In this episode of the Concierge Medical Marketing Podcast, host Steven Schwartz speaks with Jay Kimmel of Upswing Health about innovative approaches to orthopedic care. They discuss the importance of triage in managing orthopedic injuries, the role of telehealth in reducing unnecessary ER visits, and the development of an AI symptom assessment tool. Kimmel shares insights on virtual athletic training and the collaborative care model with primary care physicians, emphasizing the need for efficient and accessible healthcare solutions.

Steven Schwartz (00:25)
Hello and welcome to the Concierge Medical Marketing Podcast. I’m your host, Steve Schwartz, I’m so glad to have you along on our journey and our discussion today. My guest is Jay Kimmel of Upswing Health. Jay, thank you for being here with us today. My pleasure. you, Truly. recently become acquainted and you were telling me off camera a little bit about your background and Upswing Health and how you’re helping patients in the orthopedic space.

Jay Kimmel (00:41)
My pleasure. Thank you, Steve.

Steven Schwartz (00:53)
little differently than traditional. you first tell us a little bit about your background, your training, you started and kind of the story of how we got to today with Upswing Health, please.

Jay Kimmel (01:07)
Sure, it’s my pleasure. Thank you, Steve. So I’m an orthopedic surgeon. I specialize in sports medicine. I trained at Columbia after going to medical school in Rochester and doing a fellowship in Philly and went out into practice taking care of high school and college and recreational athletes. But I always understood the importance of primary care and

I was fortunate enough when I first started my career in Hartford, Connecticut, to become a faculty member at the University of Connecticut in the Department of Family Medicine and Orthopedics. And I was responsible for teaching the family medicine residents for over 35 years and really feel that if we’re going to fix healthcare, it’s really important to have a well-working

primary care system. In my practice, I did sports medicine. So I did surgery on knees and shoulders mostly and took care of various athletes. And we created with my co-founder, Steve Schutzer, some centers of excellence here in Hartford, Connecticut that were so successful that they were written up in the New England Journal of Medicine as the best way

for private practice orthopedist to work together with administration to create value. So we’re real believers in value-based healthcare. And we feel that if primary care groups can work successfully with specialty groups, that the future is really bright. And as you mentioned, I retired from clinical practice at the end of last year to be full-time with Upswing Health.

which is a virtual orthopedic company that uses some pretty cool technology. And we combine that with the ability to talk to a health coach who’s an athletic trainer within 15 minutes, as well as to set up a virtual visit with a orthopedist within 24 hours. And with that virtual approach, can solve

about 80 % of low and medium acuity orthopedic problems. And as we talked a little bit about off camera, we work very closely with primary care groups, particularly DPC and VPC groups to really help them co-manage their patients.

Steven Schwartz (03:45)
So it sounds a lot like telehealth slash potentially urgent care, maybe, for orthopedic situations where your patient may not be able to come in. Or maybe they just have some sort of problem like, wow, my elbows really started hurting the last day or two. And what’s going on here? able to assist with that. I on the right track here?

Jay Kimmel (04:11)
Yeah, we really think that it’s important that from the moment that you’re injured, that you have the opportunity to talk to somebody who knows what they’re talking about. And of course, if you have a concierge doc, you’re going to be much more likely to be able to get that information quickly. And a lot of people unfortunately don’t, and they wait many weeks to get in to see their primary care. Or sometimes the worst thing to do is to go to the ER.

or urgent care center if you don’t have to. Wherever you are in this country, many times when you go to the ER, unless you absolutely have to, you wait for a long period of time, you get a big bill and it’s a very, very inefficient way to get care. Think about it, I’ve been a doctor for over 40 years now and I still constantly get phone calls from friends and family and sometimes patients about

I hurt myself, what do I do? And what Upswing does is we give that information to everyone. And it’s almost like creating a situation where you have an orthopedic surgeon in the family.

