Physicians' Role in Health Reform: Doctors without (Practice) Borders

1.12.2010 SPEAKER: Roy Schoenberg, MPH, President & CEO, American Well Systems MODERATOR: Ronald Dixon, MD, MA, Associate Medical Director, MGH Beacon Hill Internal Medicine Associates; Director, Virtual Practice Project, Massachusetts General Hospital

Forum Summary

Sick people usually spend a significant percentage of their recovery time at home, and when one is sick, traveling to a hospital in order to receive medical care is burdensome.  Another problem with the existing system of medical care delivery is the difficulty of getting a timely appointment with a doctor.  In the past, many doctors addressed both of these issues by making house calls, bringing needed services directly to the consumer, but today, house calls have all but been abolished because of time constraints.  Patients still need to get in front of physicians, and recently developed online systems have the potential to facilitate these patient-physician interactions in a new way.     

American Well Systems has introduced an internet-based system to broker discretionary physician time to patients who want to communicate with a doctor.  Patients enter the system through a health plan, such as Blue Cross Blue Shield of Hawaii, and each time a patient wants to receive medical advice, he or she logs onto the system and chooses a doctor from a list of available physicians.  The physician is then notified and is asked whether he or she will accept the case.  The online system is tied to a prescription infrastructure and provides specialized malpractice insurance.  Currently, physicians and patients are always in the same state.  The company is in the process of creating a system for online referrals, and it is also seeking to develop an infrastructure to allow doctors to interact with patients in person as well as electronically.   

A convincing majority of physicians and patients who have used the system have been strongly supportive of the new technology.  Physicians felt that they were able to provide valuable care and were happy that the system allowed them to make money while avoiding overhead costs.  Patients were also generally pleased with the care that they received.  Estimates suggest that in the future, online care will reduce the frequency of office visits in this country and will help reduce the cost of healthcare.

 

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