Why Isn’t Everyone Talking To Their Doctors On The Phone?

Imagine being sprawled across your bed with a cold compress to relieve your throbbing headache.  You haven’t eaten for days and every muscle in your body feels like it’s been through a heavyweight bout.  You know you should see a doctor, but that requires energy that you can’t muster up.

This is the dream scenario for Ringadoc, a startup I recently ran across that lets you call a doctor to diagnose your issue for a flat fee.  Telemedicine has the potential to play a significant role healthcare delivery, filling a gap in primary care that may not be covered through general practitioners and retail clinics.  But despite the explosion of smartphones and tablets, why don’t I know anybody who has used or considered this type of service?  There are a few hurdles for the industry:

1) Accurate Diagnosis and Patient Trust: My wife recently had a skin issue and, because of her busy schedule, was only able to talk with several doctors over the phone.  They recommended some topical solutions and suggested she needed to reduce her stress.  After three weeks it was clear that wasn’t working, so we went to a retail clinic where she was diagnosed immediately, given antibiotics, and felt better in a few days.

Medical diagnosis is a very intimate process and often requires more than just descriptions or pictures to be accurate.  I think the public recognizes this, which is why many folks may feel uncomfortable with this process.  Until telemedicine provides and communicates accurate diagnoses on a regular basis, the public may be reluctant to give it a go.

2) Seamless Technology: To assist in these diagnoses, doctors may also require data such as blood pressure, glucose level, etc.  While the technology to do this over your smartphone exists, it would require a whole other set of devices for the patient to own, be accessible, and be able to use correctly.

On top of that, in order for telemedicine to provide significant value, there needs to be greater connectivity.  For example, if my wife had been accurately diagnosed over the phone, she still would have needed medication, requiring the doctor to send a prescription to the pharmacy.  I’m unclear on whether this connection or the ability to pass along data to specialists or a hosipital exists, but I suspect it’s several years out. 

3) Cost: Of course, looming above everything else is cost.  Telemedicine solutions can range anywhere from multimillion dollar, state-of-the-art labs (as I Simon Cowell plunked down for his tour bus) to Ringadoc’s $40 per call model.  However, until this is promoted or supported through insurance, likely reducing costs and giving the industry more credibility, I’m not sure we’ll see stronger adoption.

That’s not to say the industry isn’t looking at this.  Recently, my company has thought about virtual pharmacies, complete with live connections to pharmacists over video.  While this solution has been well-received, it will be years before we roll this out due to the scale and complexity.

Like the newer retail clinic model, I see a lot of potential for telemedicine to play a larger role in healthcare delivery.  However, there are still several fundamental patient issues to work out before it’s normal to talk with your doctor on your bed.