Steven Schwartz (05:21)
Yeah, I love it. Who do we call to get our questions answered? And maybe considering it as a first level triage, somebody did something. It’s like, you you do need to go to the emergency room. This is not something we can help you with virtually here as opposed to, know, I’ve got a repetitive stress injury in my wrist or my elbow or knee or whatever it might be. And here’s perhaps some therapy or physical therapy or, know, you can

probably be fine with some ibuprofen for a few days in icing and elevation, correct?

Jay Kimmel (05:55)
It is. And that’s the key thing is that it’s that triage function that we think is so important. Yeah, you know, there are times and I’ve certainly gotten phone calls where someone’s called me and hurt them. You know what? You need to go to the ER. But it’s sometimes things may hurt a lot. But you know, from the mechanism of injury, the fact that they can walk on it, that it’s not that serious. An ankle injury is a real classic one, which is if you sprain your ankle running down a field,

It can hurt and get very swollen, but it turns out that if you can walk on it and if it doesn’t hurt when you touch it on the bone, your chances of having a fracture are so little. And so many times during my career, I saw athletes in particular, you know, they’ll hurt themselves during the game and then they’ll wind up going, you know, finishing the game and then go to the emergency room waiting for six hours to get an x-ray, which is normal.

It would be so great if they could talk to somebody who would say in that situation, you know what? That one can wait till the morning, ice and elevate, and then we’ll get an x-ray if we need to tomorrow as opposed to having a horrible night in some ER somewhere.

Steven Schwartz (07:08)
Exactly. a shame because our ER doctors work so hard and they’re so well trained and they’re not appreciated. But I can’t tell you the last time I spoke to somebody who said, I had to go to the ER and it was an amazing experience and they saw me within 15 minutes and I was out of there within the hour and only cost me 20 bucks. never heard that story. And it’s truly, unfortunate that all.

Jay Kimmel (07:29)
and storage is the best.

Steven Schwartz (07:34)
The predominant number of stories you hear about the emergency room or emergency department are negative stories. And it’s like, whatever you do, don’t go to the emergency room if there’s a problem. You know, and on the other side, obviously the whole discussion about insurance, you know, many of these insurance programs that people have somehow the ability to afford tied together with the marketplace, you’re still going to spend a thousand or $1,500, you know, copay to go to the emergency department.

And, you know, I forgot what the percentage was of bankruptcies that are attributed to a medical issue, basically bankrupting families. And it’s a heartbreaking, I don’t remember the number, but it’s a heartbreaking statistic when I last read that.

Jay Kimmel (08:21)
Right? And we know from, we work in the state of Connecticut, we take care of their employees, of which there’s a couple hundred thousand. And we know that four or five years ago, they spent $2 million taking care of people with the diagnosis of ankle sprain, which means those folks went to the ER, had negative x-rays. Now, sometimes I can imagine, I’ve done it myself, where you have a really bad ankle sprain and you just really feel like you need to do something like that.

But most of those people were the ones that I described earlier where they just didn’t, they just really didn’t need to go. So, and there are times, you I don’t want to be saying that you should never go to the ER, but we just want people to go when they need to go. And that also goes for seeing orthopedists. As it turns out, in some of the studies have shown that, for example, a lot of back surgery is very,

unnecessary, you know, they estimate 50 % of it. And a lot of that comes from if you have a back problem and you go directly to a neurosurgeon, you’re so much more likely to get an MRI scan and so much more likely to wind up having surgery, some of which may not be necessary. And lastly, Steve, we just got some data back from the state of Connecticut. And one of the other things that we hadn’t really thought about, know that we

help people, we know we save money, but you know what, our data showed that when you looked at those that came to us compared to those that went on the traditional pathway, we decreased opioid use, like from a lot to zero on that. another really important thing is keep people away from ERs and urgent cares where they’ll get a few percocets. So we know a few of them are gonna go on to have real problems.

Steven Schwartz (10:03)
Fantastic.

Right. It’s a shame when the medicine causes a whole nother area of problems that also need to be treated down the line. And unfortunately, the opioid crisis is all about that. I know some people need it for handling pain, but part of my hope and desire is that we find a better way to help people manage pain without the addictive properties of the medicine. I’m not a doctor and can’t speak to it just as a dad.

