Virtual Doctors: A Growing Trend
With more and more people logging onto the Internet, patients are consulting the doctor without ever going to the doctor's office. On The Saturday Early Show, the "Living Better Longer" series concludes with a look at the growing trend of virtual doctor visits.
Michael Good, a family practitioner in Middletown, Conn., describes how technology has changed the way he deals with his patients. The following is our interview:
Q: How does an online consultation work?
Dr. Good: A patient who wants to ask a question or request something goes to his physician group's Web site. Ours is prohealthmd.com, and clicks on "connect with your doctor." They then log onto the online office using a logon name and password. Once inside the online office, the patient gets menu options for services, such as a med refill or test results. The patient picks one choice and answers a few questions about the issue. For medical problems, the patient picks a main symptom, such as back pain, and the system then asks them a series of questions.
Q: How often do you check to see if a patient has emailed you?
Dr. Good: We check our online messages three times a day, at 7:00 a.m., noon and 3:00 p.m. and pull the patients' charts to review before sending any answer. Once we have answered the question, the system sends the patient an email telling them that there is an answer waiting for them at the online office. They then go there and check what the doctor had to say.
Q: Is there a charge for your online services?
Dr. Good: Many of the functions, such as refilling prescriptions, asking for lab results, making appointments or requesting referrals are free. Patients who want to ask for professional advice pay a fee of $5 for a simple question (what can I take for my cold while I'm breastfeeding my baby) or $30 for diagnosing a new problem through a Web visit. Two insurance companies have started to pay for Web visits; we are hoping that three more will do so by the end of the summer.
Q: You say that many doctors and patients prefer this kind of consultation to a telephone call. Why is that?
Dr. Good: The great thing about an online consultation is that there are no busy signals and it's done on the patient's own schedule. There is also no phone tag. We've been up and running for about eight months and so far, about 800 patients in our five-doctor practice have been using it. I think that by next year about 23,000 will be using the online office. That's a big chunk of our patients, and the feedback we've been getting has been very enthusiastic.
Q: Do doctors have to worry about malpractice suits with online consultations?
Dr. Good: Compared to phone calls, you have a very clear record of what is being discussed and prescribed. With the phone - unless someone is taping the call - there is no record. No, it's not a big concern.
Q: What are some examples of when it's good to get an online consultation?
Dr. Good: Prescription refills, test results, appointments and referrals. Online consultations should be for the kind of things that you almost wonder if it is worth taking time off from work to go to the doctor's office. I have college students who have done follow-up visits online when they are out of state at school, which saves their parents some big travel bills.
Q: What are some examples of when it's not good to consult your doctor via email.
Dr. Good: Chest pain, shortness of breath and abdominal pain. It should not be used for anything that could be dangerous. Anything that needs immediate attention or requires careful evaluation to rule out something dangerous should not be handled online. We have warnings all over the site telling patients that the system should be used for routine, non-urgent questions and problems.
Q: Does the patient have to worry about privacy with these services?
Dr. Good: Email is not at all private or secure, but we've set up the office in an encrypted server so that no one but you and the doctor can look at your records. With paper records, there is more of a chance for people to inadvertantly see your records. With electronic records, you need a password.