A High-End Handler for Deep-Pocketed Patients

This spring, an athletic young nonsmoker living in Greenwich, Conn., was diagnosed with rapidly progressing Stage 4 lung cancer. It's not just his age—he's 50—and his seemingly robust health that made the case unusual. According to his physician, Barry Boyd, the patient hired a new boutique medical consultancy called ExpertConsensus, which, for a fee of $20,000 or more, convenes panels of top specialists to generate treatment plans for people with confounding illnesses.

Although an ExpertConsensus client and the specialists never meet in person, Boyd says that his patient feels he's in good hands: "We're talking to the head of lung cancer at MD Anderson [Cancer Center at University of Texas], very senior oncologists from Sloan-Kettering, Johns Hopkins, Vanderbilt." Those physicians recommended molecular profiling to target specific mutations for the man's cancer, which is now in remission.

The business of second opinions is nothing new. At Cleveland Clinic, one of America's most prestigious medical centers, $565 and the submission of relevant medical documents will get you a specialist evaluation online. And Best Doctors, a Boston-based provider of medical consultation used by employers such as PepsiCo (PEP) and Boeing (BA), offers a case review and access to 50,000 peer-reviewed specialists at no cost to the patient. But ExpertConsensus Chief Executive Officer Richard D. Forman maintains that his nine-month-old company has "no direct competitors" because it performs the dirty work of gathering documents, recruits top doctors, and minimizes institutional bias through its panel approach.

The goal: bypassing the time-consuming process of getting second and third opinions and making sense of divergent recommendations. ExpertConsensus says it gives clients access to the latest scientific advancements—some too recent to have become protocol, even at top medical centers. "To expect that your primary-care physician can keep on top of what's going on in this world is really unfair," says Forman, adding that the one-treatment-fits-all approach to medicine is obsolete given findings that each tumor and illness is distinct. "Having a group like ours scour the earth for different opportunities and experts really improves quality of care," he says.

ExpertConsensus is modeled after the work of its chairman, Robert C.J. Krasner, a former attending physician for the U.S. Congress who once served as a doctor for Ethiopian Emperor Haile Selassie and now attends to executives at top companies. He began convening expert panels for his patients four years ago, tapping his extensive connections. Serial entrepreneur Forman, co-founder of Register.com and Vitals.com, approached Krasner last December with the idea to turn that approach into a real business. Co-founder Jean-Luc Neptune, a physician with an MBA, previously launched a company that connects patients with clinical trial opportunities.

ExpertConsensus compiles a client's medical documents, summarizes the relevant information, and then enlists three to five prominent doctors per case. During a teleconference, an on-staff physician walks the experts through the client's X-rays, labs, charts, pathology, and diagnosis, while they examine the documents via computer. The company logs their discussion and passes the resulting treatment plan to the treating physician. Later there's at least one follow-up panel review. Since January, Expert-Consensus has taken on 12 clients. Most are cancer patients, but there are also Parkinson's disease and chronic fatigue cases. The founders declined to disclose company revenues, but they envision increasing their client base into the "hundreds, or even thousands," says Neptune.

The company's strategy and pricing has raised eyebrows among some in the medical world. Dr. Robert Wachter, associate chair of the University of California at San Francisco's Medicine Dept., doubts whether top experts have time to give the panel cases adequate attention. And Evan Falchuk, chief operating officer of Best Doctors, questions whether ExpertConsensus has a viable business model: "You could buy a very nice insurance policy for a family of four with that kind of money," he says.

Beyond serving wealthy clients, Forman hopes the panel outcomes will have a trickle-down effect, popularizing new approaches by exposing treating physicians like Boyd to recent advances in medicine. But Forman also points out that ExpertConsensus is a business, that his company deals with "clients, not patients," and that, although health care in America is a mess, his company is "not meant to solve a public policy issue."

The bottom line: ExpertConsensus assembles panels of leading doctors to consult on tough cases for a $20,000 minimum charge.

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