24/7 Real-time Medical Care

March 22, 2010 in Health Policy, Medicine by RangelMD

Physicians have little interest in telephonic consultations. For one, they are rarely reimbursed by insurance. For another, it is usually not easy to document the conversation. And for another, these calls usually come at times that are less than optimal such as in the middle of a busy office day or in the middle of the night which prompts an abridged conversation followed by a recommendation to make an appointment to see the doctor in person or go to the nearest ER.

Such a system is less than ideal for patients who are just have a question or concern or two and desire a brief consultation but not a full office visit. What is needed is a paradigm shift away from believing that the only way to practice medicine is with corporeal, physical contact with the patient. Enter NowClinic.com, a new service that connects patients with physicians either  online or by phone in real time (i.e. no email).

Consumers simply log onto a secure site and chat with a physician in real time through instant messaging or webcam. They can also talk over the phone. The goal is to provide quality, convenient healthcare. . .

The catch is that this service is not covered by private insurance and pigs will fly before Medicare or Medicaid even considers such a benefit.

Consumers pay $45 for the first ten-minutes, with the option of extending the discussion another three minutes if needed, and at no additional charge. According to other industry data, the majority of health care conversations are completed within the first ten minutes.

Of course, such a service ruffles the feathers of the establishment that has a vested interest in keeping the current system intact.

The absence of a hands-on exam and established relationship between doctor and patient troubles the Texas Medical Board, which is revising its telemedicine policies to deal with the concept.

The goal is to be broad enough to not hinder patient access but also make sure telemedicine is practiced safely, said Leigh Hopper, board spokeswoman.

The Texas Medical Association has also raised concerns.

“We support telemedicine, but only when a proper patient-physician relationship is established,” said Dr. William Fleming, the group’s president. “Once that relationship is established, we have no problem with it.”

Of course, telemedicine threatens the Texas Medical Board because it exemplifies how medical care is increasingly crossing state borders and such a cash only health care service threatens the American Medical Association’s monopoly on CPT coding. These cash only services also threaten advocates of government provided health care because it exemplifies the limits of socialized medicine.

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