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Doctors on demand: Silicon Valley physicians test delivery business models

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Dr. Caesar Djavaherian spends his days crisscrossing the Bay Area, stitching up lacerations and attending to his patients’ other urgent-care needs. It’s a far cry from a few years ago, when he was a disillusioned emergency room resident in New York City.

“They’re average people who do average things and have an accident,” Djavaherian recalled of the sprained ankles, sliced fingers and other common ailments he saw in the emergency room. “Should you really be burdened by costs akin to a mortgage?”

Seeking to work around the absurdities of an overburdened healthcare system, Djahaverian and co-founder Sean Parkin built ER Direct, which makes house calls for $275 during business hours or $375 on nights and weekends, plus extra for diagnostics and advanced treatments.

The Oakland-based company is part of a growing cadre of medical practices selling on-demand services as the industry adjusts to the Affordable Care Act and a dysfunctional healthcare system typified by long waits, confounding red tape, high costs and impersonal care.