In the window before his kids wake up and he has to go to work, Dr. Gregory Gebauer helps people he's never met avoid needless surgery. That's when the Florida spine surgeon reads charts and examines MRI or X-ray scans referred to him through a company called Grand Rounds, a San Francisco startup that promises to save employers money and help their workers find better care. He often finds that patients have been given an inaccurate diagnosis or recommended for an operation unlikely to help them. "There’s certainly a time and place for surgery, but usually, at least in my practice, I recommend other things before jumping to surgery," says Gebauer, who has reviewed more than 50 cases from patients across the U.S.
The full-time orthopedic surgeon is one of an army of expert doctors who moonlight remotely for Grand Rounds, which has raised $106 million in venture capital, including a $55 million round announced today. The four-year-old company, which takes its name from the term for expert presentations doctors give to their colleagues, has signed such clients as Comcast, Costco, and Jamba Juice. About 60 percent of large employers plan to offer tools like second-opinion services or other advice to help patients make medical decisions in 2016, up from 48 percent this year, according to a survey of 140 large companies by the National Business Group on Health. Grand Rounds Chief Executive Owen Tripp says about two-thirds of all its reviews lead to changes in diagnosis or treatment. The number "still shocks me,” Tripp says. "Most of the frontline care we deliver today is either inadequate or ineffective."
Grand Rounds and its competition—companies such as Best Doctors, 2nd.MD, and Accolade—are trying to help employers deal with a problem that plagues American health care: wild deviations in care among different providers and regions. For example, patients in Bradenton, Fla., get a controversial spinal fusion surgery for lower-back problems almost 14 times more frequently than patients in Bangor, Me., according to data from the Dartmouth Atlas of Health Care, which tracks disparities in care.
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