Doctoralia: a new way to choose and schedule medical services in Brazil

Abstract

This case, motivated by the transformations in the national health tech market following the COVID-19 pandemic in 2020, analyzes the increase in competition and digitalization in the sector. From the perspective of Carlos Eduardo Spezin Lopes, CEO of Doctoralia Brazil, the case explores the challenges for brand expansion, which in 2023 faced both the entry of new competitors and the need to gain consumer trust. As an additional challenge, until then, Doctoralia operated on a multilateral platform model that connected clinics, doctors, and patients, having to address the consumer trust dilemma in a healthcare market where these trust relationships, given the importance of the service provided, could present even greater complexities for the model. This teaching case is intended for undergraduate and graduate students in Health Management and Marketing, and can be used in Strategic Marketing and Consumer Behavior Analysis courses.

Keywords:
Health techs; Health services; Multilateral platform; Growth strategies; Consumer trust dilemma

Resumo

Este caso, motivado pelas transformações no mercado nacional de health techs após a pandemia de COVID-19 em 2020, analisa o aumento da concorrência e a intensificação da digitalização no setor. Sob a perspectiva de Carlos Eduardo Spezin Lopes, CEO da Doctoralia Brasil, o caso explora os desafios para a expansão da marca, que em 2023 enfrentava tanto a entrada de novos competidores quanto a necessidade de conquistar a confiança dos consumidores. Como desafio adicional, a Doctoralia operava, até aquele momento, em um modelo de plataforma multilateral que conectava clínicas, médicos e pacientes, enfrentando o dilema de confiança do consumidor em um mercado de saúde onde essas relações, pela natureza crítica dos serviços prestados, eram ainda mais complexas. Sob essa perspectiva, este caso de ensino é destinado a estudantes de graduação e pós-graduação em gestão de saúde e marketing, podendo ser utilizado nas disciplinas de Marketing Estratégico e Análise e Comportamento do Consumidor.

Palavras-chave:
Health techs; Serviços de saúde; Plataforma multilateral; Estratégias de crescimento; Dilema de confiança do consumidor

Resumen

Este caso, motivado por las transformaciones en el mercado nacional de health techs tras la pandemia de COVID-19 en 2020, analiza el aumento de la competencia y la intensificación de la digitalización en el sector. Desde la perspectiva de Carlos Eduardo Spezin Lopes, CEO de Doctoralia Brasil, el caso explora los desafíos para la expansión de la marca, que en 2023 enfrentaba tanto la entrada de nuevos competidores como la necesidad de ganar la confianza de los consumidores. Como desafío adicional, hasta ese momento Doctoralia operaba en un modelo de plataforma multilateral responsable de conectar clínicas, médicos y pacientes, enfrentándose al dilema de la confianza del consumidor en un mercado sanitario donde estas relaciones de confianza, dada la naturaleza crítica de los servicios prestados, eran todavía más complejas. Desde esta perspectiva, este caso de enseñanza está destinado a estudiantes de grado y posgrado en gestión de salud y marketing, y puede ser utilizado en las asignaturas de Marketing Estratégico y Análisis del Comportamiento del Consumidor.

Palabras clave:
Health techs; Servicios de salud; Plataforma multilateral; Estrategias de crecimiento; Dilema de confianza del consumidor

INTRODUCTION

In 2023, Carlos Eduardo Spezin Lopes, CEO of Doctoralia Brazil, faced a critical moment in the company’s trajectory. Leading operations from the office in Curitiba, in the state of Paraná, Carlos Eduardo was determined to consolidate Doctoralia’s presence in the Brazilian health-tech market—technology startups focused on the healthcare sector. Founded in Spain, by that year Doctoralia had already become one of the main global platforms for scheduling medical appointments, efficiently and reliably connecting patients and healthcare professionals.

However, despite its initial success, Doctoralia Brazil faced substantial challenges. With more than 21 million registered users in 2023 (Exame, 2023), the platform needed to attract more physicians and foster patient trust in order to maintain its relevance in an increasingly competitive market, especially with the rise of new competitors such as Dr. Consulta.

Carlos Eduardo knew that trust between patients and healthcare professionals was fundamental to the company’s sustainable growth. He understood that, in services where a patient’s health depends directly on finding the right professional, trust not only encouraged the scheduling of appointments but also created bonds of loyalty and generated spontaneous recommendations. However, building this trust in an environment of limited resources and under constant pressure for immediate results posed a significant challenge, making his task even more complex and delicate.

