Transformative Medicine: Patient Visits Move Online

Video Visits With Patients Are Taking Off

Neil Chesanow


September 24, 2014

In This Article

Why Demand Is Skyrocketing

Many physicians undoubtedly feel, as the American Medical Association (AMA) does,[9] that a hands-on visit is the preferred mode of doctor/patient interaction, and for serious health issues, that remains undisputed. But for everything else, including borderline cases, consider things from the patient's perspective.

Among the top reasons for postponing a doctor visit, the Harris Poll survey found, were an inability to take a day off from work (so said 30% of the respondents), the high cost of insurance copays and coinsurance (25%), the length of time it takes to get an appointment (16%), and cooling one's heels in the doctor's waiting room (12%).[8]

Then there's the growing problem of physician access. While over 8 million people have enrolled in state and federally facilitated health insurance exchanges, and 4.8 million additional people have enrolled in Medicaid, finding a physician these days is no easy task.[10]

Take Massachusetts, where 99% of residents are insured. A 2013 study by the Massachusetts Medical Society found the average wait time to see a family physician was 39 days; for internists, it was 50 days; for pediatricians, it was 25 days. Moreover, one half or fewer of primary care practices surveyed were not accepting new patients.[11]

The situation is only going to get worse. Unless there's a dramatic change, warns the Association of American Medical Colleges (AAMC), there will be shortage of more than 130,600 physicians by 2025.[12]

That prediction is based on growing population demand, before physician burnout is factored in. A 2012 Urban Institute Study of 500 primary care physicians found that 30% of those aged 25-49 years, and 52% of those older then 50 years, planned to leave medical practice within 5 years.[13]

A 2013 Medscape survey, Physician Lifestyles -- Linking to Burnout, found that of 24 specialties measured, burnout was a significant problem in all of them, with emergency medicine, critical care medicine, family medicine, obstetrics/gynecology, internal medicine, anesthesiology, and general surgery heading the list.[14]

As a result, 73% of adults have difficulty receiving timely medical care without having to resort to the emergency room, reports telehealth provider Teladoc.[15]

According to the firm's website, without videoconferencing or some other remote physician visit option, 8% of patients would have gone to the emergency department (average cost: $1477); 42% would have sought urgent care (average cost: $163); 1% would have seen a specialist (average cost: $196); 38% would have seen a primary doctor (average cost: $131); and 11% would do nothing.[15]

Virtual visits cost considerably less. For example, employees of the technology giant Oracle, which uses American Well's telehealth platform and virtual network of physicians, pay only a $5 copay to see a board-certified doctor online, which they can do at home or at their desks at work.[16] But even patients who pay retail rates are generally charged less than $50, a bargain compared with the alternatives.


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