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Rite Aid Drug Stores Offer Virtual Doc Visits 138

Posted by Soulskill
from the please-state-the-nature-of-the-medical-emergency dept.
Lucas123 writes "Rite Aid today announced it is offering virtual face-to-face physician consultations through an in-store kiosk. The virtual consultation services are currently being tested in the Detroit area, but the company expects they will do well and the virtual consults will expand to other regions. The service costs $45 for a 10-minute physician consultation. Consultations with nurses are free."
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Rite Aid Drug Stores Offer Virtual Doc Visits

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  • by Hazel Bergeron (2015538) on Tuesday September 27, 2011 @02:53AM (#37523992) Journal

    Why is healthcare such a rip-off? In nationalised healthcare systems, the doctors get paid insanely high; in private healthcare systems, the doctors get paid insanely high.

    We can see from countries like Cuba that doctors aren't the result of educating a rare genius. But for some reason in the Western world we feel the need to artificially constrain their supply, take them through a hazing ritual to make them cynical about their patients, then treat them like gods.

    Let's return medicine to what it started as in Greece: a calling to care for the sick. Let it be a thoroughly secure vocation for permanent healthcare workers, where there is an understanding of difficulties on both sides - not one solved by high price doctors, lawyers, insurance, third party agencies and miscellaneous bureaucracy (public or private).

    • You know its only a matter of time before IBM's Watson replaces a substantial amount of doctor consultations (being an expert system that never sleeps and all). This is not a bad thing. Just as the cost of manufacturing and some services have plummeted, so will healthcare with technological progress.

      • by shawn443 (882648)
        This free consultation is brought to you by Company Name. Company Name, for all your medical and well being needs. Company Name is dedicated to you. Please choose from the following options. Are you feeling sad? ... ...
      • by adolf (21054)

        Have you watched the movie THX-1138?

        I have, and I'm not so sure that I'm interested in having Watson be in charge of my health.

        • As if its significantly better to have someone making 5x the median income in the US and who can accept kickbacks from pharmaceutical companies is any better.

          I'll take Watson thanks.

      • by elrous0 (869638) *

        Just remember to put the blue one in your mouth and the green one up your butt.

        Or was that the other way around?

    • Re: (Score:1, Insightful)

      by Black Sabbath (118110)

      > Why is healthcare such a rip-off?

      Because you are American.

      Before anybody jumps up and yells at me that other health systems have their own problems and/or their success/efficacy is greatly inflated, let me agree with you that all those other health systems are generally crappy too.

      It's just that your health system is so fucked that it makes everyone else's crappy to mediocre systems look luxurious* by comparison.

      * in the Monty Python sense.

      • by MrL0G1C (867445)

        I'm in the UK and I'd like to point out that the National Health Service is fucking awesome, there's nothing like being able to walk into any A+E and get treated without having to worry about proving who you are or what bills there are going to be because there are any. Doctor visits, check-ups, tests etc are all 100% free.

        Why anyone would want to have the stress of worrying about health care costs is something I don't understand. Only the super-rich could have reason for wanting private health-care.

        • by sub67 (979309)

          Only the super-rich could have reason for wanting private health-care.

          We all like to pretend we're super-rich here in the US.

        • If you do have a serious problem, then you need to pay out of the pocket to get treatment in the United States, or wait years to get treatment.

        • by skegg (666571)

          Doctor visits, check-ups, tests etc are all 100% free

          Wow ... sounds too good to be true. Does that include CT scans, MRI's, ultra-sounds?

          • by MrL0G1C (867445)
            Yes to all of those, with a referral from the doctor (free) who would obviously want good reason to do so (illness, pregnancy etc). Prescriptions aren't free unless you're unemployed etc, even then they are cheap (fixed cost).
        • by c6gunner (950153)

          Why anyone would want to have the stress of worrying about health care costs is something I don't understand. Only the super-rich could have reason for wanting private health-care.

          Good point. I don't want to have to worry about a mortgage, either - let's just have the government provide communal housing for free! Only the super-rich could have reason for wanting private housing.

          • A social democracy looks after the vulnerable.

