Googling for "Hank Gardstein MD" finds only a Henry (for which Hank is a nickname) Gardstein (http://www.healthgrades.com/physician/dr-henry-gardstein-xcs...) with the same school of medicine, medical specialty, and rough date of beginning of practice as that of the profile on MetaMed.
So, "at least two of our expert researchers will validate test results to rule out any errors"?
What does that mean, exactly? As a board certified pathologist, I have some idea what I mean by validation, but what do you mean?
Next, the featured testimonial from "Jerry W." sounds fishy - it may be genuine, but it seems like it was written by marketing, and lacks any detail to provide credibility to skeptical evaluators.
Next, when research is published, there is a p value, perhaps 0.04. When you provide your recommendations to patients, I'm sure you are smart enough to hedge appropriately. How do you communicate that? Do you guarantee follow-up if new research modifies the confidence of your previous recommendations?
Finally, research evaluating one treatment versus another typically are provided in the context of routine patient care for the average patient. Your clientele here, clearly, are not run of the mill patients. With the proposed fee structure, they are also not likely pursuing routine treatment. This suggests that routinely published research will be less applicable to your customers. This amounts to being a huge selection bias. How do you plan to adjust for this issue? (As a specific example for one class of these problems, for those not familiar with these kinds of issues: the reason we don't perform routine mammograms in women starting at age 20 is not just cost - the prevalence is so low in this age range that the false positive rate is very high. So, patients who obtain a mammogram at age 20 for "screening" are at higher risk of false positives.)
Hello. I work for MetaMed, and knew Jerry (not his real name) from long before he became a client - I assure you that that page was in no way written or edited by us. We generally do not include specifics (like real names, medical histories, and so on) to protect patient privacy, which we take extremely seriously.
I see how that issue - name/history/etc. - would make it hard to provide credible success stories.
Site still not working for me, so this may be there:
Perhaps, someday, maybe include a patient story or two with medical history but no name? (With appropriate HIPAA waivers...)
Even better, it would be WAAY awesome if you posted, whenever possible, the results of your research on your site for review by anybody. It may not be in your current business model, but the "giving back" angle might be the edge that pushes you into popularity.
From Google Cache (was going to link to it, but the text-only version has a lot of over-laid text and is hard to read):
> We work with you and your doctor to figure out how advances in medical science apply to your personal health needs. Our team of researchers will do in-depth, personalized analysis to find new technologies, read scientific journals, talk to experts, and separate real medical breakthroughs from media hype. Whether it’s testing, prevention, treatment, or nutrition, if you have medical questions, we can help inform you about what the options are and what a rushed, ten-minute appointment might have overlooked.
The Sample Concierge report is interesting. Though from an admittedly quick skim I'm not sure how much of it is truly personalized. There's a lot statistics in there, which I guess is unavoidable.
http://www.metamed.com/static/Meta_Gout.pdf
In any case, I like the basic idea of this a LOT. It's an interesting direction to go in, bringing this kind of thing to semi-mass market.
By the way, the line "Our doctors are here to listen" in the call-or-chat box is brilliant. The couple of people I know who have problems they would need to take to this level are completely fed up with doctors that they feel aren't listening to them. This is the market. People who are in strong need of personal level attention.
No kidding. For three pages, effectively (with lots of whitespace).
In fact, for $5,000, your actionable items on the subject of "Difficulty Sleeping" are:
1. Get tested for sleep apnea.
2. Take melatonin.
3. Reduce caffeine intake.
Seriously? The first item is "get tested for thing you are complaining about"?
http://www.medicinenet.com/insomnia/article.htm - I typed in "Difficulty sleeping" into Google, and got this result as the first. It included all three items from the report and took somewhere under sixty seconds to find.
Don't get me wrong - this, and essentially anything medical - is ripe for innovation (I'm working on a almost polar opposite idea myself), and there are some good advances in expert systems for diagnosis that I've seen.