And a guy who’s I’ve had actually two back surgeries so far in my early fifties, but I had the herniated disc in my low back was so bad with the pain radiating down the back of the leg and whatnot that you can’t stand, you can’t sit, you can’t lay down. Nothing’s comfortable. It’s like you get to a point where surgery is the only option. And truly, but I had my last one about a year ago.

Jay Kimmel (11:03)
It sounds like in that case it was. That’s the 50 % that was needed yesterday.

Steven Schwartz (11:11)
the surgeon had told me afterward that I forgot the word he used, but essentially that my lower back area where the disc herniated was something like a train wreck, or I forgot the exact words he used, but it was very important that got the care and it’s healed beautifully. So very grateful for that. for you is obviously business is focused on the 15 minute sort of triage, I guess, for a lack of a better word.

Jay Kimmel (11:20)
Hmm.

Steven Schwartz (11:37)
and also the ability to see somebody within 24 hours as truly a specialist. I noticed on your website, you have an AI symptom assessment tool. as a person who’s in-depth involvement on the internet and every day I’m learning something new about AI technology, can you please tell us a little bit about your AI symptom assessment tool, please?

Jay Kimmel (12:01)
Sure. So one of the things that we do is, again, we want to be able to help people 24 hours a day, seven days a week. And one way to do that is with technology. So we’ve created what we call a symptom assessment tool, which is a series of algorithms that duplicates the doctor-patient experience. So if you came to my office with a shoulder problem, or you called me on the phone with a shoulder problem,

I would ask you the same questions that I’ve been asked the last 30 years. And then in my mind, I would have a differential diagnosis or a list of possible conditions that I would share with you. Well, our technology does that. And we do it all the way from the neck down to the toes. And we have a number of primary care groups that are very interested in using our technology.

to help their patients if they can’t get in to see them right away, to give them sort of an idea of what it could be. And also maybe even as these were written by leading orthopedic surgeons to maybe check a little bit on what their diagnosis is as well. So we’re very excited about that. It’s a work in progress. We have a tool that’s out there, but what we’re in the process of doing is making it even smarter.

by adding more and more AI and training the model so that it can be, right now it’s about 80 % accurate, Steve, but we’d like to get it up to about 90 or 95 % accurate using small language training of the model.

Steven Schwartz (13:38)
love it and your patients who have used it, are they finding it easy to use as far as the user experience?

Jay Kimmel (13:44)
yeah, everybody loves it. It’s really easy to use and it gives you answers that are, they’re not gonna scare you, they’re not gonna make you think that you have cancer or you’re gonna die tomorrow. Like sometimes if you just read stuff on the internet, it’s very well written and we have about a thousand people a day all over the world accessing our content because I think it’s pretty well written.

Steven Schwartz (14:12)
I it. One thing I saw on your website as well, not just talking about muscle and joint rehabilitation, but also virtual athletic training. I thought that was fascinating. In other words, leading people, perhaps I’ll let you speak on this, how to properly exercise without hurting themselves, how to warm up, how to cool down. Could you speak on that, please?

Jay Kimmel (14:21)
Mm-hmm.

Yeah, you know, in my practice, I worked hand in hand with athletic trainers for almost all of my career at the high school and college levels. And I developed a deep respect for what they do. You know, they see the athletes there on the field or in the training room and they have to triage and then give them appropriate care pathways under the supervision of a physician. And that’s what our athletic trainers do to them.

You know, can, if you’re one of our clients and if the concierge medicine docs used us and we do work very closely with them, they could use our technology and they also could have their patients instead of waiting for a visit to go see a physical therapist, for example, and we’re big believers in physical therapy, sometimes it takes a little while to get in there. Sometimes, as you said, it’s expensive. Our athletic trainers can give them rehab programs immediately.

like right away, and then the good thing about our athletic trainers, just like in a high school or college setting, is that they’ll check back in with you the next day and the day after that. And patients really love that. And that leads to very high satisfaction radius because as much as doctors like me would love to be able to call everybody every day after they see us in the office, that doesn’t happen. But having somebody call who really cares about you and then…

can help you and triage you further is really very useful.

