doctor on demand

[rh71]

http://techcrunch.com/2013/12/10/wi...-bring-a-40-virtual-house-call-to-healthcare/

Would you pay $40 for a video chat with a doc? I can see how this can be handy in some situations (ie. parents with infants in the middle of the night). The last time I went to an urgent care center ($20 co-pay, insurance was billed $250) - mostly because I hate waiting for an appointment and I got in right away. I went for a persistent cough and he basically told me to take Claritin-D along with Nasanex to prevent the post-nasal drip causing the reflex. That worked. Not to be overlooked - he also checked my throat for infection.

Quickie doctor's advice from a smartphone/tablet [for those who don't know any docs personally] for $40. Is this better than what webmd can offer? Thoughts?

 

[TheVrolok]

http://techcrunch.com/2013/12/10/wi...-bring-a-40-virtual-house-call-to-healthcare/

Would you pay $40 for a video chat with a doc? I can see how this can be handy in some situations. The last time I went to an urgent care center ($20 co-pay, insurance was billed $250) - mostly because I hate waiting for an appointment and I got in right away. I went for a persistent cough and he basically told me to take Claritin-D along with Nasanex to prevent the post-nasal drip causing the reflex. That worked. Not to be overlooked - he also checked my throat for infection.

Quickie doctor's advice from a smartphone/tablet [for those who don't know any docs personally] for $40. Is this better than what webmd can offer? Thoughts?

I think it's terrible.

Doctor on Demand is to be used for “non-emergent clinical issues that do not immediately require a direct presence, lab work or imaging.”

Is a physical exam not part of an evaluation now?

As an adjunctive tool? Perhaps. But as a dial-a-random-doc? Don't like it. I imagine the service assumes absolutely no liability for misdiagnosis/treatment?

 

[rh71]

^
Full Malpractice Coverage: Primary Telemedicine Care has historically had an extremely low malpractice rate as the cases tend to be low complexity, low acuity and are not:
Emotional types of cases
Major Interventions or Emergencies
Long standing chronic issues

 

[Ken g6]

You can even get your prescription refilled

That's worth it right there. It seems like most Obamacare plans available in my area are high-deductible plans that don't pay anything until I pay a few thousand dollars.

 

[Pray To Jesus]

History gets 90%+ for the common stuff.

 

[TheVrolok]

^
Full Malpractice Coverage: Primary Telemedicine Care has historically had an extremely low malpractice rate as the cases tend to be low complexity, low acuity and are not:
Emotional types of cases
Major Interventions or Emergencies
Long standing chronic issues

Perhaps it's had a low malpractice rate because it's also had incredibly low buy-in/utilization? Is there any factor that would prevent more complex cases? Can the doctor refuse a case once it is presented?

I still feel really icky about not having a physical exam as part of an evaluation.

Devil's Advocate here.

 

[boomerang]

I'd do it. But I do wonder how it dovetails into the requirements of Obamacare. Physicians are required to ask a lot of questions the answers for which must be documented into the big database. I suppose they could email you the forms that you could fill out and send back. But somebody has to do the data entry. Seems like a lot of back end work for little up front cost. Anyway, I'm all for it. I would not ignore a lot of little things I have a tendency to ignore if I knew I could see a Doctor through this method. I hate dropping big bucks for annoying non-critical conditions that are easily dealt with by getting a prescription.

 

[Pray To Jesus]

Perhaps it's had a low malpractice rate because it's also had incredibly low buy-in/utilization? Is there any factor that would prevent more complex cases? Can the doctor refuse a case once it is presented?

I still feel really icky about not having a physical exam as part of an evaluation.

Devil's Advocate here.

If an exam is warranted then either you come to the office or go to the ER.

 

[TheVrolok]

If an exam is warranted then either you come to the office or go to the ER.

If that's the contingency, then how is this any different from calling your doctor by phone for a quick question? (which is free)

 

[rh71]

If that's the contingency, then how is this any different from calling your doctor by phone for a quick question? (which is free)

The difference:

"I'll give him the msg..."

4 hrs later you'll get a call back if he's any good (busy).

 

[TheVrolok]

The difference:

"I'll give him the msg..."

4 hrs later you'll get a call back if he's any good (busy).

Maybe so, but then he knows you. I suppose it's not so much the "I have a cold, what do I do calls?" it's more of the "I ran out of my blood pressure medication, it's XXXX, can you refill it?" Will they defer those calls to the primary doctor? Will they need to see the bottle to refill? etc.

