Fragmentation of Care

Here is another example how we have lost our way in medicine.   The article in the WSJ is entitled Doctors Move To Webcams and it tries to introduce you to the era of virtual medical visits.  In fact, WellPoint, “the nation’s second-biggest health insurer, plans to offer a new service in all of its employer and individual plans that will allow people to consult with physicians on-demand, using laptop webcams or video-enabled tablets and smartphones. The insurer says the video consults will appeal to clients looking for “convenience and accessibility of care”.  What a crock of shit. Though I am not against technology, virtual visits via webcams only work if it augments the relationship between a patient and their OWN doctor.  What the media is missing is that theses types of trends just adds to the fragmentation of healthcare.  Going to the urgent care for issues that are not urgent is inappropriate.  Going to the webcam for issues that should be dealt with by your primary care doctor is inappropriate.   It is not good in the long term.   The naysayer’s response will be  that your family doc is just too busy so things need to be done to help offset the load.   Exactly!   But not by fragmenting care.  There needs to be a paradigm shift where family docs have only 1/3 of the amount of patients that they have now and they can do their own virtual visits only if there is an emergency which then could be followed up the next morning in their OWN office.   The only way to do this is to take the WellPoints and other third-party idiots out of the equation and go back to a direct pay system.