            A man who is homeless and unable to support himself through disability (other vulnerable categories are also eligible) is provided with housing under a legal duty of care assigned to local authorities in the UK. If he has wealth then he may be required to contribute once stable arrangements have been made.

            A man who is homeless but who has health but not wealth is not as vulnerable, so has access to free advice and a limited allowance toward his own housing arran

            • by c6gunner (950153)

              Health is not the subject of choice - the only option is to be as healthy as possible and the only question is whether the resources are available to monitor and/or treat you.

              Nonsense. Health is absolutely a choice. A person who smokes, drinks, and injects himself with heroin obviously places a lower value on health than does a vegan Buddhist tai-chi practitioner. A person who decides to spend $500,000 to get the absolute best doctor in the world obviously care more about his odds of survival than does a guy who will only spent $50. Life is ALL about choices, and death is a natural consequence of life. I don't need a government dictating how I live or how I'll die.

              You're no

              • Nonsense. Health is absolutely a choice.

                The decision for an already sufficiently healthy individual (good luck if you're psychotic!) to attempt to pursue health is a choice. But the only acceptable position for any functioning, rational, moral society is for its members to be healthy.. This means everyone in such a society, subject to a burden determined both by the state of the art in medicine and the resources available from that society, must be provided with the means to be healthy.

                Meanwhile, a society which functions based on inequalities in

          • by MrL0G1C (867445)
            UK used to have a lot of council housing - Govt. supplied housing, not free but far more reasonable prices that what the private landlords charge. Personally I don't think a system where people work hard and then buy other people houses (rent->mortgage) is fair - that's what we have now.
        • A lot of my friends and family are staunchly conservative (their words, not mine). They walk along the Republican party lines and watch a lot of Fox News, and all that kind of crap. When the discussion about healthcare comes up, I will ask questions about how they would address certain fringe cases, how they would cover certain social costs of not having socialized medicine, etc. etc. I ask these questions sincerely and earnestly because I want to hear what the self-proclaimed conservative philosophy is on
          • by MrL0G1C (867445)
            The irony is that our health care system treats more and costs half as much. The European treaties that have been signed by UK traitor politicians unfortunately demand that everything possible be privatised :-(
          • I have the same situation. The only way I have been able to get through to them is to show how it affects them. Vast uninsured masses will cultivate resistant bacteria such as MRSA, XDR-TB, etc. and these are dangerous even to rich people with health care. People with a treatable condition they cannot afford may lash out at society, or do so out of grief after losing a loved one.

            It is sad to see people so determined not to care about their fellows. Jesus would puke, if he was alive and real.
          • I'm a Christian, a conservative, and as far as I know, you're 100% on the money.

            • You know, it's funny. I was raised Christian but a few years back I just kinda walked away from that title. I don't hate Christianity, I just don't care to devote my time to any of it anymore. I have more important things to do, like learning to be a better rocket scientist. But anyways, the folks that I mentioned in the post above are often the most zealously, "Christian," of the people I know. Many of them are concerned over the fact that I don't claim Jesus as my savior anymore and what not. And yet, des
        • by Rich0 (548339)

          I dunno - I know a guy from the UK who ended up being unable to talk for a month because it took so long to get treated for pneumonia. Maybe he was doing something wrong but:

          1. He went to his doctor.
          2. The doctor first tried aspirin or whatever. A few days later he returned since it didn't work.
          3. Doctor sends for x-rays. Wait a few days for scheduling.
          3. X-ray is taken.
          4. Wait ONE WEEK for the x-ray to be read.
          5. He was diagnosed with pneumonia and given an antibiotic prescription. By this point

          • by MrL0G1C (867445)
            It sounds like the condition of your wife and the condition of the UK guy weren't the same at the point of being seen, he probably should of sought medical advice quicker when his condition progressed. For anecdotal evidence, A+E in UK are a bit slow unless it looks like you've got something life-threatening. Personally when I got a head injury (not the most serious) it took a few hours before the medic got on to his shift and x-rayed me. I admit things like hip replacements can take months, I think part
            • by Rich0 (548339)

              Well, I tend to be a bit libertarian on many things, but I think that universal healthcare is inevitable and in many ways we're just prolonging the pain right now.