But if you're attempting to get $5,000 to $50,000 out of someone, the sample report you're showing isn't selling it, at all.
Sorry about that, you're totally right - that was an older draft version that got uploaded by mistake (I work for MetaMed). We'll have the new one up in a day or so when the launch chaos has died down.
(I can send you a bunch of our more current research tonight if you're interested in this particular subject - email me at avance@metamed.com)
Insurance providers will spend a lot of money telling you, advertising aimed at "taking better care of yourself" (that they should "need" to do so is a different, though sad, indictment).
Go ahead, then. Tell 90% of insurance carriers that you have committed to, documented yoga, gym attendance, walks every day. Ask them what premium reduction they're prepared to offer as a result. Be ready to hold the phone away from your ear as they laugh.
Ask them how much they'll contribute to your weight loss efforts.
Then ask how much they'll cover of your gastric bypass surgery.
The problem with health insurance in this country is that it's not "insurance" at all. It's amortized healthcare. And surprisingly enough, most insurance providers are not charities. They make a profit off of what you are charged.
Pre-existing conditions are a fun one. Actuaries have spend countless hours analyzing and modeling segments of the populace. Along comes John Smith. He's seeking healthcare. He happens to have a pre-existing condition, say, gout. But he's young, in his thirties. He gets a gout flare-up once, maybe twice a year, and a dose of OTC NSAIDs is enough to take care of it. He knows that in time, his condition is likely to worsen, and that he'll need more active management.
But right now? He doesn't care. He's not seeking out health insurance as a result of his condition. He's just looking out for his general health.
The preponderance of a population to have this condition, and ergo this average healthcare cost, hasn't increased by virtue of him wanting insurance. But you watch, as a carrier will deny him (or at least subject him to extensive waitlisting).
> Go ahead, then. Tell 90% of insurance carriers that you have committed to, documented yoga, gym attendance, walks every day. Ask them what premium reduction they're prepared to offer as a result. Be ready to hold the phone away from your ear as they laugh.
I don't know how widespread it is, but the two major insurance carriers in my area (Rochester, NY) both have plans where can earn credits (up to ~$500) for healthy behaviour - gym memberships, yoga, etc.
> The preponderance of a population to have this condition, and ergo this average healthcare cost, hasn't increased by virtue of him wanting insurance. But you watch, as a carrier will deny him (or at least subject him to extensive waitlisting).
This, definitely. I know at least one person denied health insurance due to seeing a therapist for three months while having a rough spot in high school. It was nearly a decade ago and the therapist wrote a letter along the lines of "situational, no ongoing issue, no condition remains". No dice.
So how these really work? Do you have experts in every sub-field of medicine lined up to analyse each case? Looking at your team, everyone seems to have title "Health Researcher" but most of them have no real degree in medicine or have any real experience with specific illness. Many seem to have experience and education that is not even remotely close to "health researcher" title let alone be legally licensed to prescribe anything to anyone medicine related in US. So how these people are supposed to read complex test reports, connect subtle dots and give me advice that is better than sub-sub-specialty practicing MD who sees 100s of patients day in day out? Website is full of PR quotes without any details of how it would stand up to claims it has been making.
It would be totally impractical to have full time people studying every sub-sub-sub-specialty: if we saw a person with rare disease X once a year, what would the specialist in X do the rest of the time? That's why we have a large network of outside experts we can consult when very domain-specific knowledge is needed.
Also, as someone who spends a lot of time working with doctors, the current medical system does not train people to look at things in detail and connect subtle dots - it trains people to run around doing everything as quickly as they possibly can. (Ask anyone who's in residency if you don't believe me.) A significant part of our advantage is that we can spend much more time on a single patient than a standard ten-minute consultation.
