Amazon said its contractors take calls under supervision for two weeks after classroom training, followed by a week of coaching. The company pointed to job listings that say new hires should be “comfortable navigating or learning all things health care.” Amazon said it’s more efficient to hire through Teksystems, which has its own sick leave policy, and that its training program is adequate.
One Medical’s competitors in geriatric primary care, CVS’s Oak Street Health and ChenMed also use call centers to field inquiries from patients. (Archwell Health, another competitor, allows patients to place calls directly to clinics.)
According to training documents obtained by The Post, One Medical is aware that “speaking with someone from outside the office might conjure concerns about delays in patient care or diligence,” especially for patients who were previously able to call their doctor’s office directly.
“We do not need to draw attention” to who is “handling patient concerns,” the documents say. “However, if a concern is expressed, our goal is to reassure the patient that we are a trained and skilled One Medical Support Specialist and Part of their Care team.”
But two former call center employees called that guidance misleading, and disputed the claim that call center workers are sufficiently “trained and skilled” to handle patient calls.
One of them, who worked as a manager, said the company tries to cram too much information into two weeks in the classroom. He said he suggested extending the training period and hiring more employees directly rather than as contractors, but management denied his request.
“My feedback to them was, fine, but understand, if we try to pump these people out of these classrooms, you’re going to have an increase in patient safety issues. Which we did,” said the manager, who noted he was fired in March.
According to One Medical training documents seen by The Post, if a senior patient calls in with one of 17 “red flag” symptoms such as shortness of breath or sudden headache, call center employees are supposed to escalate the call to One Medical’s virtual medical staff.
But identifying these symptoms when talking to patients can be difficult, current and former One Medical staffers said. As a result, there were patients “who should have been triaged to emergency rooms or urgent care, and that wasn’t happening,” the former Colorado-based employee said.
For example, on March 7, a doctor in Colorado flagged a call from a patient experiencing chest tightness. According to the spreadsheet, the call center staffer had scheduled an in-office appointment the next day.
The first of the 17 red flag symptoms is “chest pain/pressure/heaviness.” The doctor who flagged the call noted that it should have been escalated and expressed concern that call center staff don’t “understand that they are triaging patients themselves.”
Such errors increased concerns that call center staff were making medical decisions they weren’t qualified to make, the current and former employees said.
Amazon said the call center worker involved in the incident was retrained and that the patient was not harmed.
‘I don’t want Amazon taking care of me’
Amazon said it created the Tempe call center as part of a centralized support system intended to answer patient phone calls faster and free up clinic staff to focus on patients. The company said patient visits recently increased from around five per day per doctor to as many as 14 per day.
But not all One Medical patients see the changes as an improvement.
Late last year, Mary Ann Stone, 92, was experiencing confusion, pain, impacted bowels and a recurring urinary tract infection — symptoms her daughter said were “hard to describe to a call center, especially a call center that has no experience with this kind of thing.”
One Medical encouraged her to come in for an appointment, but Stone ultimately wound up in the hospital. Her daughter said she doesn’t blame One Medical, but wishes she’d taken her mother there sooner: Stone died in March.
“I don’t want anyone to have to go through this,” said the daughter, who spoke on the condition of anonymity because she fears retaliation. “I don’t want Amazon taking care of me.”
A Colorado patient who said he called One Medical three times and waited between 30 and 90 minutes to talk to someone was “concerned with the lack of communication access,” according to the internal documents. Another patient’s daughter said she was worried her mom “may not try to contact [One Medical Seniors] for medical concerns if she believes no one will answer,” incident reports said.
Marilyn Overcast, 79, a One Medical patient in Shoreline, Wash., said she waited hours for a call back about her thyroid medication. “It’s frustrating,” said Overcast, who said she also was shocked when her doctor abruptly left the company.
Amazon said One Medical clinicians operate independently of Amazon and that “quality of care and positive health outcomes are their number one priority.”