Dr. Skype & Quot; Will See you Now: Yikes!

I am all for advances in technology – it is what makes medicine more of a science than an art – but… I think we are heading in the wrong direction. In USA Today’s Money Section there is a front page article titled: The D octor will see you now – online . The article says that Internet sites run by NowClinic, which is a subsidiary of United Health Group, which is the parent of United Healthcare Insurance Company, is actively treating patients via the Internet.

The article mentions a patient that was diagnosed online with an upper respiratory infection and given a prescription for an antibiotic. This “doctor visit” only cost 45 dollars. The fee may be a bargain, but not when the patient is being short-changed. I truly cannot think of one time that I have gone to the doctor and thought for a second my ailment could have been treated over the phone… or worse, the Internet.

My medical training has taught me to assess a patient’s condition from their facial appearance and gait. A physical exam for asthma or bronchitis patients is critical in deciding if a chest X-Ray, antibiotics, or no medicine at all is needed to heal the patient.

The other issue is, of course, how well your doctor knows you. I feel confident advising one of my patients that I know well and have examined in the past over the phone, but many times if they continue to feel unwell, I strongly advise them to come in for a visit. I’ll never forget the patient who called me and said she broken out in hives and the itching was terrible. This happened in the past. However, she also had a fever and the combination worried me. I asked that she come into the office the next day. Her diagnosis wasn’t hives… it was the Chickenpox! She had caught it from her daughter – she had never had Chickenpox as a child. If I had prescribed oral cortisone it could have been disastrous!

My feeling is that “Virtual Care” can be a virtual nightmare. The insurance companies have a vested interest in this type of care – cost containment. If you don’t go to a doctor’s office you will probably get less care, and they, in turn, save money. And to think things couldn’t get any worse – RiteAid Pharmacies are testing out these NowClinics in their stores to replace their current clinics, which are staffed with doctors and nurses. Yikes!

There is one area of medicine where I think Telemedicine may have some benefit and that is with skin rashes. I frequently ask patients to take photos of their rashes and send them to me so I can evaluate their condition as quickly as possible as rashes can frequently change.

I teach at The Touro College of Osteopathic Medicine in New York City. I enjoy training these doctors in using their minds and their hands – they are specially trained in physical manipulation to relieve certain medical conditions. I would hate to see these young doctors who will have much to offer their patients reduced to a 17 inch monitor where they cannot use the skills they have learned and that medicine needs so desperately… now more than ever.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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