I’ve spent most of my career at the intersection of healthcare and tech, and it’s safe to say I’m more than a little obsessed with all things digital health. But, I have a confession to make—up until last week, I’d never had a virtual visit with a doctor.
I Facetime with my friends on the regular (and use Google Hangouts with my Redox teammates), and I’m as tech savvy and app addicted as the next 20-something. Yet every interaction I’ve had with a healthcare professional has been in a traditional physician office environment.
I’m not alone—despite the hype, it appears that consumer adoption of telehealth is, on the whole, still fairly low. When I spoke at a health tech-focused event the other month, a quick poll of the 100+ person audience revealed only a small handful had ever seen a provider via video, yet apparently the majority of us want to. According to a 2017 American Well Telehealth Consumer Survey, 66% of Americans reported that they would attend an appointment via video. Moreover, 57% of primary care physicians indicated that they would be open to holding appointments with patients via video, too.
So, what’s the deal? As it turns out, there are a number of perceived barriers to adoption on both the patient and provider sides. A 2016 Medscape survey revealed that the top concern for patients is getting the correct diagnosis via video. They also pointed to the lack of access to telemedicine as a big challenge. For providers, practice issues were top of mind, with malpractice and liability concerns ranking highest. Not surprisingly, reimbursement was also high on the list. Ultimately, it’s also just a matter of preference: 68% of patients surveyed would prefer to see doctors in person.
Up until this past weekend, I fell into that bucket of non-adopters (with the caveat that I’m fortunate enough to not have the need to see a physician more than once a year or so), but an unexpected bout of hay fever quickly changed all that.
When I made the move from Boston to Austin a couple months ago, people warned me of high pollen count the way you might warn someone of an approaching category five hurricane:
“Run (literally, run) to CVS and buy every pack of Zyrtec and bottle of Flonase you can get your hands on.”
“Close all your windows and doors, and Amazon Prime an air purifier ASAP.”
“DON’T GO OUTSIDE.”
Of course, having zero allergies to speak of (save one freak incident with hives and Tide with Febreze back in college… don’t ask), I ignorantly assumed that I’d be immune to all this, gleefully strolling through Texas Hill Country without a single sneeze in sight.
Fast forward to this past Saturday—my eyes were watering incessantly, my nose was literally dripping (gross), and I could barely go ten minutes without succumbing to a sneezing fit. In desperation, I raided the medicine cabinet for my boyfriend’s supply of over-the-counter allergy meds. After a healthy dose of antihistamines, decongestants, and nasal spray, I was certain I’d be back to normal.
No such luck.
Twelve hours of suffering later, I finally accepted the fact that this situation wasn’t going to improve without some professional help. I needed to see a doctor. But it was 6 pm on a Saturday, and I didn’t have a go-to primary care physician I could call here in Austin (in all likelihood, he or she wouldn’t have been available until Monday anyways). Urgent care could easily mean a three-hour-plus wait, and with my high-deductible health insurance plan, I knew I’d be paying out of pocket.
That’s when my boyfriend suggested using Doctor on Demand (full disclosure: he’s the founder and CEO of Chiron Health, and knows the telemedicine scene well). While the $75 price tag made me hesitate, I knew a standard office visit at an in-network provider would cost me double that.
So, I went ahead and downloaded the app. Providing my basic medical history made the signup process a little tedious, but not terribly so (and will likely be the norm for these types of applications until patient authentication becomes a reality). Within a few minutes, I was given the option to select a doctor, or the soonest available appointment. I opted for the latter, and was booked with a board-certified family medicine practitioner just 30 minutes later. In the meantime, I reviewed her bio, provided a quick description of my symptoms, and even uploaded photos of the over-the-counter allergy meds I’d taken earlier that day.
A few minutes before my appointment, I received a text notification telling me to log into the Doctor on Demand app and find a well-lit, private location for my visit. Shortly thereafter, I was video chatting with my doctor just as if I was seeing her in person. She did a virtual exam of my nose and throat via video, and we discussed my symptoms and the OTC remedies that had failed to provide relief. Less than 15 minutes later, she’d confirmed that I was suffering from severe seasonal allergies, and a prescription for a short-term steroid treatment had been sent to a 24-hour pharmacy down the road.
I would be feeling better within a couple hours. It was that easy.
But that’s not all—before I’d even left the apartment to pick up the prescription, I had an email summary of my visit waiting in my inbox, including diagnosis and treatment details. There was no need to take notes or try to remember the doctor’s instructions in the midst of a sneezing fit. Wanting to ensure I got the best price for the prescribed drug, I quickly pulled up the GoodRx app and found a pharmacy discount coupon that would get me the seven-day dose pack for just $19. The entire process—from downloaded the app to having the prescription in my hands—took about an hour, and cost me less than $100.
When my eyes stopped tearing up and I could finally breathe normally, I reflected on the whole experience. My honest opinion? All things considered, it worked pretty darn well! Yes, it’s not appropriate for a wide range of conditions, and yes, you’d probably opt to see your PCP in person if given the option (hence why a handful of telehealth companies are pursuing that model for routine follow-up care, prescription refills, and the like). But for acute issues like a sore throat or a UTI, finding near-immediate treatment and relief without spending hours in an urgent care waiting room can be well worth the out-of-pocket cost. And now that many commercial payers are covering telemedicine visits, cost may become even less of a question.
Industry experts and healthcare nerds (myself included) spend a lot of time talking about the problems that plague our broken system. There’s no doubt that so much remains to be done to deliver effective, high-quality, and affordable care to all, but it’s experiences like mine that force me to take a step back and acknowledge just how far we’ve come in consumer-driven care. In large part, this progress is thanks to the entrepreneurs to have had the courage to challenge the status quo and do their part to help make healthcare a little bit better.