Patients who have used Amazon Care's services have largely reported a positive experience—but some health professionals who have worked for the organization claim the company sometimes prioritizes growth over the best standard of care, Caroline O'Donovan writes for the Washington Post.

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Amazon Care's approach to health care

Since Amazon Care's debut as a primary and urgent care alternative for Amazon's Seattle-based employees, the service has expanded rapidly. Currently, Amazon Care is available in all 50 states, with in-person services in at least seven cities. It also provides services to other companies, including Hilton and Whole Foods Market.

In recent years, Amazon Care has become a major piece of the company's health care venture. For instance, Amazon CEO Andy Jassy has prioritized the health care business, calling Amazon Care an example of "iterative innovation."

In July, Amazon announced plans to purchase One Medical—a move that demonstrates its ambition to become a consumer health care brand. In addition, this month, Amazon Care announced plans to offer virtual mental health services through a partnership with Ginger, an on-demand therapy company.

According to reviews, ratings, and employee interviews, most patients who have used Amazon Care have reported positive experiences, with many citing the convenience the service provides. "They could see when I was on my way, just like your package," said a nurse who previously worked on Amazon Care's mobile team.

In news releases about Amazon Care, Amazon claims it has "a satisfaction rating of 4.7 out of 5."

Amazon is "really good at making it really easy for you," said Tom Andriola, chief digital officer at UC Irvine Health, where he has partnered with Amazon on several initiatives. "Most people's experience with health care is anything but that."

Historically, Amazon's ability to be "fast, frugal and obsessed with delighting customers" has allowed it to become an industry leader in multiple areas, including logistics, cloud computing, and entertainment, O'Donovan writes.

What former Amazon Care staff are saying

Six health professionals who previously worked for Amazon Care spoke with the Washington Post anonymously, questioning the company's approach to health care.

There's a "tension between what would give you good ratings versus what is sound clinical care," one said.

For example, when fielding calls for Amazon Care, a nurse found herself speaking with a suicidal patient, but she had no way to transfer the caller to someone who could help. Instead, she told them to call another number, and then she hung up—in violation of standard protocol not to abandon a patient in crisis.

Former employees also reported that Amazon Care often did not provide them with working medical technology, such as wireless stethoscopes, and that there were various logistical difficulties working in the field, including sometimes providing care in dangerous situations.

However, spokesperson Christina Smith said Amazon Care clinicians "are trained and empowered to refuse to enter any space they feel is unsafe, to leave a space if it begins to feel unsafe, and to leave all equipment behind and prioritize only their own safety" and that it has "never had a reported safety incident in any Care visit."

Health care consultant Paddy Padmanabhan said it is normal to see differing opinions between the technology and medical sides of a health care start-up—but Amazon may have underestimated some of those challenges.

"The early tensions within Amazon Care underscore the challenges inherent in bringing the Amazon mentality to medicine," O'Donovan notes.

"Fast forward, and they realized those kinds of services require degrees of staffing and scaling that's not easy in the health-care world," Padmanabhan said.

Still, Amazon has said that patient and employee safety are top priorities when building Amazon Care, adding that the company values the input and opinions of its clinical staff, and uses it to enhance the service.

For example, while Amazon Care employees "have always had a process to escalate emergencies," they can now transfer calls internally, Smith said.

"Across Amazon, we strive for constant innovation on behalf of our customers. As a result, Amazon Care has evolved and improved for both patients and clinicians since the days of our pilot program," Smith added.

As Amazon continues its expansion into health care, it is "going to try and do what they do in every other line of business: They're going to try and make it better than everyone else, make it less expensive and get crazy adoption because of convenience," according to a former Amazon Care executive.

"But," the executive added, "health-care is different. It's hard." (O'Donovan, Washington Post, 8/19)