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Visit With Your Doctor -- Online

A visit to the doctor could involve merely turning on your computer.

Some major insurance companies are beginning to cover the costs of such virtual office visits.

On The Early Show Tuesday, medical contributor Dr. Holly Phillips of CBS station WCBS-TV in New York told co-anchor Maggie Rodriguez the ideal patient for such a setup is one who has an ongoing relationship with a physician: The doctor knows the patient's medical history and has a sense from that history of where the patient's non-emergency complaint, or other concern, may be coming from. It's somewhat akin to phone calls patients now make to their doctors, with the added potential benefit of software designed to focus the patient's mind on what's really wrong.

"This is really for follow-up. It's designed to replace the phone call, not the office visit," Phillips said.

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Certain medical conditions lend themselves better than others to this kind of approach, Phillips says. For instance -- chronic conditions such as high blood pressure. If the doctor is confident that the patient knows how to take blood pressure at home, he or she can do so, report the results to the doctor, and save themselves a trip to the office. Another valuable use can be following up after a patient has started a medication. From the patient's description, the doctor can get a sense both of the effectiveness and the possible side effects.

The main potential benefit for the doctor, she says, is convenience. Phone calls from patients can take a lot of time out of a doctor's day at very inconvenient moments -- not to mention the phone tag involved in reaching each other. Having the patient's description of symptoms arrive online can make life a lot easier. "It's not to replace the physical," Phillips stressed. "It's just to cut out some of those annoying phone calls."

Also, there's a fee attached. Doctors have been collecting $25 to $35 per online session. If insurance covers it, a patient might have a $5 co-pay.

Phillips says there are possible drawbacks. As a practicing physician, she says, she wonders whether certain diagnoses should really be handled online: You just can't characterize the severity of a patient's symptoms without seeing him or her or even hearing their voice. Take blood in the urine, for example. It could be a simple infection, or bladder cancer. There's nothing that can replace human interaction, and the laying on of hands. And even doctors who use this system are encouraged to tell patients to come in when there's any doubt.

"This is not the place where a patient should be diagnosed," Phillips emphasized. "The practice of medicine is a human one. We don't just look at symptoms. We look at the whole patient. You cannot replace sitting down, face-to-face with a patient, really learning about them as a whole person. ... The physical is absolutely essential.

"The Internet has its place ... but there's nothing that can replace a true office visit," she added.

The availability of virtual visits, Phillips notes, depends on doctors setting up their offices so they can use the interactive software. And nationwide, there aren't that many who've done it. For example, fewer than two percent of doctors affiliated with Cigna Insurance are set up for it. But insurers, who are looking to save lots of money on office visits, hope that number will grow.

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