              The nature of healthcare does not make for good consumer choices - are you really going to haggle with a doctor in the ER the way you might with a car salesman?

              Plus, insurance is going to be untenable as our knowledge of medicine increases. When you can accurately classify the risk of injury then insurance stops working unless you force everybody

    • Because:
      1. It takes a vast amount of training. An encyclopedic knowledge of all common illnesses and most of the rare ones too. That's why the education process is so demanding.
      2. Because when they make mistakes, people die. That makes medicine a legal minefield, and drives very high standards.
      • (1) I admit that I had a fairly privileged upbringing, but I have a few schoolfriends who went into medicine. It really doesn't require "an encyclopedic knowledge of all common illnesses and most of the rare ones" - it requires a good knowledge of all common illnesses and some of the rarer ones, with the latter learnt about for exams/practical testing then mostly forgotten about just as in any other field.

        The demanding bit is the hazing which occurs at the start of the practical hospital training. You are m

        • by swb (14022)

          My neighbor's daughter became a nurse and I'm always amazed when I see her Facebook postings "Whew -- just finished 3 16s and a 24, ready to enjoy 14 days off."

          I'm surprised that staffing works like that. One, is it really helpful to have a nurse be awake and on the job for 16 hours? I get punchy doing IT work after about 12 hours. 24 hours? That seems crazy.

          How does it work that she can work 3-4 days and then have like two weeks off? This seems to happen a lot, and while not all shifts are as crazy l

      • by sjames (1099)

        Those points are constants in medical practice, but it's not so crazy expensive in other countries. I don't mean it is crazy expensive but it comes out of your taxes, I mean all expenditures taken together are lower in practically every other country in the world including those whose healthcare ranks better than the U.S.

        • It's not just "lower", it's about half(in terms of % of GDP) in most other OECD countries. Now certainly part of this can be attributed to the general state of health in the US(it's not good), and of course people will scream trial lawyers, which do take a toll on the system, but not nearly as much as the private health insurance system does.

          I personally like the Japanese system, you pay a certain amount every year based on your salary(it's not expensive at all), and then for every covered medical expens
      • 2. Because when they make mistakes, people die. That makes medicine a legal minefield, and drives very high standards.

        No, when a doctor makes a mistake a _person_ dies. When an engineer makes a mistake hundreds of people die.

        Who is more stressed?

      • by sjames (1099)

        That article's own numbers don't support it's conclusion. It claims auto workers make more money, but then cites $75k as compared to the doctor's $99k. It wants us to be upset that it is possible for a skilled tradesman putting in a great deal of overtime can earn nearly as much as a doctor working a normal work week.

        I'm not saying doctor's are being paid lavishly, but they're nowhere near sitting on sidewalk with a "will diagnose for food" sign. Of course, they don't tend to get laid off, and they don't go

    • I agree wholeheartedly. And, like in the ancient Greek medicine, treat the elementary particle "person" as a human being again. The ancient Greek medicine is not a fight of symptoms, it is a whole healthcare. The basis was a balance, like in so many other medicine systems in other cultures. So the personal situation, mental environment, domestic environment etc. were all investigated when you visited the doctor. But off course the doctor knew you. He was a member of your own community. Not some unknown call

      • by c6gunner (950153)

        The basis was bullshit, like in so many other "medicine systems" in other cultures.

        FTFY

        • On the contrary. The basis was, as in any science, observations. That we laugh about the theory that they developed on top of that observations is irrelevant. In a few centuries people will laugh about our current theories as well.
    • by lakeland (218447)

      Er, not really

      Name one nationalised healthcare system in which the doctors get paid insanely high.

      I guess it depends what you consider insane. Where I live the average doctor is paid approximately four times the average wage. is that insanely high? Doctors are smarter than the average punter and harder working. I would've said that most people with enough intelligence and diligence to go into med that decide to go elsewhere end up getting only slightly lower salaries - perhaps 20%.

      I don't know, I never

    • Why is healthcare such a rip-off?

      ...But for some reason in the Western world we feel the need to artificially constrain their supply, take them through a hazing ritual to make them cynical about their patients, then treat them like gods.