Well, standard consultation does not cost $5000. If I have $5000 to spend, why should I use this website as opposed to directly finding another expert (with real MD degree and hand-on experience) and get their second opinion? I'm not sure of equivalent hourly rate of doctors but even at $500 per hour, I should be able to get a real specialist to study my reports in-depth and take their couple of hours of consulting time for a fraction of the cost. Again website needs to make explicit how much it would cost, who would do the work and what are their credentials. Lot of statistics such as 50% of second opinions contradicts looks very bogus. Is it from a reliable source?
Interesting idea, but I'm wondering about the iterative nature of some diagnosis and treatment. I'm specifically thinking about how my wife went through lots of trial and error with eliminating particular things from her diet to get a handle on what was making her feel so terrible.
The way I'm reading the site, it feels more like a one-shot "we'll run a bunch of tests and give you a single comprehensive analysis" which seems like a good idea in theory, but scares me in practice.
With every research report, we include a summary of what we can do further research on if something changes, we get new information, or the budget is expanded. You're right that we don't make this very prominent on the site, though - thanks for the feedback.
A rushed ten minute consult annoys us all, but How often is my medical condition going to be something that say paying the doctor to take 45 mins would not uncover.
Most of us have diseases that are horses not zebra - and you have a strong financial incentive to encourage hypochondriacs to keep hearing zebra.
If my condition has Gregory House stumped, sure ill pay you but otherwise that lump on your skin is a cyst not a tumour and that shortness of breath is lack of fitness not a heart failure.
There are a good deal of misdiagnoses that cause more months of suffering, especially with diseases like Crohn's disease. Maybe a service like this could prevent that with the help of a more accurate up front diagnosis. Diseases aren't as rare as people tend to think (~1.5 million with a digestive disease in the U.S. alone).
That said, here are a couple things which make me skeptical about this:
1) They make claims involving rounded numbers without sources, such as "50% of second opinions contradict the original diagnosis." That's a red flag for me. Would be nice for me to see some sources for claims like that on a site wishing to sell medical research services.
2) Several of the medical researchers do not have a background in anything medical. In fact, one of the senior health researchers' area of expertise includes herbal medicine and Naturopathy (which is a bit anti-vaccination: http://en.wikipedia.org/wiki/Naturopathy). I would not be happy If I got suggested any alternative medicine remedies for my disease at the cost of $5,000.
Some things that are labeled "alternative medicine" have actual studies, with decent sample sizes and good methodologies, showing that they work. These things are worth paying attention to. The rest don't meet our standards and get ignored.
Most things with evidence are readily accepted in modern medicine. Is there an alternative medicine treatment with good evidence that is nevertheless rejected by modern medicine that you can think of as an example?
Foxglove is a really silly idea as a herbal medicine because it is available in a quantified purified form from the pharmacy called digoxin and you will minimise the change of running out of the very narrow therapeutic window that digoxin is both efficacious and non-toxic within.
Side effects of digitalis (the active component) toxicity include but are not limited to DEATH
Saying take foxglove instead of digitalis is kind of like saying take willow bark instead of aspirin, but potentially MUCH MORE DANGEROUS.
If what you mean to say is 'we shiuldnt give profits to the pharmaceutical-medical-industrial complex because I believe it is acting against my best interests' then go ahead and say so; however if thr best example of an 'alternative' medicine being efficacious or safer is foxglove you are woefully underinformed
As the saying goes, alternative medicine that works becomes medicine. That is digoxin
The FDA recognizes foxglove as a toxin, not a treatment [1]. You don't want to consume foxglove because, like virtually all herbal supplements, the doses of the active ingredient can vary wildly.
So, we have its derivative, digoxin, available as a prescription medication. And many people do take it. It's helpful for some symptoms of heart failure. One thing it doesn't do, quite notably, is reduce mortality. Anyway, this is an available, commonly prescribed treatment
Not to belabor the point, but I was hoping to hear about alternative medicines that are not accepted but have evidence supporting them.
According to our research, more than 3% of the American population reports their health to be "good" or "excellent", and spends more than $40,000 annually on medical care. Our service won't be useful for every sniffle (unless you're Bill Gates), but there's a huge amount of opportunity for products in the medical field.
