Calling Dr. Windows Vista
Have you ever picked up a cough, and a week or so into it wished that you could just call your doctor and ask a few questions about it? Wouldn’t it be so much easier to email your orthopedic surgeon, and just ask, “hey doc, I rolled my ankle a week ago, and it’s still swollen. Should I come in and have it looked at?”
This would be followed by the equally easy response of either “Hello there, no need to come in, just keep icing and resting for at least another 2 weeks,” or “you should probably get an x-ray if it has been that long.” Is this where medicine should be heading? Or is this a formula for erasing personalized medicine, the other futuristic goal? Can medicine head towards being both cost effective and efficient while maintaining a personalized touch, or are the two mutually exclusive?
In a recent article in Health Affairs, modernization of health practices is manifested in a merging of primary care with social media. Social networking sites similar to Facebook are being utilized by physicians and their private practices to create a type of all-access forum.
On this website, patients can speak to the physicians directly through instant messaging, email the physician, and even chat and network with other patients who have similar problems. One such practice operates what they have named Hello Health, a website that has become an example of the transforming practice of primary care.
At Hello Health, patients can make an appointment either in person or online. Wait a minute…online? Is this truly the scenario outlined above? In a sense, it is, and the most important part for most people, payment, is quite simple: there is a basic enrollment fee to join the “office/practice” and for every online “visit” with a physician there is a fee of $50 to $100. Luckily for the patient, sending the physician an email does not constitute a visit. What’s the catch? No health insurance is taken.
So where does this leave us? You can sign into a medical practice like Facebook, “friend” your doctor and essentially pay per minute of health care advice received online. This poses many disadvantages, of course, such as the fact that the physician can do only so much without a physical exam, and the chances are that an in-office visit will result, bringing you back to square one minus a few hundred dollars. Then there is the ethical side of things.
Are we comfortable talking about personal information to a physician-as-screen-name? Has the technology reached the point of optimal security for this information to be shared online? It seems like there is a hint of a good idea in there somewhere, as social networking dominates the daily life of nearly every waking person today, but I would venture to say that it is still too risky technologically and much more so for the integrity of personalized medicine.
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