people make these choices is not because of slick marketing working against them, it's because the existing process to get medical treatment is paternalistic, hard to navigate and often expensive.

If you want safe and really high quality medical care you should absolutely have a personal physician you have a personal relationship with, who understands your lifestyle, your risk factors for side effects, and your medical needs deeply. How many Americans have that? Maybe a few dozen? The market has responded to just how terrible the existing system is.

> If you want safe and really high quality medical care you should absolutely have a personal physician you have a personal relationship with, who understands your lifestyle, your risk factors for side effects, and your medical needs deeply. How many Americans have that? Maybe a few dozen?

A bit of a tangent: I have this here in the US, through a model called Direct Primary Care. I pay $50/mo for a single provider, unlimited visits / communication, and highly discounted labs. She makes house calls on occasion. This doctor is working solely in my interest, and has little concern of insurance, except to help me navigate that system should I need a specialist, prior authorization, etc.

I do worry that it's sustainable, but I think there must by a way to scale up this practice of the general practitioner working in the interest of the patient.

My previous doctor was part of a large health system, who also happens to be directly associated with the large regional insurance provider whom my employer supplied to me without another choice. Every 8 minute visit centered around insurance and billing, with my health seeming to be a distant second. It seemed every visit had to end in some kind of prescription or referral, arrived at quickly and without much discussion. It quickly became clear they were not working in my interest, and I sought other options, eventually landing on the Direct Primary Care model. Now I have full 1 hour visits, and someone who seeks to understand what is happening for me completely, not through the lens of a payer.

$50 + health insurance? I saw my PCP after my health insurance had unknowingly lapsed and a physical was ~$1k with just some basic blood work.

How people justify paying $1000 for probably less than 15 minutes of work is beyond me.

That included lab work, talking to the front desk people, the nurse who took the blood, the GP, the drivers, the janitors, the record-keepers, the lab techs, and the calibration work on equipment and who knows who else.

That is way, way more than 15 minutes of work.

I recently got a physical exam, including ultra sound, two urine samples, and bloodwork, at a private doctor in Austria and it cost 150€. You Americans are crazy.

I'm not sure how a physical would be more than 15 minutes of work. Lab techs? Standard blood tests are all automated, the most complicated part is putting the stickers on the vials. Yes, someone needs to calibrate the machine, but the machine processes 1000s of samples per day. I just checked, the price for a standard blood panel at a local lab is 14€. It's really not a complicated procedure.

Drivers? Janitors? What the hell are you paying those guys to justify a $1000 bill? And you really don't need to hire a driver to get a box of samples to the lab at the end of the day.