This is the sort of service that a general practitioner should be providing.
The vast majority of patients have routine problems. Though these might be distressing to the individuals, the "standard of care" (assuming correct diagnosis) is established practice, and this service would not affect that.
For the few with very rare conditions, or with useless primary care physicians, this service might be useful, however the price is very high for what is essentially a diagnostic/referral service.
Nevertheless, I think it could be commercially successful, given the number of people who think they know more about medicine and medical practice than their doctors do.
There are many conditions which are extremely common, but for which more effective treatments don't propagate to patients. About 5% of the US population has clinical depression, for example, and writing gratitude letters has been shown in studies to be quite effective at treating depression (more so than drugs or therapy). Yet, most patients don't know about it.
Yes, I did see that, but it doesn't address the important part of the assertion (more so than drugs or therapy) so to be charitable, I assume the OP has a different reference in mind.
Good point, although it's hard to say without reading the full-text. Personally, I wasn't interested enough to pay for access to read it. shrug Still, it is suggestive that the OP isn't totally blowing smoke on this.
Interesting; I don't have the same take. If the OP's assertion is true, then he's referencing an under-recognized study of critical importance. If it's just hyperbole sitting on top of truth (whether due to an incorrect recollection or otherwise), that's a big problem.
Claims that have some truth to them, but which are not correct, are both endemic to and hazardous in healthcare. I will argue that in this type of conversation, claims of fact that are disputed but ultimately unsupported must be taken to be false until shown otherwise.
(The fulltext of the article that you found doesn't use the terms "SSRI", "medication", "drug", or "therapy", but I haven't read it in depth to see if they're using some unusual synonyms.)
I sincerely hope his scientific evidence of the efficacy of letters of gratitude does not come from this reference within the "Journal of Happiness Studies" with a whopping sample size of 219.
The rate of propagation of new treatments is an issue, certainly. However, it is something that a good primary care physician is able to (or rather, should) look-up in an instant if the first line treatment isn't effective. There are no secret treatments being withheld from anyone. Any really cutting-edge research is also of uncertain benefit, simply because it hasn't been tested often enough.
For reference, make sure your site can handle real traffic before posting it to HN. Not doing so will hurt your brand and reduce chances of getting some good initial traction. More so with such type of service. My initial perception is that I cannot trust a business with my health when they can't even properly setup a website.
Whenever we run a test in medicine, we ask, "How would the result affect management?" If the result, one way or another, would not change management, the test is not worth running.
The site is down so I have to go from the headline, but I'd ask the same question: how would this service affect clinical management? Can you offer an example?
> Whenever we run a test in medicine, we ask, "How would the result affect management?"
Yet, a lot of unnecessary tests are run daily at every hospital I've seen. But what's worse is that often times doctors are reluctant to find out more about a patient's illness simply because they believe "it wouldn't affect treatment and it's not worth it anyway". It doesn't take a scientist to figure out why this approach can be disastrous. At the same time, high-paying private patients are often considered to be worth finding out the specifics.
The whole system of clinical knowledge and action is broken from this point on. Doctors often do not keep current with advances in medical research, and I encountered a few who are actively opposed to it, asserting that medicine should not go any further than it does today because it's considered "unnatural".
Medicine is in danger of becoming scientifically bankrupt. This startup, while I think it's a great concept, is a symptom of this disease. Practitioners, even in the odd case they're interested in advanced knowledge that is not being passed down from whoever the resident rockstar surgeon is, generally do not have proper access to current knowledge and statistics.
It seems to me this system, where a life is more often than not considered ephemeral and expendable (except if you're a small child or a pregnant woman), this system is broken and cannot in its current form provide the services we will need as our civilization advances. As it is, this system plays into the hands of religion and pseudo science (a trend which doctors are generally comfortable with), and it is one of the dehumanizing factors that make our hospitals places of desperation instead of regeneration.