Steven Schwartz (16:08)
You’ve mentioned that you care for the employees of the state of Connecticut and athletes and whatnot. But for somebody listening to this, can just a person who’s not affiliated with some big group or organization also just reach out and utilize your services?

Jay Kimmel (16:26)
At the present time, we don’t really have a D to C function. We will eventually, but at the present time, our users are really businesses and clients and primary care docs and captives that have hired us. What people can do though, and what they do at the rate of about a thousand a day around the world is if you Google things like

ankle sprain or foot bruise or hand injury. Upswing usually comes up in the first couple and they can read about the content. They can access the self-help programs that are built into that content and someday down the road they’ll be able to set up appointments to talk with us.

Steven Schwartz (17:14)
So that’s the direction you’re going to be able to help the end consumer outside of an arrangement with another business, but not today.

Jay Kimmel (17:24)
But not today, but what we really feel is the place that’s most useful for us, honestly, is concierge and DPC and virtual primary care groups because we feel we can help those doctors really co-manage their patients. We understand that it’s the primary care docs patient, but if they can add our services, work with us, refer to us, at the moment they see the patient in the office or

if for some reason they can’t get to that patient and refer them to us, then we’re different than, say, our competitors that are physical therapy groups. We’re built to work hand in hand with other physicians. So every time one of our athletic trainers sees somebody, we create a note, and that note goes back to the primary care doctors to keep them in the loop, just like we would do in a multi-specialty group, for example.

Steven Schwartz (18:20)
I love it. How long have you been in business?

Jay Kimmel (18:23)
about four years now. Yeah. Yeah.

Steven Schwartz (18:25)
Excellent. That’s so exciting and it sounds like you’re really growing. You’ve got a great footprint on the internet. So as people search, they can find you. In my digital marketing space, we call that SEO, search engine optimization. What content do you add to your website with links to that content so that when people search, obviously the web page or content pops up toward the top of the Google search. that’s great. So I guess one final question I have for you.

Jay Kimmel (18:39)
Yes.

Steven Schwartz (18:54)
If a concierge or DPC physician or office manager is listening to this podcast interview, really likes what we’re talking about wants to get more information about how they could potentially work with their practice with upswing health, how can they get in touch with you?

Jay Kimmel (19:14)
Sure, well I would love to hear from them. You can reach me at my initial jkimmel at upswinghealth.com or info@upswinghealth.com And again, we love working with primary care doctors, whether it be concierge or direct primary care or virtual primary care groups. And they seem to really like working with us as well.

Steven Schwartz (19:37)
Nice. Well, you seem like a great guy and I’m thrilled to have the opportunity to meet you and get to know you better. And I just I wish you all the very, very best with your business and elevating health care for all Americans who desperately need an improved experience, easier access, great care done quicker and less cost and hassle. mean, that’s a kind of a winning combination in my book.

Jay Kimmel (19:56)
Mm-hmm.

Thank you. Thank you for the kind words,

Steven Schwartz (20:08)
Well, truly, truly my pleasure. So thank you for taking the time to be with us today. quick I do want to mention as we talked a little bit about digital marketing, I wrote a book called The Definitive Guide to Winning with Digital Marketing for Concierge Medical Practices. And if anybody would like a copy of that book, it’s completely free. It’s available through our website, conciergemd.marketing. It’s on the homepage. Just go there, scroll down and pop in your email address, hit the button.

and it’ll send you a link where you can download the book, read it with my compliments. And obviously if you have any questions, need any help, any guidance, please feel free to reach out to me personally. 772-304-2420, rings right to my iPhone. So Dr. J. Kimmel, truly a pleasure spending time with you today. I do appreciate you taking the time to be on our podcast.

Jay Kimmel (20:59)
Thank you, Steve.

Steven Schwartz (21:00)
Yes, have a great day. Bye everyone.