Jennifer Betit Yen
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Is Forward the Health Care of the Future?  Maybe...Maybe Not.

2/9/2019

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Picture
Futuristic Health Care?
I read about forward when I was Los Angeles based and it seemed amazing – the medical care of the future!  Body scans, blood work, genetic screening, all your data in one place, AND, best of all, 24/7 access to a care team who would have all your data at their fingertips to answer all your questions and help streamline your medical care.  The website promises a mere 1-2 minute wait to see your doctor and an average of a full HOUR spent with a fully focused, caring doctor at every visit.  All this costs about $149 a month.  I decided to give it a go.
 
Quick and Dirty Summary
If you want to skip the lengthy details, my overall grade is a B.  The doctors I met were really nice and seemed medically knowledgeable and quite competent.  The 24/7 online “Care Team” is flat out terrible.  It is also difficult to find anyone to talk to if you are having trouble with the “Care Team.”  The body scan was cool but nothing spectacular.  The genetic profile was fascinating and more helpful than, say, a 23andme health screening, since forward provided preventative steps and other resources to help address anything negative you might be genetically predisposed to.  Having data in one place on your phone is nice, but you could do the same thing with a good primary care doc with a little extra effort on your own part.  The 1-2 minute wait time to see your doctor promised on the website was more like 10-15 minutes in my experience.  The 60 minutes with your doctor promised by the website was an exaggeration in my experience.  I spent about 30 minutes at each visit and did feel like it could get harried and rushed there, the same as at a “normal” doctor’s office.  The unlimited visits sounds nice but I generally found when you text for an appointment, it takes quite a few texts back'n forth before you actually get one and, when scheduling via the app, you're looking at least a week or two out, which may be fine, but it's not as immediate as the website makes it seem.

"Emergency Test":  Since forward promises all manner of blood tests and blood work, I thought when and what from this would I need so urgently that I couldn't just get it from a "normal" primary care doctor?  Well, what if you were in an accident and you needed blood?  The first thing you would need to know is your blood type, if you didn't already know it.  So, after forward did all manner of blood work on me, I texted the "Care Team" and asked them my blood type.  They said they didn't know, don't test for it and that was that.  Epic fail.  
​
There are, however, other services that might make it worth your while like unlimited visits to the doc, certain blood testing and a plethora of vaccines that might be especially useful for frequent travelers to exotic locations.  The website promises an on-site pharmacy and free generic prescriptions, however, the one prescription I received from forward, I had to go to a Duane Reade to fill and pay my regular co-pay for.
 
In More Detail
My main issue with forward, and why I wouldn’t give them an A grade, is the 24/7 “Care Team.” Forward promises 24/7 access to a highly qualified team of nurse practitioners, doctors and “care coordinators” who have access to all your data in one place, can answer your questions all the time and can coordinate your appointments, visits, referrals, prescriptions, etc.  That sounds awesome but my experience was a lot different.  
 
The way you contact the “Care Team” is by texting them through an app on your phone.  If you’re lucky enough to have a doctor reply to you, her name and photo will appear by her text.  The vast, vast majority of the time, I had a “care coordinator” respond. These are “anonymous,” bot-like responders who seem to make up the majority of the “Care Team.”  They are perfunctory, don’t often appear to have taken any time to familiarize themselves with your (the patient’s) profile or medical needs, and they had an astoundingly high error rate.  
 
What do I mean by that? One example: both myself and another forward member I know were told by our forward doctors to see outside specialists regarding some (fairly simple) questions.  For me, it was a foot X-Ray.  The “Care Team” is supposed to set up your referral with the outside specialist and they are then supposed to call you to make an appointment.  In both of our cases, the “Care Team” texted us that they’d sent our referrals but days passed and we never got calls to set up the appointments.  We both contacted the “Care Team” again and, after much confused back and forth, were given the numbers of the offices at which to schedule our appointments and told to call ourselves instead of them doing it for us.  We both did so and both of us – we were each calling a different specialist for totally different things – were told by the specialist offices that they had no idea who we were, that forward never made a referral and that they had no idea what we were talking about.  Ummm…oh.
 