Hello. I agree with your criticisms of the medical system, and MetaMed was started specifically to help fix these problems - to bring science back into medicine. It's impossible for any one person to keep current with all research, so we provide a service where a team of scientists can keep up on the latest research for individual physicians and patients. We're all about giving access to statistics and scientific knowledge - it's what we do.
As I said: I think it's a great idea and I wish you all the success in the world. If only this wasn't necessary... I also hope that you don't encounter too much resistance from practitioners.
> But what's worse is that often times doctors are reluctant to find out more about a patient's illness simply because they believe "it wouldn't affect treatment and it's not worth it anyway". It doesn't take a scientist to figure out why this approach can be disastrous.
Some tests will not change management (just get a chest ct? no chest x-ray needed); other tests could change management but are unlikely to have an unusual result (have appendicitis? skin biopsy is probably not indicated). So without context it's possible to both agree and disagree with you equally emphatically.
> At the same time, high-paying private patients are often considered to be worth finding out the specifics.
More often, it seems that people who can pay push for and get unnecessary services, finding out specifics in a way that does not affect management.
I am still very curious to hear from the creators of this company how they think it will affect management, and whether they have an example.
Medicine needs a huge amount of change. Whether or not this affects management basically determines whether this has utility or is simply high-end entertainment.
It's not just the perspective of a patient or a relative of a patient, though I can offer that too. This is the profession as I encountered it in medical school and clinical phases of my university career. Granted, it's in Germany not the US, but I'm guessing it can't be that different on the other side of the Atlantic.
Sorry, I completely changed 100% of the text that you replied to. I should have deleted the original and written a new one, but at the time I saw no reply.
> If the result, one way or another, would not change management, the test is not worth running
That's got some rationality to it, but how do you value the impact to the patient of simply having an answer? I know people who've broken down and cried with relief when they finally knew what was wrong and the search was over, even though it just meant a lifetime of living with the disease for them.
A test that means the difference between knowing a diagnosis and not knowing a diagnosis is often management-changing. If this test gives you the diagnosis, even if there is no therapeutic option for that disorder, then it means that your search for an answer is through (ending the need for continued testing, anxious uncertainty, etc).
In other posts I offer examples of tests that would not change management, and surely experienced clinicians could offer myriad other examples. (A lot of it depends on the clinical context.)
But thank you for bringing this up; I agree that a diagnosis is, in itself, valuable for patients (and care providers).
It's not everyday medicine where you work on simple problems following a statistical approach - an appendicitis is more likely than a Meckel diverticulum, and a simple overeating is even more likely than both.
But there are complicated cases - not very often, but that's the one I like, and that most of the passionated doctors do too. Hell - I love such cases.
A quick story - I once had the chance to make a one-in-a-million diagnosis while working in the ER of a small hospital, around 2004.
A patient presented with a psychiatric history and a psychiatric diagnosis, but somehow it didn't feel right. I had this odd feeling when talking to the patient - no psychiatric symptoms of no kind. It seemed wrong. I ordered basic blood tests (checking for hyponatremia, etc), X-rays - all normal.
It was a bit late so I asked for the patient to be served a lunch before being discharged, deeply unsatisfied. Around 10 minutes later, the patient had a new episode - but this time it was in an hospital and I did not have to rely on eyewitnesses - it looked a lot like neurological problem, not a psychiatric problem.
After another round of blood tests (I don't like it when I don't know what's happening), brain scan, etc. everything was normal. I noticed the glucose was normal - it should not be, since the patient had had an hospital lunch (in my hospital it included marmelade, and all kind of sweet things!)
So I ordered a test to check for insulinoma (I'm weird, I know - its incidence is like one-in-a-million) because it made sense - and the test was negative.