Background

In 2007, in the city of Barcelona, Doctoralia emerged. The health tech, founded by Albert Armengol, Frederic Llordachs and David Díaz, was created as an online appointment-scheduling platform aimed at serving small clinics, medical offices, and independent physicians. A few years later, in 2009, the Spanish website began offering the option for physicians to write short summaries about themselves on the platform in order to attract more users to the business. Only in 2012 did Doctoralia begin allowing patients to leave reviews for physicians, a feature that would become one of the platform’s trademarks.

But the major leap for Doctoralia would come in 2016, after it was acquired by the Polish group DocPlanner Group. The acquisition made Doctoralia the third-largest health tech in the world as it expanded into new regions in Spain, Portugal, and parts of Latin America. From this acquisition onward, the Brazilian version of the Doctoralia website—which began operating in the country in May 2017—led by CEO Carlos Eduardo Spezin Lopes, started to receive financial investments and a series of upgrades, becoming one of the main health techs in the country and within the entire DocPlanner Group (Renato, 2021).

Over the years, and up to 2023, Doctoralia Brazil continued operating through a business model that was free for patients but paid for physicians, who, in order to register on the platform, had to pay a monthly subscription fee. During this period, the platform had more than 21 million registered users in Brazil (Exame, 2023), representing approximately 10% of the national population, according to the 2022 Census of the Brazilian Institute of Geography and Statistics (IBGE). However, as with any platform business model—responsible for connecting the service provider with the end consumer, in this case physicians and healthcare clinics to patients—Carlos Eduardo Lopes understood the importance of attracting more physicians to the platform. Only in this way could Doctoralia maintain its relevance in the competitive Brazilian market, especially with the entry of new competitors.

One of the greatest challenges for Carlos Eduardo and his team was gaining the trust of new users (physicians and patients), as this would increase the platform’s relevance and expand the company’s share of wallet (SOW)¹, helping Doctoralia surpass competitors such as Dr. Consulta, which had been consolidating its position in the national context. Carlos Eduardo often cited Uber as an example, highlighting how the company became the largest urban mobility company in the world without owning any cars, merely connecting available drivers to passengers who needed private rides. Inspired by Uber’s model, Carlos Eduardo aimed to turn Doctoralia into the largest healthcare company in Brazil, even without employing a single physician.

But he knew that the challenges were considerable, since, unlike choosing a “car ride,” the decision-making process involved in selecting a medical specialist by patients who may be facing an illness is much more complex. Carlos Eduardo knew that in healthcare services the main priority was to provide a positive experience from physicians to patients, so that the latter could generate recommendations for the service, thereby increasing the platform’s relevance. Only a positive experience, based on a service rich in trust attributes, would allow Doctoralia Brazil to expand its SOW and surpass competitors. This would also be essential to reaching new consumer markets, such as the interior of Brazil, where the choice of a physician still largely followed traditional methods, such as word of mouth.

Additionally, Carlos Eduardo and his team still needed to overcome cultural issues, such as Brazilian consumers’ resistance to considering the opinions of unknown individuals when choosing a healthcare service. In this context, technology played a crucial role, offering patients a reliable and accessible platform for comparing reviews and information about healthcare professionals. Carlos Eduardo’s main objective was to demonstrate to patients that, in the absence of a recommendation within their personal circle, Doctoralia was the best option for seeking evaluations and deciding on a healthcare professional. The logic was simple: the more patients accessed the website to search for healthcare services and left their reviews, the more relevant the platform would become for physicians, clinics, and patients, functioning as a kind of TripAdvisor for medicine.

The health-tech market in Brazil

The sudden need for change due to the COVID-19 pandemic caused the healthcare sector to advance at an accelerated pace. The year 2021, in particular, exceeded all expectations, recording more than US$ 44 billion invested in healthcare innovation around the world, twice the US$ 22 billion invested in 2020 and far above the US$ 14 billion in 2019 (Distrito, 2024). In Brazil, the peak period for founding health techs occurred between 2017 and 2019, with an average of nearly 240 new companies per year (Medicina S/A, 2021). Since 2019, Brazilian health techs have received more than US$ 1.3 billion in investments, representing approximately 80% of the total amount invested in Latin America. In 2023, the country recorded 1,381 health techs, offering solutions ranging from tools for clinic, hospital, and laboratory management to artificial intelligence technologies aimed at diagnostics, decision support, and robotic solutions for remote care and prosthetics development (Distrito, 2024).