My friend, much more determined than me, kept at it, messaging the forward team repeatedly and calling the specialist, until he finally managed to get his appointment, long after he probably should have.  I became frustrated with forward’s lack of response and inability to handle communications with a 3rd party provider and independently went on zocdoc.com and just made myself an appointment with an unrelated office to get the help I needed.
 
Example 2:  When my genetics report was ready, I tried to schedule an appointment and the app told me it would be over a month before a doctor could see me.  What happened to prompt and unlimited visits?!  I had to exchange several texts with the “Care Team” before I finally got a sooner appointment.  The “Care Team” got confused and made mistakes with regard to who the appointment was supposed to be with.  Not a big deal in the grand scheme of thing, however, for $149 a month, you expect a wee little bit more.
 
Example 3:  The one prescription I received from forward (that wasn’t dispensed by the promised on-site pharmacy and did charge me a co-pay) was ineffective.  When I messaged the “Care Team,” to let them know it didn’t work, I got a curt reply to go find myself a specialist then.  No offer, as the website promises, to make a referral or set up another visit or even consult with my doctor at forward.  Ummmm…oh.
 
Example 4:   My forward doctor promised me a list of vegan foods that were high in Omega-3’s (because, really, who doesn’t want to up their intake of plant-based Omega-3’s?) and when I followed up via the app to ask about the list, the “Care Team” literally responded that they do not endorse “a specific kind” – what the heck does that mean?  They don’t endorse specific kinds of food? – and that I should “read through all the choices on Amazon” or “find them at [your] local stores.”  WTF?  I mean, seriously, WTF?  First of all, the doc puts a note that she’ll send me some foods containing Omega-3’s. No endorsements requested. Second, I should read through all the choices on Amazon??? AMAZON?  Not even Google (haha)?  I am being told by the “Care Team” to address my health care needs by searching “Omega-3 foods” on Amazon?  Third, I can find them at my local stores?  Find what, exactly?  That’s what my question was – what exact foods did she recommend I look for?  An Omega-3 from fish oil doesn’t necessarily equate to an Omega-3 in flax oil.  What the physician and I had discussed was how to get a certain Omega-3 benefits typically obtained from fish oil through, instead, plant sources, knowing that flax wasn’t going to be a sufficient substitute and something else would be needed.  
 
I texted back to the “Care Team” and told them that it was pretty much ridiculous that the team who was supposed to centralize, streamline and consolidate all of my medical data and make everything easy never seemed to have a clue what was going on.  When I later got my list of vegan Omega-3 food recs, it contained flax oil (which we’d already discussed WASN’T a sufficient substitute) and scallops (which, sorry, are not vegan – scallops have eyes and they can see and move and feel and all that good stuff (more at https://www.thoughtco.com/facts-about-scallops-2291857)) and I felt like I couldn’t even respond with the follow up questions about the flax oil (or scallops) because I’d just get another harried and confused bot-like “care coordinator” with no information, off-topic information or wrong information.  Ay yi yi.  
**Side note:  if you need vegan Omega-3's, I went outside forward to an unrelated nutritionist and she told me algal oil and hemp seed oil.**
 
I could actually rant about the “Care Team” for a long time but I figure that’s enough for now.  Bottom line:  if you have a bunch of extra cash and you’ve already donated lots to charity to save the earth and still have spare cash, it’s worth a try.  If you have mild, chronic, easily-treatable maladies and/or travel to exotic locations a lot, might be cost effective for you because you could go the doctor’s office all the time and/or get most of your travel vaccines there.  For specialized maladies, they’re just going to refer you out anyway, so…not helpful. Having the blood work and genetic data at your fingertips is cool, but I could probably get it similarly situated with one good primary care physician, too.
 
Forward could fix this and they should.  A first step would be including the name of whoever you're chatting with on their app so there is at least some accountability.  So far, I haven’t gotten much response or satisfaction from the “Care Team.”  I like the doctors, though.
 
That’s my take. Looking forward to hearing thoughts from anyone else who has tried forward.  

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