      Health care is a ripoff because while information is cheap, regulation is expensive.

      "We" don't feel the need to constrain supply, the government cartel granted a monopoly on legally providing health care services and controlling access to medication and medical equipment feels the need because they need yachts and summer homes in the Hamptons.

      Health care is cheap; health care regulation is expensive crony capitalism.

      • by PSandusky (740962)

        >

        Health care is cheap; health care regulation is expensive crony capitalism.

        Um... no. At least, not necessarily.

        I worked for a blood bank for several years, and because blood banks by definition supply both pharmacologics (plasma fractions, IIRC) and biologics (practically everything else), they are subject to FDA regulation as defined in the CFR for those types of agents. My particular blood bank was under a consent decree with FDA for failing to follow those regulations in whole and/or in part, and that failure to follow can have real consequences for the patient -- accidental in

    • In nationalised healthcare systems, the doctors get paid insanely high; in private healthcare systems, the doctors get paid insanely high.

      There are a lot of people who make a lot more money than doctors who have jobs of far less importance. Say what you will about the practice of medicine in this country (or others) but really the salary isn't out of line for what they do.

      then treat them like gods.

      I do agree we could do without that part.

    • by jellomizer (103300) on Tuesday September 27, 2011 @08:39AM (#37525242)

      Doctors pay is only the small part of the cost. Don't blame the Professional doing the work.

      Where does your money go...
      1. Malpractice insurance - Because the Doctor makes a mistake people feel they should sue them for a ton of money, although he is just trying to help.
      2. Unpaid Health Care - Health care has a high rate of treatment to people who cannot afford to be treated. So that is factored into the cost
      3. Insurances and Medicare/Medicaid - Their goal is to find a way not to pay the doctor unless they go threw a bunch of loops requiring more staff or cutting into his business time. Heck just dealing with the IT Staff alone you run into the biggest IT Idiots in the world. Here is how a typical integration project works....
      ME: My claim has been rejected why is that.
      INSURANCE COMPANY (IC): We changed our format around.
      ME: When was I notified about this
      IC: We posted the notification change on our webpage in www.insurancecomapyname.com/edi/specifications/hipaa/99dnnvnakkk222/837/changes.html
      ME: I am looking at the page right now I don't see a path to get there.
      IC: You should have this link bookmarked.
      ME: When did you tell people about this page.
      IC: We had the link up for one day on December 25th 2 years ago.
      ME: Can I have YOUR 837 specifications....
      IC: We follow the 837 standard you should know it.
      ME: I want a copy of your version of the specifications.
      IC: It is just like what we require on the paper form.
      ME: Please can I have the specs to be sure I am doing it your way.
      IC: OK... (Gives you a generic 837 standard spec)
      ME: (Follows the specs as giving, runs the test and gets rejections back, a week later) What is wrong why isn't this working.
      IC: Well we don't follow those areas of the specs. We put those values in this filed
      ME: (Follows the specs as giving, runs the test and gets rejections back, a week later) What is wrong why isn't this working.
      IC: Well we don't follow those areas of the specs. We put those values in this filed ... (this will be about 25 iterations sometimes in those iterations we again beg for the full specs to follow for them)
      ME: Ok it seems to process why is it rejecting.
      IC: Well the claim is too old so we wont pay it.
      4. Staff, front desk, practice managers, billers, nurses....
      5. Building upkeep
      6. Medical Equipment ...
      The doctor while getting paid well isn't really everything you are paying for.

      • by blair1q (305137)

        The fact that you put malpractice insurance first on that list means you're still being fooled by the industry propaganda.

        Malpractice is less than 2% of healthcare costs, but 50% of healthcare's excuses for high prices.

        • 2% is a big cut. But that is an average 2% so that means less then 1% for some organizations and a lot more for the small provider...

    • by dciman (106457)

      Because the poor overworked doctor that you are seeing has to be able to pay back the $300K in debt they owe to the government. Until we fundamentally change the way doctors are trained and, more importantly, who funds the bill, nothing is going to change.

    • by Kjella (173770)

      Why is healthcare such a rip-off? In nationalised healthcare systems, the doctors get paid insanely high; in private healthcare systems, the doctors get paid insanely high.

