Imagine a doctor’s office as less fluorescent-lit waiting room and more private club. Filled with plants and warm lighting, soft music plays in the background as the receptionist — rather than ignoring you — actually smiles.
This is the model for Tia Clinic, a Manhattan spa-of-sorts that’s taken the next step in the burgeoning “self-care” economy. The wellness lounge model isn’t exactly new — not in New York, anyway. The city already has such places as Every Woman Wellness, the Women’s Wellness Center, and The Well, a venue that touts itself as a “complete ecosystem for wellness.” For a $500 (U.S.) initiation fee and $375 per month, The Well provides you with a health coach, yoga sessions, meditation and “curated weekly programming.”
The people behind Tia, however, are striving for a more affordable setting while also providing medical care, the kind that usually requires a visit to your physician. Tia’s goal — charging less while merging the health, beauty and “wellness” fad with actual health care — might seem to be an impossible challenge.
After a much publicized opening earlier this year, Tia found out just how challenging it was.
Tia was started by two college friends from Cornell University, Carolyn Witte and Felicity Yost, both 29. Each comes from a tech background: Witte previously worked at Google, and Yost was a product manager at Owler, a data insights platform.
“Women have been forced into this health-care system that’s clearly not designed for them,” Witte says. She cites her diagnosis of polycystic ovary syndrome, a hormonal disorder that can cause infertility, as the driving force behind Tia’s creation.
She had visited gynecologists, primary care providers, fertility specialists and naturopaths. “I did everything — and I found myself in the depths of the internet, diagnosing myself,” she says. “Finally, when I thought I had PCOS, I insisted on getting an appointment with a fertility specialist on the Upper West Side. I went there and had an ultrasound, and it validated my own hypothesis. I was 25.”
After learning that PCOS is also the leading cause of heart disease and diabetes in women, Witte says she was shocked when her doctor at the time told her: “When you can’t get pregnant, or you have diabetes, come back to me.” That was the moment, she says, that she saw how “broken” the health-care system was for women.
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Her experience inspired her to create a technology platform using software that, with patient input, can help address mental and physical health issues for women and even suggest foods and vitamins. Eventually, Witte and Yost considered making Tia a clinic and not just an app. But going from app to brick-and-mortar business wasn’t easy.
When they opened the doors to their Flatiron neighbourhood location early this year, so many women signed up that wait times for appointments extended to months, with hundreds more on the waiting list. The long wait triggered a backlash.
“We were like a new restaurant that opened, and you thought maybe you’d get five diners a day — and we ended up with 25,” says Dr. Stephanie McClellan, Tia’s first physician and a practising gynecologist. “I had this delusion that we were going to be treating primarily 25- to 30-year-old young women who needed birth control pills or an IUD replaced.” Instead, Tia has had patients with diabetes and thyroid disorders who needed much more complex treatment.
McClellan says she pushed the founders to slow down client intake, taking in a maximum of 12 women for medical appointments per day and expanding office hours. Limiting the number of daily appointments now allows for 40-minute visits.
The clinic also hired two new doctors — a second gynecologist and a primary care physician — to work with McClellan and two nurse practitioners. Tia, which currently has 800 members and a waiting list of hundreds, now guarantees appointment availability within two weeks.
In addition to traditional gynecological and primary care, the clinic also offers acupuncture and even a group wellness workshop. You can get a pap smear at Tia, but you can also get a flu shot and a strep test. Witte says she hopes to incorporate mental health professionals at some point.
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“Women get very frustrated because they feel like they get fragmented and incompatible care,” McClellan says. “Tia’s core differentiation isn’t just about putting primary care, gynecology and wellness services under one roof,” she adds. “It’s about an integrative care philosophy.”
While it isn’t necessarily meant to be a co-working space, Tia members are invited to come by even if they don’t have an appointment. The walls are lined with whimsical geometric paintings and murals by New York-based artist Alex Proba, and visitors can log into the free Wi-Fi while spreading out on comfortable couches. The common areas are even equipped with a refrigerator filled with CBD-infused seltzer and canned wine.
“We designed a living room, not a waiting room,” Witte says.
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Though the waiting list shows the model has promise, Tia faces stiff competition. The Well is also banking on a subscription model: With room for 2,000 members — 700 more than Tia — The Well includes one-on-one meetings with a “health concierge” and yoga and meditation classes, as well as classes that focus on everything from energy healing to mindfulness. Members can also purchase such add-ons as acupuncture, reiki and reflexology. The vitamin bar, juice and coffee stations will cost you, though.
Tia, meanwhile, hosts events targeted more toward health concerns, such as gut health clinics and eating disorder workshops.
The Tia membership, which includes admission to events at the space, allows members the ability to book an appointment and access its app, which comes with a chat function and features such as menstrual cycle-tracking. Membership costs as much as $15 per month, or $150 per year. The app has changed over time, Witte says.
“In the early days, we used to have a human in a loop, so what that means is: Depending on what question you asked, you’d either get an automated bot answer or, if the bot didn’t understand you, a human,” she says. “Today, the entire platform is automated.”
For Tia clinic patients who are members, there’s a live chat. “That’s one of the value propositions of joining,” Witte says. These care co-ordinators are your quarterbacks and personal assistants for your health care.”
Not all services are covered by insurance at Tia. If you want acupuncture, for instance, you’ll have to cough up some cash. Indeed, there are a lot of things the $15 per month membership won’t get you, and Tia doesn’t currently accept Medicaid, Medicare or Health First. And that, says Monica McLemore, an assistant professor for family health-care nursing at University of California at San Francisco, is a key problem with the model.
“People who have public insurance should not have differential access to services,” McLemore says. “Wellness, to me, is a product sold by capitalism. It assumes personal ‘self-care’ and other types of interventions that are sold to people — that aren’t generally evidence-based — are somehow universally possible and achievable if you can pay for it.”
Women’s health care and reproductive care are becoming inaccessible in some places, McLemore says, pointing to efforts by the Trump administration and some states to roll back abortion rights. Slapping a membership fee on the current model, she says, probably won’t help.
McClellan disagrees. With women’s clinics shutting down around the country, she says places such as Tia have the ability to step in and support practitioners. “Of course, if we’re not in the state, we could not perform procedures,” she says. (Tia has only one location.) “But we could certainly be an educational platform in those areas.”
Membership health programs,” McLemore says, “only ensure access to health or wellness if you can afford it. It undermines the public good argument that there are basic services that we think are important to our citizens.”