Beyond the numbers, it is important to position the Brazilian health-tech market in the global landscape to understand its challenges and opportunities. Although Brazil stands out in Latin America as one of the main hubs for digital health innovation—driven by a population of more than 210 million people—in 2023 the country still faced significant challenges related to infrastructure and regulation, especially when compared to more mature markets such as the United States and some European countries.

Despite advances such as the General Data Protection Law (LGPD) (Lei n. 13.709, 2018) and Law No. 14,510/2022 (Lei n. 14.510, 2022), which authorized and regulated telehealth practices in Brazil, clear regulations for system integration were still lacking, hindering interoperability, which is essential for processes such as issuing and validating electronic prescriptions. Moreover, the absence of standardized data and terminology—especially in electronic medical records—combined with disagreements among health councils, created inconsistencies in the storage and use of medical information. In the field of data security, although the LGPD represents an important milestone, its application to digital health remained limited, and the lack of specific guidelines from the National Data Protection Authority (ANPD) increased legal uncertainty. These regulatory obstacles limited innovation and highlighted the need for a clearer normative framework capable of driving efficiency and sector development (Saúde Digital Brasil, 2023).

Health techs such as Doctoralia typically directed their services primarily toward individuals seeking private healthcare, whether through health insurance or out-of-pocket consultations. In contrast, in 2023 more than 70% of the Brazilian population depended exclusively on public healthcare services provided by the Unified Health System (SUS) (Ministério da Saúde, n.d.). Although they primarily served distinct audiences, health techs and SUS exerted mutual influence, contributing to the development of the healthcare sector in Brazil. Among health techs, Doctoralia faced competitors that could be organized into three main categories: generalist digital platforms, specialist digital platforms, and integrated services. This diversity of models reflected the growing demand for innovative and accessible healthcare solutions.

Generalist digital platforms offered consumers the ability to find and schedule appointments with physicians from various specialties, covering a wide range of options. Designed to meet different medical needs, these platforms had a broader scope. An example is BoaConsulta, which connected patients to professionals in various fields such as cardiology, dermatology, and general practice, as well as dentists and psychologists. The platform aimed to provide a practical search and scheduling experience, with filters by specialty, location, and price, offering both in-person and telemedicine consultations.

Specialist digital platforms, on the other hand, often focused on a specific area of healthcare, serving an audience with well-defined needs. These platforms stood out for their specialization and personalized experience offered to users. Zenklub was an example of this model, specializing in mental health and emotional well-being. On this platform, users found psychologists, psychiatrists, therapists, and coaches, with the aim of addressing demands related to emotional health and personal development. Unlike generalist platforms, Zenklub focused primarily on creating an environment centered on emotional care.

Integrated services went beyond scheduling, combining the connection with healthcare professionals with the direct provision of medical services, usually in physical clinics or proprietary virtual environments. An example was Dr. Consulta, which offered in-person medical consultations, telemedicine, exams, vaccines, and even minor surgeries performed in clinics or proprietary virtual environments.

Founded in 2011, Dr. Consulta operated as a network of affordable clinics in Brazil, offering accessible medical services across several specialties. With a model that combined technology and operational efficiency, the company used digital tools that facilitated the scheduling of consultations and exams, whether through the website or app, eliminating bureaucracies and reducing patient waiting times. Physicians working in the clinics were generally contracted as independent service providers, without formal employment ties, and had access to technologies such as electronic medical records, which provided greater continuity in care and simplified clinic management. Technological integration also enabled data analysis, contributing to demand forecasting, resource optimization, and personalized patient experiences. Additionally, Dr. Consulta used telemedicine as a way to expand access to consultations, maintaining a scalable and accessible model.

In the years that followed, Dr. Consulta would consolidate itself as one of Doctoralia’s biggest competitors regarding access to healthcare services in Brazil. In 2021 and 2022, the iBest Award—one of the country’s most prominent awards recognizing outstanding digital initiatives in various categories—highlighted Dr. Consulta as the major winner in the health-tech category, consolidating its relevance in the sector by winning both the popular vote and the jury vote. Despite this outcome, the competition was intense, with Doctoralia ranking among the three finalists in both categories during both years.

