Tele-Medicine is for Getting E.D. Medicine

That’s what a patient told me when I asked him what he thought of his virtual visit with his specialist. It also is good for getting a medical marijuana card. In other words, video medicine is good for a perfunctory visit to get comply with regulations and get paid. 

I wondered why the big practices jumped quickly to telemed. The practices say they eliminate the risk of cross infecting patients, which is the best reason to do these visits. The Big Medicine practices also say it reduces the risk of doctors getting infected. Sorry. If office-based physicians are afraid of infectious patients, they should re-examine their career choice. This is the life we’ve chosen.

My suspicions about the real reason the Medical-Industrial complex embraced remote doctoring were confirmed by this story about Urology practices. They found they could lay off most of their office staff, but still see a full complement of virtual patients and get reimbursed as if they actually touched the patients. How did palpating the abdomen or the prostate become obsolete so quickly? One mega-group had “a grant to support our initial telemedicine program, we had actually pre-purchased a bunch of telemedicine equipment that we were able to pretty quickly deploy in our clinics. We were able to upgrade those to have nice video capabilities and nice microphone capabilities.” They made money coming and going. They may never see an office patient again. Like colleges that switched to remote learning, they want to continue with reduced overhead, yet charge full price while delivering an inferior product. 

For the past 2 months, I have come to my office in Westchester County (adjacent to New York City) every day. All the other offices in my building shut their doors. I assume most are serving their patients remotely, but I get plenty of calls from patients unable to reach their other doctors. I’ve triaged patients to help them decide if they really wanted to come in or if a phone call would suffice. I’ve even stumbled through face time or a zoom call, and received selfies of boils and rashes. 

Certainly, there are good uses for video conferencing with patients, but the mega-clinics seem to have incorporated it as a new way to churn patients. Don’t get me wrong. It’s nice to get paid from insurance companies for phone calls. And I found another suitable use for virtual visits. They are also perfectly suitable for renewing benzodiazepines and hypnotics.

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