The Doctr Is In

from the housecalls-by-IM dept

Wed, Oct 3rd 2007 8:03pm — Dennis Yang

Back in the day, when you were sick, you would call the doctor, and they make a house call to diagnose your condition and provide care. In this modern age of managed care, where doctors are evaluated on the volume of patients that they are able to process, house calls are now but a distant memory. Now, Dr. Jay Parkinson, a Brooklyn doctor, brought the house call back -- but it's been updated for the times. Parkinson has started a new medical practice that centers around instant messenger, email and house calls. During regular business hours, he is available to his patients for online medical consultations. Dr. Parkinson then pays the patient a house call only if it is really necessary (you get two included house calls in the fee), but most issues can be addressed virtually. This is not surprising since studies confirm that online chat with your doctor is nearly as effective as an in-person visit. Specializing in young adults age 18 to 40 without traditional health insurance, this approach could teach a few things to the health care industry. Of course, what he's doing is really similar to what many nurse practitioners do, so you could see him scaling his practice by employing a staff of nurse practitioners who answer IMs and emails, and then escalating qualifying issues to doctors and specialists. A second interesting point about Parkinson's plan is that since all of his clients are very price conscious (since they're paying out of pocket), he actively shops around for the best value specialists to send his clients to. In the age of copayments and insurance, you very rarely see much price comparison shopping in health care. As we've discussed here before, the current health care system is beset with problems, so it's encouraging to see a differentiated spur some excitement (and competition) in a very homogeneous marketplace.

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Filed Under: doctors, im, medicine

18 Comments

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RandomThoughts, 3 Oct 2007 @ 8:15pm

There is a practice that kind of operates like this, but it is for folks that can afford to pay for extra services. They make housecalls, they have the latest equipment, because their clients are not worried about paying for great healthcare.

Dealing with the young won't solve our healthcare problems, because typically the young don't need much healthcare.

As for the studies that show online chat is almost as effective as a doctor visit, I wonder if its because it works through chat or because a typical doctor visit doesn't allow much time for the doctor to really spend time with you? Maybe that bar isn't all that high.

As for finding value in specialists, I have doubts about that one. If you need a specialist, you probably have a problem. If you have a problem, you probably shouldn't be looking to save money, you should be looking for someone who will save your life. Someone who is the best.

In NYC? How many teaching hospitals are within 50 miles? That is where you will find cutting edge medicine being done. No insurance? No problem.
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Bonzo, 3 Oct 2007 @ 8:46pm

"Doctr". You clever nerd, you.
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Anonymous Coward, 3 Oct 2007 @ 8:55pm

I think its a bloody good idea.
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Anonymous Coward, 3 Oct 2007 @ 9:50pm

"Doctor Parkinson declared I'm not surprised to see you here You've got smokers cough from smoking Brewer's droop from drinking beer I don't know how you came to get the Bette Davis knees But worst of all young man, you've got Industrial Disease"
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Anonymous Coward, 3 Oct 2007 @ 9:51pm

He wrote me a prescription he said "You are depressed I'm glad came came to see me to get this off your chest Come back and see me later - next patient please Send in another victim of Industrial Disease"
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Tim, 3 Oct 2007 @ 11:08pm

lawsuit
Can you say lawsuit? This genius is diagnosing patients via e-mail without malpractice insurance? He just better hope that the hipster "artist" he diagnoses through instant messenger doesn't have lawyer parents.
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Morgan, 3 Oct 2007 @ 11:36pm

LOVE IT
I wanted to do something like this, sort of a triage, with an Indian doctor at one end watching a webcam, and basically telling whether you can relax or whether you should seek real treatment. "Is this just a rash?"

Anyway, obviously in our legal climate it would be suit-city, but I think something similar, and a whole range of services, could give some much needed options and price pressure to the entire market.

This guy's idea is probably much better, and I wish him luck.
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RandomThoughts, 4 Oct 2007 @ 6:10am

You don't think this type of thing is happening already is some cutting edge teaching hospitals? Second opinions can and are being done from a distance.

