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Telemedicine's Expanding Options

Scott Mace, for HealthLeaders Media, April 29, 2014

"The Teladoc offering is just basically continuing down that path of saying, there are going to be some young, hip consumers that are going to want to be able to video chat with their doctor at 2 in the morning, because they're working on some computer algorithm and don't want to leave their office or their apartment, and they're going to want to access it that way, and we need to be able to deliver it that way," Henick says.

Some physicians also view services such as Teladoc as their new career path. Timothy Howard, MD, was a family practitioner in Huntsville, Ala., for 20 years. In 2009, to earn additional income, he began working for Teladoc as one of its physicians reachable by telemedicine technology, primarily
via telephone.

This January, after providing several months' notice, the 52-year-old left private practice to work for Teladoc full time. "I want to practice actual medicine and take care of people and not a bunch of administrative things," he says. "You're talking directly to the patient. You don't have a third party or someone else telling you 'Restrictions here, restrictions there, do this, this is preapproved,' this kind of thing. It's really pretty straightforward."

At the top of the list of conditions Howard treats via telemedicine: sinus problems, urinary tract infections, allergies, flu, cough, and ear infections. Video is "exclusively requested by the patient, when they desire to either let you see them or their child," he says.

Due to Teladoc's low overhead, "it's very possible to earn a living with it," Howard says. Out of an average of 180–240 patients per week, four or five a week have problems severe enough that he refers them to seek in-person help.

"The key is that we're episodic," Howard says. "We are not seen as the primary care physician. The urgent may take the place of the important. But that's one of the nuances, and I tell patients all the time, 'I said, the best way to be cared for as a patient by a physician is a hands-on exam.' "

Services such as Teladoc also set and monitor their own quality standards, such as whether doctors are overprescribing antibiotics, Howard says.

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1 comments on "Telemedicine's Expanding Options"


Dr. S Khattab (5/1/2014 at 11:12 PM)
Very interesting attempt to help the process of providing for the ill. However, it is not clear what is being provided from the following list of Medical Services: Engaging the patient, inviting patients to share their medical history in confidence, taking a FULL history, more engaging, sharing the analysis by provider to patient, suggesting methods of physically examining the patient over the waves, recommending a path to solve the diagnostic problem, ordering diagnostic tests or images, more engagement regarding the tests when results are available, recommending the next step whether in the form of more counseling or specialist input, discussing a treatment plan or if incurable just wait and your illness will spontaneously disappear, a different plan of action, prescribing a remedy without physical exam, following up on the advice provided to the patient and being responsive as well as responsible to the patient, recommending a return tele-medical visit to discuss patients progress with the tele-medical recommendations.