At this time, I was just a medical resident - the seniors were a bit mad at me for having spent so much time (and costly diagnostic procedures) on what was proven wrong, and what should be wrong in the first place - because it is so unfrequent. And that's not what one is expected to do in the ER (fortunately, it was late at night)
Yet I wasn't satisfied, so I asked the patient to be transferred in the university hospital neurological department for further tests. Something was happening, we didn't know what, someone had labelled the patient "crazy" (not politically correct, but truth is psychiatric patient issues are usually less investigated) but there was something.
Guess what- weeks later I got a letter, they found it was a rare variant of insulinoma that our basic test did not detect.
That's one of my best moment in life !! That day I made a difference - I removed a wrongful psychiatric diagnosis and gave the proper diagnosis. Patients with insulinoma should not get institutionalized in a psychiatric hospital.
That's the medicine I love. Fixing basic problems is the job a mechanic.
The kind of medicine I love is unfortunately not possible with the current healthcare setup - and even with usual patients, because most people don't care. They want a quick fix.
This startup idea is just great, to take care of people who want the real deal. I wish you luck!!
I'm sure you will find great clinicians who will take going as deep as the rabbit hole goes to give excellent care.
I wish more doctors were like you. I was in the ER last month and have seen 6 different doctors since and none really seemed to care once the problem got more complicated than the stock answer or giving me some painkillers :(
Like I said, after the ER I've went to 6 doctors. I didn't go to the ER by choice. I literally passed out, they rushed me to the ER. I followed up with specialists and they had no idea what was wrong and didn't really seem to think figuring it out was worth their time.
Usually, it's more an opportunity cost ie what could have been charged if the same things had been done in the neuro ward.
In the ER in France, it's more or less a flat rate that gets charged - which incentivizes cost reduction. There is an exception if the patient is admitted, but with the billing rules of the time, it reverted to a flat rate if the patient was transferred to another hospital.
Considering this was not the patient first contact with an hospital and that the last times they had found nothing (it didn't seem to me they looked very hard), I just couldn't pass the bucket and hope this time they did things right - the last few times they didn't, so why now?
Working in hospitals taught me at least one thing - never trust other people work. You want something done well, you do it yourself.
Sorry if that doesn't make me a team player, but I've seen so many bad things happen :-(
[Another thing I learnt today - when one remember work stories 9 years later, it usually does not speak well about the work environment]
This just might be one of my favorite responses on HN. Thanks for your share. I agree, Vassar, Alyssa Vance, and the others at MetaMed truly want to make a difference in the current health system.
I like the idea in concept but have a couple critiques.
1) Pricing- even the most basic package is ridiculous. For $5000 I would not only fly to your city to spend as much time with you in a face-to-face meeting discussing your medical problems, but I would give you my personal cell phone number for any questions or concerns at a later date.
2) Chart reviews- I don't know the credentials of the people doing the reviews, but I am highly suspect of anyone other than a board certified physician in a given specialty providing medical advise or in any way guiding diagnostic decisions.
Having said that, I think there is real opportunity here. I wish you the best of luck.
My guess is that your "productize step" is to also use your researchers to train a specialized medical search engine you'll keep on the back-end (sort of a Mahalo+Watson).
If that isn't what you're doing, let me know. Maybe I can help get you there.
As a patient, I'd worry that the "at least two of our expert researchers will validate test results to rule out any errors" would get steered towards the less credentialed folks - the Eagle Scout philosophy major rather than the one or two MDs on the list of staff.
I'd have more comments, but the site appears to have gone for now...
Health Researcher:
Justin Alderis is an Eagle Scout who co-chaired the Princeton Philosophical Society for four years while he earned his BS degree from Princeton University, with a focus on the philosophy underlying cognitive science.
For patients with some serious ailments this is all fine but what about less serious issues like..a person with allergies, thyroid, migraine etc. These are kinds of things which bother people but still not enough to spend 5000 for analysis.
Probably a profile based pricing is a good idea? Just a thought.
An allergist is likely to have plenty of access to research, data analysis, etc. about their specialty, and cost significantly less than $5,000.