By late 2021, Dr. Consulta had slightly more than one thousand healthcare professionals registered on its scheduling platform (Mendes, 2021). During the same period, Doctoralia, in Brazil alone, had around twelve thousand specialists registered on its platform (Doctoralia, 2022a). Moreover, while Dr. Consulta served 900 thousand patients in 2021, according to the “Pipeline” column of Valor Econômico Magazine (Mendes, 2021), Doctoralia reached nine million appointment bookings (Medicina S/A, 2024).

Even with smaller absolute numbers, Dr. Consulta was growing. In 2022, it received a US$ 33 million investment from a scale-up fund² specialized in digital businesses (Mendes, 2021). This investment enabled its expansion into new markets such as health plans, further intensifying competition with Doctoralia and increasing pressure in a sector that, only a few years earlier, had seemed like a blue ocean.

Doctoralia and its business model

Doctoralia operated as a typical multilateral platform, connecting patients and healthcare professionals in an interactive digital environment. Through the platform, patients could schedule appointments, publish reviews about physicians or clinics, and access opinions from other users who had already used the services of a given healthcare professional (Appendix 1). Additionally, it was possible to post health-related questions directly answered by registered physicians (Appendix 2). In this sense, Doctoralia also functioned as an interactive forum, similar to TripAdvisor, where tourists share opinions about restaurants, lodging, and experiences.

For in-person consultations, patients used the platform to search for a specific professional, schedule the appointment, and subsequently go to the office. Payment and other process steps, such as receipt issuance and potential reimbursements, were carried out directly between patient and physician, outside Doctoralia’s digital environment.

With the COVID-19 pandemic in 2020, Doctoralia began offering telemedicine to its users. In this context, patients could search for a specific professional, schedule the appointment, and subsequently be seen virtually by the physician through a Doctoralia tool. In such cases, the payment could be made privately, using credit cards or other methods, or through a health insurance plan if the physician was accredited. In private appointments, Doctoralia managed the payments, transferring the amount to the healthcare professional. In appointments carried out through a health plan, the transfer was done directly by the insurer.

Beyond telemedicine services, Doctoralia also offered management tools for clinics and medical offices, including scheduling management and telephone call management, optimizing administrative workflow and patient service. Although free for patients, physicians, other healthcare professionals, and clinics needed to pay to access tools aimed at customer acquisition and retention. Among the features offered were online scheduling, electronic medical records, waiting lists, and even a professional website.

In Brazil, these and other functionalities were offered in three subscription plans: Starter Plan, Plus Plan, and Vip Plan, as described in Appendix 3. In addition, Doctoralia provided exclusive and personalized resources for clinics, such as Agenda Doctoralia Clínicas, whose price was provided upon request, and Doctoralia Phone, which had a monthly cost per license. The latter offered advanced features such as call recording and tracking, VoIP tailored for medical centers, and tools for monitoring results from marketing campaigns, as detailed in Appendix 4.

Doctoralia and its consumer trust problem

In 2017, Carlos Eduardo Lopes took on the challenge of leading Doctoralia’s entry into the Brazilian market and quickly achieved success. With the support of strategic investments, effective marketing campaigns, and innovative management, the company rapidly increased its number of users and registered healthcare professionals, establishing itself as one of the pioneers in the national health-tech market (Pozzobon, 2018). This growth was further accelerated during the COVID-19 pandemic, when the regulation of telemedicine opened new opportunities. Carlos Eduardo and his team invested intensively in the digitalization and expansion of the platform, which resulted in a significant increase in Doctoralia’s key performance indicators (Doctoralia, 2022b).

However, the pandemic also brought new challenges. The health-tech market became more competitive, with new players entering and major companies, such as health insurance providers, increasing their investments in technology and telemedicine. In addition to Dr. Consulta, competitors such as BoaConsulta, Zenklub, Conexa Saúde and Amparo Saúde gained prominence. Conexa Saúde, which began operations in Brazil in 2016, became one of the largest digital health platforms in Latin America, with strong telemedicine activity. Amparo Saúde, founded in 2017, became known for offering an integrated model that combined medical consultations, exams, and telemedicine in a single solution. Doctoralia began facing pressure not only from competitors but also from its parent company, the DocPlanner Group, which expected accelerated growth to ensure leadership in the sector. The speed of this expansion was considered essential to avoiding loss of relevance, as happened with Uber Eats in Brazil, which was surpassed by more aggressive competitors (Barbosa & Russo, 2023).

