Flip-flopping through a lot of insurance policies right now. My Geisinger policy ends tomorrow, and I start a policy through Blue Cross on the 1st. In February I'm switching to a policy through Cigna.
A key benefit I've noticed for the new year is long-distance doctoring. For my Cigna policy my co-pays have jumped to $30 to see my PCP, and $50 for a specialist. Considering the number of appointments I have in a week sometimes this adds up quick.
'Seeing' a doctor by telephone, video conference, or even email though is free.
Now the convenience of this is extraordinary; no travel, no travel expenses, and no co-pay.
This isn't available for chronic conditions and specialists currently, but covers a vast majority of acute illnesses. It's marketed as an inexpensive alternative to urgent care or ER when it's after your PCP's hours or they simply aren't available. Or, if you don't want to pay a co-pay.
While this sounds awesome, and is going to be attractive to a number of people, it's dangerous. Hell, I could even see the perks to this. I've been known to simply email my PCP and ask her to order a few tests because I'm seasoned in what's wrong with my body, but I've even been wrong from time to time.
Being wrong is dangerous when it comes to your health.
These doctors are allowed to make diagnoses without a physical examination, and write prescriptions for treatment. This is for a number of things from strep throat, respiratory infection, to a stomach virus and even a bladder infection.
While you can accomplish a great deal simply by asking the patient about their symptoms, this is not superior to labs, radiology, and physical examination.
How can a doctor see inside an ear canal or a throat through an email? How can they palpate the abdomen or kidneys through a video conference? How can they listen for breath sounds in each side of the lung independently over the telephone?
To someone experienced in the many things that can go wrong by a small overlooked detail; this feels dangerous.
Bladder infections that are really kidney infections, abscesses that are really MRSA, respiratory infections that are really pulmonary emboli. Gastritis that's actually a perforated bowel. The possibilities are terrifying.
Is this the next step in our broken health care system, illness for profit. The next advancement in the conveyor belt of cookie-cutter treating patients and meeting quotas and time constraints?
Is this really helping us, and for our own benefit? Or is it a for-profit medical system using our known dislike of physically going to the doctor against us?
In an era where electronic medical records open up a myriad of security risks, shrank by the vast benefit of their availability, what security risks does this open up? What protection of privacy does a patient really have against someone they've never even met getting some of their most sensitive information?
How do the doctors even verify that it's really you over email? How are you going to be protected from identity theft?
How will these doctors access our complete medical records to allow them to even be able to properly assess and diagnose? Depending on where they're from or what network they're affiliated with I doubt they even can.
Are they going to teach you how to take your own vitals? Will symptoms get lost in communication barriers?
This worries me a lot, what about you?
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