Comments on: Medicine Without Borders

By: William Boyles / Friend of John Goodman

William Boyles / Friend of John Goodman — Fri, 28 Dec 2007 19:31:18 +0000

I would revise your title to be “Medicine Without Doctors” since the impact of this telemedicine scenario on today’s distribution of medical workflow will be a rebalancing of required task versus the required academic degree and associated fees charged by doctors. The ratio of specialists to primary care in the U.S. versus all other countries will be the first casualty because more than half of the task list of the average specialist could be performed by a nurse or online. If as I believe telemedicine proves to be a catalyst for such a rebalancing, the biggest opposition to telemedicine will come for physicians, not insurers. Like medical tourism (which is also not really about borders), the real threat is to the medical establishment and the real opposition will be the AMA and specialty societies, not consumers.

By: David

David — Mon, 17 Dec 2007 17:48:15 +0000

I have enjoyed receiving your health alerts, so thank you for including me.

Regarding your comment below stating that insurance companies are an obstacle to telemedicine, I must disagree. Each time I meet with physicians, hospitals, employers and brokers/consultants, the question is posed to the group as to why the “suppliers” (physicians/hospitals) are charging such varying prices for their services in relation to their peers, and why the employer (the ultimate payor) is allowing one of their employees to access an MRI at $2,600, when they can get similar service for $600 in close proximity or access a hospital for a certain procedure with a 3x higher complication rate. And the suppliers are then pushed to think if they are really going to be able to compete as the employers begin demanding value for the varying price point for the services provided.

By: Robert White

Robert White — Fri, 14 Dec 2007 16:23:08 +0000

When I worked at Medicare (HFCA), I worked in the Fraud and Abuse section and I was the telemedicine expert. This was in 1999. At that time the only reason HFCA would not agree to pay for telemedicine is no one can prove that the care was provided. The state of Georia had a system were it provided telemedicine to its prisoners. Because the prisoners didn’t have the same right to privacy as you or I, the state could monitor the use of telemedicine. They set up a gate keeper who controled access to the use of the states system. This was determined to be the only system (at that time) that would work.

By: Jason

Jason — Tue, 11 Dec 2007 23:54:47 +0000

Koodos John and Bob, You know Teledoc has been great for me and my family, We love it, just the sheer convienence alone is worth the cost. I actualy called Teledoc one Satuday afternoon when my son was complaining of an ear infection and after talking to the doctor within in an hour we were picking up our prescription, and never had to go through the hassle of getting to the doctors office on a saturday when our primary doctors office was closed. How great is that?

By: Bob

Bob — Mon, 10 Dec 2007 18:37:19 +0000

This needs to be memorialized in a bronze plaque!!
When is clinical medicine going to enter the 21st century?
This message ought to be distributed to every medical society, every board of medical exminers, every physician organization, every doctor, every regulatory organization and every insurance company in the country.