$5,000 would buy me consultations with 250 allergists, who'd likely be basing their conclusions on the same sort of research available to the health researchers at MetaMed, as well as it being their actual medical specialty.
The price is based on the amount of work that goes into each report. While people might like to get detailed information about their allergies, and would like to pay $200 for it, we can't review medical records and the literature for that little. Researcher time costs more than that.
You definitely need a better landing page. Plus your pricing page needs work. Since this is not a cheap service, I would test a version that did not post prices but encouraged inquiries.
I'm a marketing consultant/software engineer. Have plenty of data that points to not listing prices over $1500. Not in your industry, of course. But I have data from different markets.
I did a write-up for MetaMed for my site:
http://bit.ly/YZb3G8/ Please share it if you can. If you know any journalists/bloggers that wish to interview MetaMed founding team, please let me or the person who posted this know.
The website (now loading) lists many health researchers on your team, but it doesn't say say much about their credentials and/or experience in biology/medicine. Can you give us some more details?
It also looks like many are associated with the "Singularity Institute." My exposure to that group left me feeling like it was some sort of cult of charlatans and wide-eyed dreamers. The presentations I've seen from them featured graphs without units and a lot of hand waving without hard data or independent validation. Almost like a sort of Scientology for Silicon Valley.
Site's down. Perhaps you can put a teaser of what metamed is about in the comments so we have something to read/vote on while you get your site up again.
Not to be that guy, but on the Overview page for Patients & Caregivers, in the picture with the two women, it says "treatment regime" - I believe it should be "treatment regimen".
Definition #2 of "regime" makes sense to me for this context, though I think regimen is more common in the US (regime is more common in the UK): https://www.google.com/search?q=define%3Aregime
MD here. The headline on your webpage: "For serious medical conditions, you need direct access to the world’s best researchers." [my emphasis added]
Pardon my skepticism, but that sentence and the rest of your not-functioning-very-well website smell of nothing more than an attempt to ripoff very vulnerable people, and other marketing bullshit.
But do please prove me wrong - kindly link to the world-class research your docs and researchers have done thus far.
What surprised me most about that page is that the Chief Science Officer doesn't have an MD or a PhD, though several other employees do. (Also, the Singularity Institute ties immediately rub me the wrong way, though that's a matter for another time.)
That's what scared me. Seriously, for a company like this, a Chief Science Officer must have a PhD. And there needs to be a Chief Medical Officer that is an MD (possibly the same person).
Starting a company like this with med students (I'm sure she's nice, but the VP of
Biology hasn't even finished her MD yet), is not the way to do this. It's a way to get sued.
So while the goals may be good, this is not the way to do it.
Our consultant network includes Nobel laureates, heads of biology departments, famous professors, and as top-rate people as one can find. They aren't on the first version of the site because a) they're not full-time employees - being very busy, they usually only have a few hours a week - and b), before you ask someone to be on a website, you first have to show them the site, and the site's only been up for about twelve hours because it's launch day. We're currently compiling our business, scientific and medical advisory boards, and will have them up over the next few weeks.
Also, why the rudeness? In terms of the disagreement hierarchy (http://www.paulgraham.com/disagree.html), you're using DH1 through DH3 - attacking credentials and tone rather than facts.
> Also, why the rudeness? In terms of the disagreement hierarchy (http://www.paulgraham.com/disagree.html), you're using DH1 through DH3 - attacking credentials and tone rather than facts.
I think you've got things turned around a bit here. He's not using claims of authority to spuriously attack an argument that you're making. You are the one asserting authority, and he's asking for proof. Since you are basing some of your credibility on authority, it seems like a reasonable request.
It's very hard to discuss the facts when you withhold them. I would like to know who these Nobel laureates are. If they have examined your service but do not have enough confidence in it to be associated with it publicly that is interesting information.
That doctor was disbarred (http://w3.health.state.ny.us/opmc/factions.nsf/cd901a6816701...) for writing online pharmacy prescriptions.
Same guy?