      I guess that depends on your definition of "insanely high". Here in Norway an average doctor makes around 750000 NOK/year ($130k) and the average full time employee 450000 NOK/year ($80k) so about 2/3rds more. You have to study for 6 years so your study costs are among the highest short of PhDs and with progressive tax earning more in fewer years gives you a higher tax burden. They are admittedly one of the highest earning groups but it is by no means insane. Perhaps you were thinking of the US?

    • by tlhIngan (30335)

      Why is healthcare such a rip-off? In nationalised healthcare systems, the doctors get paid insanely high; in private healthcare systems, the doctors get paid insanely high.

      You have to remember, that a M.D. has a doctorate degree. And before they can basically earn any money, they have to get their doctorate. So at med school, they get their bachelor's, then do their masters, internships, residencies, then their doctorate. At which point then they can go and make money. But it's still a multi-year process an

      • Most doctors do not get their masters. An MD is not a PhD. There is no PhD in medicine, it is a professional degree like JD or DDS.

        You CAN get your PhD or masters in something else before med school (Usually someone that doesn't get into med school 1st time will take a year off to get a "Masters of Public Health", Dietetics or Physiology).

        I've heard of people that have PhDs in in Virology and an MD, but they end up doing more research than actual medicine practice.

  • So this virtual 'doctor' earns about $561,600 salary a year for consulting services? There is no liability, no physical exam, no prescription services. This is a great business model!

    • Great job taking into account the cost of the infrastructure & greater company profit. I still say the service is a bit pricy. I'd feel more comfortable for $25/10m or $50/30m, perhaps that's what will happen if the service is successful.
      • Pretty sure if the service is successful it'll just illustrate that $45/10m is the cost that people are willing to bear, and it won't change.
        • if it barely just projects to turn a profit they'll drop the price to increase potential clients, maybe, kinda...
  • by Anonymous Coward on Tuesday September 27, 2011 @03:17AM (#37524100)

    Has the US health care system really come to this?

    Please enlighten me, do Americans consider $45 for a 10 minute virtual doctor visit an attractive price?

    In Australia seeing a real physician (GP) in the flesh within a few hours for any reasonable length of time typically costs between $35-$60, of which the public health system pays $35. So net cost to me is $FREE-$25.

    I recently dropped a weight on my foot which fractured my toes, I went to my local bulk billing GP without an appointment, was seen within 30 minutes, was referred to get an X-ray across the road without an appointment (wait time - 10 minutes, X-ray time, 10 minutes, result with professional summary time - 40 minutes), then returned to the original GP, wait time - 5 minutes.

    Total net cost to me for all of the above - $0 (no private health insurance involved here).

    • by elrous0 (869638) *

      I went to my local bulk billing GP without an appointment, was seen within 30 minutes, was referred to get an X-ray across the road without an appointment (wait time - 10 minutes, X-ray time, 10 minutes, result with professional summary time - 40 minutes), then returned to the original GP, wait time - 5 minutes.

      In the U.S., you're going to spend more time than that dealing with the paperwork. And god help you if you don't have insurance. That means an emergency room visit. And one of those is going to basically bankrupt you (that's not an exaggeration, an ER visit for even a simple thing here can end up costing well into the ten-of-thousands of dollars). About your only hope in the U.S. if you're uninsured is getting on Medicare or Medicaid. And if you're under 65 or employed at all, good luck with *that*.

      It must

      • Please. Go to a general practitioner, get an xray for your foot, maybe a cast. It will cost about 100-200 bucks with no insurance help at all. I recently did this exact thing when i dislocated my shoulder.

        Want to rack up HUGE medical bills? Go to an ER for a fractured toe.

      • by Cruciform (42896)

        Maybe Ron Paul would chip in the rest, since that was his go-to platform on healthcare.

        We just had a serious accident in the family, which resulted in that family member being kept in Nuerosciences, under constant supervision, for days. It's been just over a week now. The costs associated with this is the US would have destroyed any financial future my family had left.

        In Canada it comes out as a manageable chunk of my taxes, and if the same disaster befalls someone else they'll be protected too.

