Ridiculous Study of the Week: Telemedicine Docs Give More Antibiotics

In a shocking study (to no one), “kids with cold symptoms seen via telemedicine visits were far more likely to be prescribed antibiotics than those who went to a doctor’s office or clinic”.

Crazy, right? You would think that a doctor with NO relationship to the patient would REALLY hold their ground against an angry parent ONLY using the telemedicine service just to get antibiotics.

And this is why the telemedicine services are mostly horseshit, unless you are the patient’s regular doctor. If I offend you then, well, whatever. Hey, I understand some docs need to make a living. Even DPC docs moonlight with telemedicine. Hell, I may need to someday. But let’s not kid ourselves. We are all adults here. We know this is NOT the same as the real thing and anyone who says so is bullshitting themselves.

It is all about money. And it is mostly about others making money OFF us. Check out Tytocare (picture above). I want to vomit.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Ridiculous Study of the Week: Telemedicine Docs Give More Antibiotics

  1. Randy
    April 10, 2019 at 11:12 am

    Using telemedicine for peds is nuts and I would probably be prescribing antibiotics all the time just for CYA purposes. Where I think telemedicine may have a better role is longitudinal care of chronic problems, though obviously kinks would have to be worked out.

  2. RSW
    April 9, 2019 at 1:29 pm

    “Let’s take a look now at that discharge. Hold your phone in your right hand, and take your left hand and . . .”

  3. Dave
    April 9, 2019 at 11:30 am

    I’ve never done telemedicine, so maybe I’m missing some things, but it scares the $h!t out of me…how are you supposed to take good care of a patient with *no vital signs?!* Sure, maybe you can coach someone to take a pulse, or maybe (if they have a thermometer) a temp, but what if that kid with a cold has a pulse ox of 87%!? What if the person with flu like symptoms and a mild tachycardia also has an accompanying BP of 85/40?! It sounds like a disaster (and a lawsuit) waiting to happen…I can just see the next wave of commercials on Lifetime: “Have you been misdiagnosed by a careless telemedicine doctor? Has you child died because a telemedicine doctor couldn’t diagnose early signs of bacterial meningitis over a video chat? Call the law offices of Canni, Suem, and Howe right now!!!”

    I’d be curious to see whether the telemedicine system prescribes even more unnecessary antibiotics than the NP/PA – in – a – box walk in clinics….

    • Steve O'
      April 9, 2019 at 3:18 pm

      After decades, people have learned to trust brands, and mistrust humans. I’m hoping for telemedicine called Amazon Care, Google Doc or TeleTrump Videocare.
      The car industry is about moving metal, baby. American corporate health is about moving drugs and squeezing out the middleman clerk-doctor who inputs the order Myth and Mediocrity are America’s standard.

  4. Bill Ameen, MD
    April 9, 2019 at 10:51 am

    Once again, Dr. Doug, you nailed it. It’s hard for me to come up with cases in which telemedicine ISN’T bullshit. Maybe, if someone is housebound or lives a huge distance from a doctor, he or she might get psychiatric advice or home remedy advice, but calling in antibiotics for colds and other URIs is absolutely antagonistic to current recommendations. As a DPC doctor I’m sure you often have to give useful advice to keep your patients out of the ED. With telemedicine, my understanding is that usually Skype is used so the doctor can view the patient’s skin rash or whatever. What I don’t understand is, with millions of cars on the best road system in the world, people can’t GO somewhere to be SEEN? Which is exactly why urgent care is successful (with mid-levels writing far too many antibiotics)!

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