When to embrace the digital doc
In a world where you can manage your money, order a ride to the airport, and shop for pretty much everything via your phone, going to the doctor’s office is probably one of the only things you still do face-to-face. For the most part, that’s for a good reason. Your medical care requires much more specialized expertise than depositing a check, after all.
But if you’ve ever waited more than an hour at an urgent care clinic for a sore throat, you know that the whole business of going to a doctor can seem frustratingly antiquated. How many times have you wanted to see a doctor, but decided to postpone it for as long as possible on account of the hassle? The trek there, the rude receptionist, the waiting room—all for just three minutes of doctor time. Oy.
Well, it looks like change might finally be on the horizon: Thanks to the growing availability of telemedicine or telehealth services, you can now skip all of that noise and video conference with a doctor from home any time–even in your pajamas. Sounds amazing, if also a little too good to be true. We talked to experts to find out whether it’s worth a try.
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Is it safe?
Telemedicine has actually been around for some time. Right now there are about 200 telemedicine networks and more than half of U.S. hospitals are using it in some way to better connect doctors with patients with chronic illnesses like heart disease, according to the American Telemedicine Association. Certain health insurance companies are also hopping on-board to reimburse for online visits. But because of the wide availability of smartphones it’s only now that we’re starting to see new services for everyday health complaints.
Even the always conservative American Medical Association agrees that it can be helpful, though it’s not a total substitute for in-person care.”We need more research, but there are plenty of circumstances where a video call with a doctor could work,” says Robert M. Wah, MD, president of the American Medical Association and a reproductive endocrinologist in McLean, Va. That said, he adds: “Better information is what leads to better decisions, so on balance, face-to-face is best. Being in the office with your doctor offers a more complete picture of whatever is going on.”
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But according to some of the brains behind the phenomenon—executives who see a business opportunity in making healthcare more accessible, and yes, the physicians moving their practices online—when used appropriately, telemedicine is not only safe, it’s a much-needed option.
“The fact is my doctors are treating patients every day who have gaps in their care,” says Peter Antall, MD, a pediatrician in Thousand Oaks, Calif. and president and medical director of the Online Care Group, which provides doctors for patients to see online via Amwell. “We don’t aspire to be your primary care physician, but we recognize that many people don’t have a primary care doctor. Even if they do, it’s not convenient or even feasible for that primary care doctor to be available 24-7.”
On top of that, “using a whole afternoon to see a doctor in-person is in many cases, unnecessary,”says Ron Gutman, the CEO of HealthTap, an app and healthcare platform that like Amwell, allows you to log in, choose a doctor, and see him or her via video within minutes. According to Healthtap’s research, “between 35 and 40% of visits are for simple issues that can be solved with a conversation. But doctors ask you to come in because of the way payment works: the only way they will get reimbursed by your insurance is if you make the trip.” (With Healthtap, you pay $44 per visit via their concierge service, or for unlimited access to on-call doctors for $99 per month with Healthtap prime. They don’t take insurance, but some platforms, like Amwell, do.)
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And if you’re worried about who you’ll meet on the other end: “We’re working with real, board-certified doctors that we’ve vetted for you,” Gutman continues. “They are very protective of their medical licenses. If you’re dialing in for a scary situation they will say, get to the ER now. They will tell you when you need in-person care.”
When can I use it?
As Dr. Wah says, online visits aren’t going to replace seeing your doctor in real life. But it may be helpful to have the option in your back pocket when certain situations arise.
Let’s say you wake up one morning and your eye is red, puffy, and oozing. For something like that, Dr. Antall explains, you can be connected within minutes with a doctor who can confirm whether you have pink eye and send a prescription for eyedrops to your local pharmacy, if needed. Same goes for when you have say, a lingering cough or a sinus infection.
If you have a chronic condition like diabetes or asthma, you might want to look into it as an extra resource. “It’s useful when it’s a Friday night. Your sugars are out of whack and you can’t figure out why, and the regular doctor is unreachable until Monday,” Dr. Antall explains. “Or maybe you’re an asthmatic who’s out of your inhaler refills.” It’s also helpful for skin issues: A new study published in JAMA Dermatology found that people with eczema who were treated remotely by sending pictures to dermatologists fared just as well as those treated in-person.
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You can also easily get a second opinion. Maybe you have fibroids and your doctor has recommended a certain type of surgery. Signing up for something like Healthtap, which has a database of more than 64,000 doctors in 137 specialties, can be an easy, convenient way to get advice from a handful of experts. You can spend an afternoon asking all the questions you want before making your final decision.
And finally, you know those times when you’re in some pain or have a weird symptom, but you’re not quite sure if you need to see a doctor or not? You can use one of these apps to ask a few questions, explains Buck Parker, MD, a general surgeon who sees patients via HealthTap eight hours a week. “A lot of what I’m doing is simply answering basic questions: ‘I smashed my finger in the door, does it look broken?’ for example. It’s almost like ‘pre-doctor’s visits’ where we can really save people a lot of hassle by counseling them on whether they need to see a doctor in-person or not.”
But how much can you really do over video?
You can’t do blood tests or urinalysis, that’s for sure. “But you can direct the patient to push on lymph nodes or a swollen ankle in the right spot (so the doctor can see how it reacts), and you can ask all the necessary questions,” Dr. Antall says.
To stretch the video capabilities, there are also solutions like HealthSpot, which creates kiosks that are sort of like the medical version of an ATM, says the company’s CEO Steve Cashman. Staffed with doctors from big health systems like the Mayo Clinic, the Cleveland Clinic, and Kaiser Permanente and located in places like community centers and strip malls, all you do is step inside and the doctor appears on screen. The kiosk is equipped with diagnostic devices like a digital stethoscope and thermometer as well as digital scopes for looking in ears, throat and getting close-ups on your skin.
Right now Healthspot only has about 20 stations across the country, but soon you might see them at a Rite-Aid near you.
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