        Sure, our he

      • by Rich0 (548339)

        Well, the reality is that nobody pays more than $500 for an ER visit. However, the ER visit might well be billed in the thousands of dollars range.

        That is the first thing I'd change about US healthcare if I were in charge:
        1. Everybody pays the same price for everything.
        2. Hospitals must publish their price lists.
        3. For any particular diagnosis/treatment/etc you get one bill and you pay it. None of the crazy everybody-and-their-uncle is an independent contractor business.

        The real problem with being unin

    • by fhage (596871)
      Yes. This is a great deal for about 100 million people in the US.

      Here's why. Many people in the US, like myself, have no health insurance or what is made available to us has a very high annual deductible. ($6000/yr in the case of my insurance). After paying 28 years of premiums as a young healthy adult, as I turn 50, the rules all change and I'm effectively left to my own devices to find health care services. To Illustrate; let's say I've come down with a sinus infection (4th time in my life. - I recogn

    • by Xacid (560407)

      The value added here is probably time & convenience. It's kind of a pain to schedule appointments, then have to wait sometimes up to an hour to be seen, and then be herded in and out once you finally are seen.

      It's kind of like the difference between getting a hooker vs. getting married. ;)

    • by Pionar (620916)

      Not really, if you have insurance. I pay $25 for a GP visit under my insurance plan, same if it's a specialist (though, with most insurance, it's more), and $200 for an emergency room visit.

      Although, I do pay $180 per month for the insurance.

    • by sherriw (794536)

      I'm a Canadian and had to go to a clinic in Florida when on vacation. I saw the doctor for about 10mins to explain my sore throat. Came out of there with a $235 bill for the visit and a written prescription note, and $50 for the strep-throat test. The antibiotics were a deal at $25 at the drug store across the street. Luckily my travel insurance back home reimbursed me for all of it.

      So yeah, $45 is a bargain...

      Us Canadians need to take out travel insurance mainly to cover us in case we have to use the US he

    • Oh, you are *SO* in the lucky seat compared to the U.S. system.

      Let me put it this way.... When I was working for a company that had excellent health insurance, my pay architecture was like this:

      Regular Doc's Visit: $20
      Emergency: $60
      EVERY single medication: $10
      Total cost per month for the meds I take: $30 flat.
      The pay was ~$610/mo. The contracting company I was working for covered this 100%.

      I had to have brain surgery to fix the epilepsy issue that was a result of scar tissue surrounding (and part of) the

  • Gee, who would expect an unbiased, independent recommendation from a doctor who works for a store, that sells drugs?

    "Hi, I'm your Virtual Pfizer/Novartis/Merck Doc . . . I'm sure that your illness will fall into a category that fits our product offerings."

    "I don't want to gossip, but I would stay away from Dr. Wallgreens . . . his stuff uses powder made from DNA replication from the ground up remains of old Sam Walton's bones. He is considered a bit of a quack in the Virtual Doctor Community."

    • by c6gunner (950153)

      Gee, who would expect an unbiased, independent recommendation from a doctor who works for a store, that sells drugs?

      I dunno ... how about the hundreds of millions of people who go to homeopaths, naturopaths, nutritionists, etc? They seem to have no problem with conflicts of interest, so why would they have an issue with this?

    • by drosboro (1046516)

      Perhaps even more likely:

      "I am not a robot. I am a unicorn."

  • Generally speaking, I'd like some sort of diagnostic tests beyond a conversation and a limited visual inspection via streaming with questionable resolution.
    • Also, what happens if their advice is just "You'll need to go to the doctor's office/emergency room"? Does the $45 get refunded?
  • So I could pay $45 to have a doctor talk to me, unable to examine me, unable to do anything other than make generic suggestions based on my conditions, or I could pay around a hundred and actually find out what's wrong with me?

    Think I might pick the latter so I don't end up paying for both when the first run of suggestions doesn't pan out.