And back to the "I have a cold.." calls.. are we going to see an increase in inappropriate antibiotic usage because these consumers will feel incredibly shorted if they spend 40 bucks for a "Drink plenty of fluids and get some rest?"

What about pain calls? Are they going to be giving pain meds out?

Will they only have the patient's medication list by his/her report? What about the innumerable patients who don't know their meds/dosages/etc.?
Again, Devil's Advocate.

 

[abj13]

What about pain calls? Are they going to be giving pain meds out?

That wouldn't work. Any narcotic prescription that requires a DEA number has to be hand-written or hand-signed. So physicians cannot call in a prescription for oxycodone...

 

[Hail The Brain Slug]

That wouldn't work. Any narcotic prescription that requires a DEA number has to be hand-written or hand-signed. So physicians cannot call in a prescription for oxycodone...

Wrong. Any schedule II narcotic prescription requires a hard copy in all states. For the other schedules (III - IV), it's state-dependent. In Oregon and California, big sellers like Norco, Vicodin, Xanax, Valium, and others can be phoned or faxed in.

 

[Markbnj]

I was recently in a small regional hospital for something alarming that turned out to be not such a big deal, but in the middle of it they wheeled a video cart in and I was talking to a neurologist in Rhode Island about my symptoms. He had my MRI in front of him, and was able to do a pretty thorough consult with the aid of a PA on our end. So I would say it has its place in terms of making specialized resources available more widely.

 

[abj13]

Wrong. Any schedule II narcotic prescription requires a hard copy in all states. For the other schedules (III - IV), it's state-dependent. In Oregon and California, big sellers like Norco, Vicodin, Xanax, Valium, and others can be phoned or faxed in. (I specify Oregon and California because I am not versed in the pharmacy law of any other states)

State-dependent. In PA, they'd reject benzo's or Acetaminophen/Hydrocodone scripts called/faxed.

 

[Hail The Brain Slug]

State-dependent. In PA, they'd reject benzo's or Acetaminophen/Hydrocodone scripts called/faxed.

That's exactly what I said. I'd field a guess that there are more than my two states of practice that allow faxed and phoned schedule III-V's. That means yes, in some cases they could refill/prescribe pain medications.

Gods help us if they do.

 

[TheVrolok]

I was recently in a small regional hospital for something alarming that turned out to be not such a big deal, but in the middle of it they wheeled a video cart in and I was talking to a neurologist in Rhode Island about my symptoms. He had my MRI in front of him, and was able to do a pretty thorough consult with the aid of a PA on our end. So I would say it has its place in terms of making specialized resources available more widely.

Those Neuro robots are pretty fucking crazy.

 

[mikeford]

We have Blue Cross which until it gets canceled next month includes a free nurse hot line to ask questions, with I expect the same results as talking to a doctor, anything over a VERY low threshold and they will say go to the ER or see your doctor for a in person exam.

Refill a prescription is all web pages and electronic for me. I go through a portal on the Blue Cross site to the Rx mail order and they either fax or electronically communicate with the doctor for refills, or I can take the bottle to a local CVS and they can do it without shipping in a day or so.

 

[Mr. Pedantic]

I wouldn't use it, even if I didn't know any docs. Personal presence is extremely important, not just for physical examination/bloods, but also for non-verbal communication. It's not good for diagnosis, it's not good for treatment, it's not good for communication. All it'll really be good for are the worried well and those whose problems are so barn-door or so mild that not having a physical appointment wouldn't matter.

 

[Markbnj]

Those Neuro robots are pretty fucking crazy.

He was almost human. Must be Japanese.

 

[Leros]

I could see it being useful, especially if they can create prescriptions for you.

I hate sitting in a waiting room for an hour, telling the doc you have a cough, have him say "oh yeah, must be the cold everybody has" and give you the same prescription he gave to be everybody else with a cough.

 

[Cappuccino]

Anybody watch Embarrassing bodies live from the clinic?

 

[TheVrolok]

I could see it being useful, especially if they can create prescriptions for you.

I hate sitting in a waiting room for an hour, telling the doc you have a cough, have him say "oh yeah, must be the cold everybody has" and give you the same prescription he gave to be everybody else with a cough.

Especially when in reality, all you need is OTC cough medicine?

 

[Broheim]

we've had a service like that for many years here in Denmark, just over the phone. It works pretty well. Helps take the load off of PCPs and emergency rooms.