Undermining the system an unintended consequence of telemedicine?

Telemedicine’s doctor-patient virtual consults may undermine the healthcare system, if Mass General neurologist Dr Lee Schwamm is to be believed from his comments at last week’s iHT2 Health IT Summit in Boston. Urgent care delivered by telemedicine not only commits the mortal sin of siloing data, not ‘doing an adequate job’ of passing to the primary care physician, but attracts dissatisfied doctors who want to set their own hours. And the cardinal sin: telemedicine attracts wealthier patients, paying cash, who by using these services are “…pulling dollars out of the healthcare system that are desperately needed to care for poorer patients.”

Quite a leap of logic here, when his real concern should be quick availability of patient care–not having to wait hours in a doctor’s office or ER/ED because you’re triaged as not bleeding-on-the-floor urgent. Virtual consult rates at least for now also tend to be low–$40-45 per visit–and appealing to those without insurance, not seeing a doctor on a regular basis (no chronic conditions) or anyone with a high deductible. Doctors are still also free, despite Dr Schwamm’s snark, to better utilize their time–and yes, make additional income–through signing on to telemedicine as part of their practice. So is this a lash back on a factor that’s undermining the establishment which Dr Schwamm is part of? Perhaps Dr Schwamm can explain? Stephanie Baum takes a puzzled view over at MedCityNews.

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  1. phmarr@gmail.com

    Strange opinions, indeed. If I am a wealthy patient, do I really prefer a teleconsulting, or better a private, planned, rendez-vous with a premium specialist? The latter would he really be a « tired med », if I had a choice?
    And second, as a neurologist myself, how in the world would I deny the leap in stroke care brought up by teleconsulting???
    My point: if asked their opinion on their end, dinosaurs might have emitted a rather negative stance…