    • by darekgla (2447906)
      Partially, you are right, however please do not be under a delusion that most doctors know what they are doing if they can just get hold of you and have a time for the medical examination.Modern medicine is far from perfect and still very unwise.I am not that sure if the future generations will laugh our therapies like we do the ones used in the middle age. With exemption of dentists and surgeons, most fields may offer you a temporary relief but on the other hand for e.g. shorten your life or 'sell' you d
      • With a few exceptions, unless it's a common ailment with clearly defined symptoms and/or easily detectable with diagnostic tests, many doctors are simply making a best-guess estimate of what you have. In addition, they are so busy (read over-booked) they rarely have the time to devote to really digging into hard cases. I've known a few people with difficult diagnoses, and they bounced around to several physicians before they found one willing to take the time and go further than prescribing a few pills.

  • House gets out of prison and "virtual doctor" is the only gig he can get. Abrasive bedside manner! Pissed off executives! An interesting life-threatening case stumbled upon out of the blue! The episode writes itself.

    .
  • virtual customer service. Use your imagination, and you can be served virtually. Then when you're done you can go somewhere else to interact with someone who cares.
  • Your new pacemaker comes with 50 million free beats!

    You can buy additional beats at pulsemore.com

    (Close to home) [gocomics.com]

  • Pharmacies should be banned from hiring physicians due to the conflict of interest inherent in this situation: the physician is probably under a lot of pressure to sell drugs stocked by the pharmacy. If pharmacies really cared about patient health they would recognize that the physical exam component of a medical visit is an integral part of effective medical practice. I just wonder what is going to happen when (not if) someone with a life threatening condition is misdiagnosed and dies because of their "bus
    • by Binkleyz (175773)
      So, need to reply to just a few things here, not just your point, so hope you don't mind me hijacking your post.

      Little story:

      About 2 years ago, I was having coughing fits severe and long enough that I was on the verge of blacking out (from lack of oxygen) several times. I called my primary care doctor, but even with the description I gave, their only advice was to either come in the following day or go to the ER.

      So, being a reasonable sort of person, I decided to take the middle path. I went to one

      • by Dunbal (464142) * on Tuesday September 27, 2011 @09:24AM (#37525574)

        Hey no problem. Communication is what it's all about. I'm glad you had a positive experience.

        My point of view is that of a physician, because I am one myself. It's absolutely true that any pre-schooler can follow an algorithm and "cure" disease with a high degree of success. After all that is why, in your country, you let nurses and "physician assistants" screen patients and do the grunt-work. Medicine is not hard. However I will argue that in the US medicine has become all about the technology and the tests, and not at all about the patient. I don't practice in the US, but one hears stories of regular CT scans for migraines, abdominal ultrasounds for appendicitis, etc. Mixed in with these stories is a healthy dose of "defensive medicine" (I will do these tests exclusively to lessen my likelyhood of being sued for negligence because there is a faint possibility of a misdiagnosis).

        At the end of the day when you add it all up, you end up with a very expensive health system. Yeah ok you paid $20 for the consultation. Now how much did the X-ray cost? How much did the spirometry (blowing in the tube) cost? Even if you didn't pay up front, someone somewhere paid for the equipment, the film, and the little disposable cardboard toilet-paper roll thing you blow in (you would not believe how much those cost!). Now compare that with visiting someone like me, who probably would have prescribed you the same antibiotic and the same cough syrup after a couple minutes of listening to your lungs through your back, and tapping you on the ribs with my finger. No x-ray. No spirometry. Which is more efficient?

        A doctor is not supposed to order tests just to order tests. They only do that on medical shows. Well no, they are doing that regularly in the US. But you are supposed to know the results of the test before you get it. The test exists to prove your hypothesis (the diagnostic impression), not to "brute-force" a diagnosis. Now admittedly there are cases where a diagnosis is not clear - older patients with several chronic diseases, unconscious patients, pediatric patients, patients with very slight symptoms. These are harder to diagnose and more testing might be required. But in the example you gave me - a patient with a severe cough - the possibilities are very limited. Yes there are many many possibilities - pulmonary fibrosis, sarcoidosis, lung cancer, TB, asthma, etc etc etc. However you consider the age of the patient, how long you've had the symptoms, how severe the symptoms are, obstructive versus restrictive problem (through a physical exam, no spirometry required), and it's a pretty safe bet we're up against pneumonitis (viral most likely) or pneumonia (bacterial). Despite everything the CDC and infectologists say about overprescription of antibiotics, I would probably send you home with antibiotics (viral infections do sometimes turn into bacterial ones due to all that inflammation) and a note to come back in a few days if you are not recovered. If you don't recover, THEN we start looking at x-rays, etc.

