A Radical Rethinking of Primary Care That Could Make Everyone Healthier

At 8:15 every weekday morning, the Culinary Extra Clinic team meets to talk about patients its members are most worried about. There are more than one thousand regular clinic patients in the Las Vegas area, most of whom work in hospitality jobs at the city's hotels and casinos. All of the patients are chronically ill, and the team members discuss those who are currently in the hospital or have just been discharged. But they also focus on other, less obvious, concerns.

The team—which includes doctors, health coaches, a social worker and a behavioral health specialist—might brainstorm a way to pay for an expensive test, like an MRI, that a patient can't afford. They might decide to take a patient to the grocery store. Last week, they chose to soothe a hospitalized patient's overwhelmed wife by getting her a massage. Carolina Pavese, the head nurse, says of the team's approach: "If that's going to make it better, let's do that."

The clinic practice is run by Iora Health, a Cambridge-based start-up that believes it can make patients healthier at a lower cost by increasing access to basic health care services and by thinking more broadly about what basic services should be. "We often say, our job is not to improve people's health," says founder and CEO Dr. Rushika Fernandopulle. "Our job is to improve people's life. And that will improve people's health."