In this challenging scenario, Carlos Eduardo identified the consumer trust dilemma as one of the main barriers to Doctoralia’s growth. The “trust dilemma” in the healthcare sector refers to the challenge consumers face in assessing the reliability of medical services and professionals, especially on digital platforms. Unlike other sectors, such as transportation or delivery, where digital platforms quickly became established, the healthcare sector presents far more complex barriers. Choosing a physician or clinic involves a high degree of sensitivity, as it directly affects a patient’s health and well-being. In this context, perceived risk is high, making trust a crucial factor in consumer decision-making (Pappas, 2016; Zeng et al., 2019).

In Brazil, this dilemma is even more pronounced due to cultural and social factors. Many consumers prefer to trust recommendations from friends and family, showing resistance toward evaluations made by strangers on digital platforms. This difficulty is aggravated by information asymmetry, as consumers have little technical knowledge about healthcare, and by the intangible nature of medical services, whose quality can only be assessed after the experience. Additionally, Doctoralia’s user profile is diverse, covering different age groups and socioeconomic levels: young people tend to be more receptive to online reviews, whereas older individuals often prefer traditional methods; low-income consumers, in turn, face barriers related both to access and to familiarity with digital tools, which reduces their willingness to trust platforms such as Doctoralia (Saúde Digital Brasil, 2023; NielsenIQ, 2024).

Carlos Eduardo knew that overcoming the consumer trust dilemma was essential to ensuring Doctoralia’s growth in the national landscape. With a limited budget and increasingly intense competition, he wondered: How can consumers be convinced that Doctoralia is, in fact, the best option for seeking medical recommendations in Brazil?

ACKNOWLEDGMENTS

We thank the institutions involved—the COPPEAD Graduate School of Business at the Federal University of Rio de Janeiro, through its Center for Studies in Health Services Management (CES-COPPEAD/UFRJ), and Tecnológico de Monterrey, Business School—for supporting this research.

APPENDICES

Appendix 1
Doctoralia website homepage

Appendix 2
“Ask the Expert (specialist)” section of the Doctoralia website

Appendix 3
Plans for healthcare professionals

Appendix 4
Plans for healthcare clinics

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• 1
  It refers to the proportion of a consumer’s total spending in a given product or service category that is directed toward a particular provider or brand.
• 2
  A type of investment fund that focuses on supporting companies that have already moved beyond the initial start-up phase and have demonstrated success and significant growth potential. These funds seek to provide capital and additional resources to help such companies scale their operations rapidly.

• TEACHING NOTES
  the teaching notes for this case have restricted access and are available only to faculty and instructors affiliated with the academic institution upon request at: https://periodicos.fgv.br/cadernosebape/article/view/97121
• DATA AVAILABILITY
  The dataset supporting the findings of this study is not publicly available.
• REVIEWERS
  Roberta Campos (Escola Superior de Propaganda e Marketing, São Paulo / SP - Brazil). ORCID: https://orcid.org/0000-0002-7091-7901
• REVIEWERS
  One of the reviewers did not authorize the disclosure of their identity.
• PEER REVIEW REPORT
  The peer review report is a vailable at the following link: URL. https://periodicos.fgv.br/rap/article/view/97100
• 20
  [Translated version] Note: All quotes in English translated by this article’s translator

Edited by

• EDITOR-IN-CHIEF
  Hélio Arthur Reis Irigaray (Fundação Getulio Vargas, Rio de Janeiro / RJ - Brazil). ORCID: https://orcid.org/0000-0001-9580-7859

• ASSOCIATE EDITOR
  Fabricio Stocker (Fundação Getulio Vargas, Rio de Janeiro / RJ - Brazil). ORCID: https://orcid.org/0000-0001-6340-9127

Data availability

The dataset supporting the findings of this study is not publicly available.

Publication Dates

• Publication in this collection
  26 Jan 2026
• Date of issue
  Nov-Dec 2025

History

• Received
  30 Aug 2024
• Accepted
  06 Mar 2025