        What they are doing is all the testing up front. That's great when you want to sell tests. It's great when you have patients who are more trusting of a machine than the human doctor sitting in front of them. But it's not really good "medicine". My $0.02.

        • by Binkleyz (175773)
          Undoubtedly you are correct.

          The X-Ray they did was apparently to confirm their thoughts on the pneumonia, but the rest of the diagnosis seemed (to my admittedly untrained eye) to be good deduction and experience.

          I can speak to the "Physician Assistant" thing personally, as an ex-girlfriend was one.. The law varies from state to state, but at least in Pennsylvania, becoming a PA requires several years of graduate-school education and a sort of mini-internship/residency period. They can pretty much do any

          • by Binkleyz (175773)
            forgot to add the word "physician" at the end there.... ;)
          • by PSandusky (740962)

            I wouldn't call PA school "graduate-school education." I'd call it a post-bac program, but let's not call it graduate school. I hear that from enough starry-eyed undergrads that think all programs (PA, MD, MS, PhD) programs are the same, so they should be able to bide their time in one (MS, PhD) while they wait for an acceptance from another (MD, PA).

        • by Reziac (43301) *

          As an experienced livestock producer, I know the value of being able to eyeball-judge the situation and cut to the chase. Treat the obvious before spending a fortune on tests. But insurance won't pay for that; insurance wants everything itemized and justified. (I've watched that force veterinary charges up by a factor of 10 or more in just ten years, despite only 1% of pets being insured.) You can't itemize a "tap on the chest" on an insurance form. :(

        • What about the cost to go to medical school? How much is the health care cost comprised of in order to help the doctor repay student loans?

          I'm more and more wanting UHC to happen here in America.

  • There are lot of things that can be done on the phone, but visiting a doctor is not one of them. Diagnosis requires physical presence, a doctor can't examine a patient that is not there.
    • There are lot of things that can be done on the phone, but visiting a doctor is not one of them. Diagnosis requires physical presence, a doctor can't examine a patient that is not there.

      I'm gonna call BS on that. At least to some degree. About 85% of diagnoses come from the history (listening to what the patient says, correlating that with their age, sex, comorbid conditions, etc.). Maybe 10% is physical exam and maybe 50% of that at the level of looking generally at the patient (as opposed to doing a pelvic exam or something equally annoying). Sometimes you really need to do that and of course sometimes a doc in the box (or a doc in the tube, as in TFA) should work just fine.

      Sometime

  • They can save plenty of man-hours because the diagnosis will be simple for 90% of patients - gunshot or stab wound.
  • A competing service has been around for some time. You get a word processor were you write down your symptoms, and ads for the appropriate medicines appear on any website that you visit subsequently.

    They're called the "Google Docs".

  • Local independent Urgent Care clinics in my community have prescription medication vending machines inside. If this is the route we're gonna take, we might as well just have drive through shacks where you stop first at the doctor vending machine and then the drug machine next to it.
  • I'm hesitant to read TFA.

  • by rickroma (2471828)
    Pharmacies should be banned from hiring physicians due to the conflict of interest inherent in this situation: the physician is probably under a lot of pressure to sell drugs stocked by the pharmacy. +1
  • I can't see anyone selling malpractice/liability insurance for this scheme at a reasonable price - there's just too much to miss when using telepresence rather than being there. It will just take one lawsuit because some teledoc misses something that should have been caught had he/she been there in person and the whole idea of telemedicine will go out the window.

  • My wife used to work in a Walgreens in a particularly bad part of town, so there will be the poor coming in willy nilly at all hours of the day asking for advice from any employee in the store who happens to be walking past - guy stocking milk cartons, pharmacy assistants, the retail store manager - What to put on this rash? What to do with this pulsing pain in my stomach? etc. She's seen plenty of times where an illegal migrant construction worker with a nail through their hand or eyeball would come in ask

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