Doctolib: fighting covid-19 with digital transformation
The use of teleconsultation has increased by a hundred time since the outbreak. With an exponential growth, and by supporting practitioners and hospitals, Doctolib is building an empire in digital health.
Doctolib is a French-German unicorn launched in 2013, valued at more than €1 billion in 2019 [1]. The company is focusing on bringing digital transformation to the health system. The company started by offering a consultation management software for health professionals. The purpose of this software is to lighten their administrative burden and reduce up to 30% of their time spent on administrative tasks [2]. The product gradually shifted to a platform with an online appointment-booking service to connect patients with practitioners. Doctolib is charging the latter with a subscription fee. It built its success through a cross-side network effect by incentivizing patients to join. The company extended to other services by offering a centralized database for practitioners to share information of a referred patient in a secure channel and by adding the possibility to subscribe for a video consultation software [3]. Doctolib is now a major player in France and Germany.
Covid-19, a boost for Doctolib
The covid-19 pandemic is a major boost for Doctolib. Habits and reflexes have changed deeply. Video consultation is now a critical tool for health professionals to continue to ensure medical consultations without exposing themselves or their patients. Before the crisis, the adoption of video consultation was slowed down by regulations. In France, the government was quick to change its position. It implemented new measures to allow the full reimbursement of video consultations and put an end to the rule which imposed a patient could only be reimbursed if the health practitioner was previously following him [6]. The number of daily video consultations grew from 1,000 before the outbreak to more than 100,000 on Doctolib’s platform [5]. 30,000 practitioners have adopted it. This number is growing everyday and the company estimates that about one out of ten consultations in France is now virtual.
The company is actively investing effort and resources to fight the crisis. Early on after the outbreak, the company has been offering the video consultation service for free for current subscribers of its platform. Doctolib has also launched a vast plan to support hospitals. Around 1,400 employees are voluntarily deployed to help hospitals, clinics or newly created covid-centers [5]. Their mission is to help the latter to use digital technologies, like setting up devices for video consultation or implementing technologies to improve the efficiency of operations.
(Courtesy od Doctolib)
Sustaining success and growth?
The company was already growing fast before the crisis and was seeing video consultations as a major opportunity. The company was planning to hire more than 200 engineers according to a source [8] and around 3,000 employees in total according to another one [7].
The future of video consultations
The CEO is confident that the boom of video consultations will carry long after the pandemic. The firm has been conducting surveys and found out that 74% of practitioners and 80% of patients are willing to continue using video consultations. They have evaluated that in the long term one out of five consultations would remain virtual, so twice as more as today [9].
The goal of Doctolib’s is not to make every physical examination virtual, but video consultations along with Doctolib’s platform provide value to both patients and health professionals for many use cases. Beyond the gain in convenience, doctors can follow-up more efficiently and regularly. Doctolib enables the latter to monetize these follow-ups. Virtual consultations will also help to fight the problem of the ongoing medical desertification, where some rural areas are struggling to attract health professionals. The use of video consultations is also helping the efficiency of clinics and hospitals. They could help to address bottlenecks by outsourcing consultations, or limit queuing in hospitals by making some types of consultations virtual. The company should be confident that they could go back to monetize their video consulting services. They would not be losing much customers, as these services are very valuable for them.
Livi, the French brand of the Swedish startup Kry, is one of the main competitors of Doctolib in video consultation. Livi took a different approach, it is employing its own health practitioners on part-time contracts for video consultations. 150 doctors are working in France for the platform, accessible seven days a week [10]. However, the business model is more difficult to scale. Practitioners have to commit time to the platform and are not serving their regular patients. Doctolib brings more value to doctors and patients by being a more open platform and enabling them to maintain a relationship.
An occasion to build a strong network
The success of Doctolib’s platform relies on a strong cross-side network effect. The engagement of the company in the crisis is paying back as it is strengthening its network. More practitioners and patients are adopting the platform for video consultations. The company is also building strong relationship with clinics and hospitals by helping them for free to leverage digital technologies. In 2017, Doctolib won a bid solicitation from Assistance publique – Hôpitaux de Paris, which represents the largest hospital system in Europe [3]. Patients who wanted to make an online appointment in these hospitals could only do so with Doctolib’s platform. The company is likely to sign similar contracts with the hospitals and clinics it is helping. So big players would join their network. As multi-homing is unlikely for health professionals (it would be a hassle for them to have several consultation management applications and they would have to pay for multiple subscriptions), strengthening both side of its network is giving a big edge to Doctolib against its competitors with a similar business model.
What would be difficult for Doctolib is to scale to other countries than Germany and France. They would have to build new networks of patients and health professionals. In other countries, the crisis would likely benefit to similar incumbent companies. Doctolib has plenty of opportunities in the two countries where it is implemented to transform our health system with digital technologies. The spectacular growth of Doctolib raises however concerns as the firm is becoming more and more a monopoly in the field of digital health.
Bibliography:
[3] https://fr.wikipedia.org/wiki/Doctolib
[6] https://siecledigital.fr/2020/04/24/doctolib-les-chiffres-de-la-teleconsultation-sont-tombes/
How do you expect this sudden growth to pan out? Recently Harvard College switched to a remote telephone urgent care line, rather than in-person meetings, which at least signals to me that some of the conversion to digital may be permanent. However, there’s worries that people are not visiting the doctor due to fears of picking up coronavirus during the visit. (https://www.statnews.com/2020/04/23/coronavirus-phobia-keeping-heart-patients-away-from-er/) When these worries subside, do you think that Doctolib will have gone too far and need to cut back, or will they be able to transition in someway to continue to use the resources (bandwidth, personnel, etc.) that they’ve built up during this crisis?
You made some good points. I think teleconsultations cannot replace all consultations. My personal view is that in a different context, most of them will have to remain in person to be done properly. But Doctolib is expecting telemedecine to grow and sustain in the long term to a size even bigger than today’s. We shall see. I think they will be very successful notably because they are combining lots of different digital solutions, telemedecine being one of them, into their platform.
And thanks for sharing the article!