Although, if you have a rash and they are checking it out, unless you have a high def camera sending pics, in person would be better. Routine things can be done through chat or email, but doctors do need to actually be able to judge body language and tone, because they know we lie to them anyway.
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Anonymous Coward, 4 Oct 2007 @ 6:41am

It's the age of co-pay and red tape that has screwed up our health care. This is exactly what we need if we want to reduce heath care costs enough to be able to provide health care for everyone who needs it.

John Stossel did a report on 20/20 about Wal-Mart clinics - same concept - doctor gives you a menu of services and lets you know prices up front. Since he knows you're paying for it yourself - or at least need to know the dollar amounts - he doesn't screw you around.

This beats the hell out of HillaryCare, and will save our health care dilemma.
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Anonymous Coward, 4 Oct 2007 @ 6:48am

Re:
"If you have a problem, you probably shouldn't be looking to save money, you should be looking for someone who will save your life. Someone who is the best."

It's not either/or. Having your live saved is not an excuse for being financially raped, and it's not necessary either. It may seem heartless to apply capitalist market forces to even complex procedures that save lives, but in the end more lives will actually get saved and they may not go broke in the process.
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Anonymous Coward, 4 Oct 2007 @ 6:51am

i wonder if he has a pink r like flickr
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California, 4 Oct 2007 @ 6:52am

Kaiser is doing this kind of diagnosis already. They have Advise Nurse Practitioners who you can call and can tell you not to worry or to get your butt in to the hospital. You can also trade emails with your doctor for consultation. This is all at no extra charge. Although you do have to be a member.

For example my son had Pink Eye. I knew he had pink eye and I hate going to the hospital. So I called the Nurse and described his symptoms. She prescribed some meds and that was it. No co-pay on a visit to the Doctor, no waiting for hours to see the doctor, just pick up the meds in an hour.
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anon, 4 Oct 2007 @ 7:44am

House Calls
House calls in this day and time are dangerous and can get you killed. I don't blame doctors one bit for not wanting to make house calls! It's dangerous enough for police to go into some of the homes these days!
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Danny, 4 Oct 2007 @ 7:46am

Could be on to something...
This may be an good idea to an extent. About two weeks ago I went to back specialist. I took my previous x-rays (about 1 month old at the time) so he could look at them. We spoke about them he and recommended a physical therapist. My copay for this 20min. visit? $70. I paid $70 for a converstation with a doctor. No exam, no perscriptions, just talking. I have copay options so I may not be eligible for this online solution but I'm sure there are plenty of people that pay out of pocket that don't want to pay over $100 for a doctor visit just to talk to him/her.

And RandomThoughts,

Dealing with the young won't solve our healthcare problems, because typically the young don't need much healthcare.

While I agree dealing with the young won't solve the nation's immdiate healthcare problems it will help prevent some of them from happening decades down the road when today's young are tommorow's elderly.
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Norm, 4 Oct 2007 @ 8:11am

HIPPA and email
My doctor in California won't take or send email unless I log into their website and use their email. He said that due to HIPPA he would get a $10K per email fine for sending medical information via unencrypted email.
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Just Me, 4 Oct 2007 @ 8:15am

#15
I don't know that system or the laws associated, but maybe those rules are geared more towards personal medical info? It mnay be that saying "You may have ___, and you should goto hospitol/take an advil" might not count...not sure.

What's this "copay" situation?
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icngasn, 4 Oct 2007 @ 9:01am

RE: #1
"Dealing with the young won't solve our healthcare problems, because typically the young don't need much healthcare."

Dealing with the young is called preventative medicine, and is the most cost effective and positive way of dealing with health care issues. Waiting till a patient is very sick only benefits the drug companies.
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Danny, 4 Oct 2007 @ 10:04am

Re: #15
In case you aren't being sarcastic copay is a system offered that allows you the patient to pay only a portion of your medical expenses while the rest is paid by your insurance company.
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