Apple fails at something? Heresy, you say? It’s true. Here is the headline in the WSJ:

Apple Struggles in Push to Make Healthcare Its Greatest Legacy

Tech giant has envisioned hiring doctors to offer primary care, now focused on Watch

It’s just another tech company out on the west coast who thought they could hack primary care and failed. They are even getting on DPC by using a subscription-based personalized health program:

Apple has envisioned an audacious plan for healthcare, offering its own primary-care medical service with Apple-employed doctors at its own clinics, according to people familiar with the plan and documents. To test that and other bold healthcare ideas, it took over clinics that catered to its employees and built a team with scores of clinicians, engineers, product designers and others.

It goes on to say:

One of its most ambitious healthcare ideas was a plan to offer primary-care medicine, conceived in 2016, according to documents and the people familiar with the plan. An Apple team spent months trying to figure out how the flood of health and wellness data collected from users of its smartwatch, first released in 2015, might be used to improve healthcare, the people said.

Apple Chief Operating Officer Jeff Williams, who oversees the health team, urged employees to think big. He said Apple should disrupt what he called the “363” and “break fix” model of care in the U.S., where patients may not see their doctors 363 days a year and only visit when something goes wrong, according to people familiar with his ideas.

You really don’t see any mention of how important a doctor is in their equation, do you? Nope. That’s the problem.

Apple would offer primary care, but also continuous health monitoring as part of a subscription-based personalized health program, according to these people and the documents.

If Apple could prove that its combination of device sensors, software and services could improve people’s health and lower costs, the company could franchise the model to health systems and even other countries, according to the documents.

The depth of training of family doctors and years of education is what makes primary care so important. A few variables on a Apple Watch does NOT replace us.

To start, Apple chose to test the service out on its own employees. Apple took over employee health clinics near its headquarters that were being run by a startup and turned them into test beds for new health services, say people familiar with the changes. In 2017 it hired Dr. Sumbul Desai from Stanford University to run the effort, which was given the code name Casper, said the people familiar with the plan.

The effort continues today, but Apple has struggled to move Casper past a preliminary stage, say people familiar with its operations.

Dr. Desai’s unit in particular has seen multiple departures by employees who say its culture discourages critical feedback, which is potentially problematic for a unit focused on products and services related to personal health, according to people familiar with its culture and the documents. Some employees expressed concerns that internal data about the clinics’ performance, data that was recently used to support the rollout of a new digital health app, has been inaccurate or compiled haphazardly, according to the documents and people familiar with the data.

It looks like Casper has become a ghost. But, wait, there’s more:

A recent initiative for Dr. Desai’s team, a digital health app called HealthHabit that is being tested on California-based Apple employees, has struggled with low engagement since the app’s launch roughly six months ago, according to documents and people familiar with the app.

HealthHabit offers to connect people with clinicians via chat and encourages them to set health challenges such as “I will exercise more this week.” Those with a history of hypertension can be connected to health coaches who can send them a blood-pressure monitor and scale and advise them on healthier habits.

Sorry, Apple, but you can’t outdo family doctors by replacing them with tech. Tech may augment what we do but we are instrumental to the healthcare system.

Could a Direct Primary Care model fix Apple’s health initiative? Maybe. But maybe not. Real DPC clinics work because the patients are paying and have skin in the game. That creates engagement which Apple wanted. Doctors own the practices so there is no turnover, something mentioned to be a problem in the article above. Lastly, doctors only use data that they have been trained to see as scientifically valid. Not all data is important or proven to do anything. It is the ability to delete a lot of the noise that makes us good and allows us to concentrate on the patient. In fact, the subtle nuances of knowing the patient and observing them give us many of the clues to finding a diagnosis and helping them. For reference, see Dr. Joseph Bell who was the inspiration for Sherlock Holmes.

Sorry, Apple, but you still need family doctors doing many of the old-fashioned things called practicing medicine.