Interview with Dr Andrew Stein

It was in November 2022 and it took about six months planning before we launched. One of my side hustles is being interested in patient education. I wrote my first book as a registrar in London in 1997, ‘Kidney Failure Explained’. I’m no longer the lead author as I passed it to somebody else but it’s now on its sixth edition. It was the first book in the English language as a patient information book for people with kidney failure.

The reason I got interested in patient education is that I’ve got two crazy beliefs. Belief one is that I don’t really believe in the idea of ‘stupid people’. I think there are people who are disadvantaged by their place of birth or they’re born to the wrong parents in the wrong part of town; and clever people are able to teach almost anybody to do almost anything.

Belief number two is that I believe the NHS does have enough money and beds and telescopes and tablets, and we just don’t use them very well. I think it’s highly inefficient and we know that advantaged people live longer than disadvantaged people. Partly as they know how to work around those inefficiences. Why? They are more articulate, have good networks and know what to do when the system doesn’t work.

The website combines these two beliefs. One, that anybody can be educated to do almost anything; and two, that people like me have a duty to teach them how to use the system, how to use the NHS better.

My sixth book ‘The NHS Explained’, was published last year. My two deputies and I realised we had 40,000 words left over which couldn’t be included in the book. So they suggested we put those words on the internet. We now have over 100,000 viewers a month, and over 4000 views a day. We’re also starting to make some money from it through Google Ads, and we need to think about where we take it next.

Around the mid 90s – way before the internet was commonplace – there was no decent health information for the public. There were no books, websites, apps, pamphlets, videos, CDs nor DVDs.

There was zilch in my kidney world, and therefore you were constantly giving patients bad news. And then they’d cry and ask if we could recommend any information. All we could do is explain that there isn’t any information but take the tablets and then you’re going on to dialysis.

I started writing, on a practical level, to have something to give to patients. When the Internet was born, it suddenly opened people’s eyes. Now anyone can do it.

Well my colleagues are much younger than me and more ambitious. Our ultimate aim is to create ‘Hoogle’ – a health version of Google – in ten years’ time. This may sound like a fantasy, but the idea is that if you are concerned by something health wise, you would consult the website and input all your information.

Hoogle could reply with an initial likely diagnosis, book a GP appointment, and then any subsequent appointments such as an MRI scan. You would be referred to a consultant of your choice at a hospital of your choice, and the whole thing would be uploaded in your Google diary. If surgery is needed, your operation would be booked when convenient for you, as well as post-surgical options such as physiotherapy for example.

This is clearly not possible at the moment because no single computer system can know every health provider in the country, and it may be that the country might need ten, twenty, fifty regional Hoogles.

For now, I’m trying to build not just the website but the other elements too. I see the website as the head of an octopus with the legs being social media such as Twitter, Tik Tok, Instagram, Podcasts etc.

It will one day move from being a patient information portal to a dynamic, interactive site like booking.com – something that becomes part of people’s lives.