When Dr. Teresa Myers took a call from a woman who thought she'd gotten strep throat right smack in the middle of an important business trip, the Akron, Ohio-based family medicine physician who loves telemedicine so much she actually does it in her spare time didn't mean to scream.
But when the patient -- hoping a doc could diagnose her problem via her iPhone camera so that she could get a prescription without going to an ER -- pointed her phone's flashlight toward the back of her throat, Myers couldn't restrain herself.
"Oh my God!" she yelled. "You've got exudate!" To which the patient yelled back, "What does that mean?" (Dr. Myers explained that it's the white discharge often visible on one's tonsils when they have the highly contagious strep, and that she had yelled because she'd never expected to see it so clearly during a phone visit.)
"That was probably the most rewarding 10 minutes," said Myers, who was able to do an exam, make a diagnosis, and write a prescription in 10 minutes.
Myers is among a growing group of physicians in the US practicing telemedicine. She currently works with the Online Care Group, which manages telemedicine physicians for American Well, which this week announced the introduction of $49 10-minute video chats with doctors online and via mobile phones and tablets in 44 states and Washington, D.C.
While many services are popping up that connect patients to doctors through phone calls -- think Teladoc, First Stop Health, and Apogee Doctor On Call, to name a few -- American Well claims to be the first to offer immediate, live video visits on mobile devices, the Web, and at kiosks. (Disclosure: This writer does occasional work as a contract editor for First Stop Health.)
And while American Well has been offering phone calls with physicians in roughly 20 states for a few years, until this week it only offered the service through insurance providers. Patients had to log onto their health plans to talk to a doc.
Now, the service is offered directly to consumers, with a fixed rate of $49 for 10 minutes and an additional 3 to 5 minutes running anywhere from free to $10 or so depending on whether the patient has health insurance that covers these visits. Those without health insurance are certainly saving a lot of money via this doctor's "visit," and those with health insurance may find that their plan completely covers the virtual visit, or that it still saved them in fees they may have incurred had they rushed off to the ER first.
"We really feel we're developing a whole new way of practicing medicine, and it's exciting," said Dr. Peter Antall, medical director of the Online Care Group who has been recruiting physicians for this service for the past two years.
He said the group currently employs 45 full-time staff physicians and just over 100 contractor physicians, with another 100 or so in varying stages of vetting. The physicians have the benefit of working full-time or part-time from their personal or home offices, though the criteria are strict to ensure that patients who call in see a private and professional environment.
And while Antall acknowledges that there are many skeptics of telemedicine -- those who worry about privacy, the quality of virtual visits, and so forth -- he thinks we'll get over it eventually. "Patients do have to get comfortable with this, but I remember a time where we were worried about electronic banking, and we got over that. Maybe it isn't perfect, but it is as close as it could be, and there are mechanisms in place to deal with potential security breaches."
Likewise, not all physicians are convinced of the virtues of telemedicine. But some, like Myers, are doing everything they can to get the word out about the benefits.
Even -- or perhaps especially -- over the phone, Myers' enthusiasm is infectious. She argues that she often makes stronger connections during her phone exams than in clinics and hospitals because both she and the patients are in the comfort of their own environments, with patients often calling from their own beds and relieved to learn they don't have some horrible, rare disease they read about online, or that they don't have to go to an ER just to get a simple prescription. Sometimes, she says, they even call back requesting her specifically.
She goes on to list several other benefits as well -- her patients don't risk infecting others by going to hospitals or clinics, not to mention risk infecting the doctor, and they don't have to spend time, money, and energy on a trip to the ER, nor the hefty bill that comes with said trip.
And in the case of the patient who had strep throat, Myers basically taught her how to examine her own lymph nodes, which she realized she'd never done before in her years of practice in clinics because she simply performs the exams herself. But when patients must be a doctor's hands, they become better informed about how to analyze their own symptoms, and can better monitor them throughout the course of taking medications to determine when to stop.
Myers, who still practices medicine full-time in hospital and clinical settings, stresses that she doesn't see these online visits as replacements of traditional medicine in any sense.
"I guarantee that not a single person who practices telemedicine would say this is a replacement of traditional medicine," she said. "This is an extension of traditional model care. With telemedicine, we can appropriately triage patients to higher levels of care needed to avoid preventable negative outcomes, which includes direct and indirect costs. We're constantly talking about how our health care system is drained, how we overspend, and this is a way we can do things more effectively and efficiently."
The free American Well app is available at the Apple App Store and Google Play store, and the new service can also be accessed online at www.americanwell.com.