It's the 21st century version of a house call: Pick up the telephone, recount your symptoms to a doctor and get your diagnosis and even a prescription in about 15 minutes.
Earlier this year, TelaDoc Medical Services, a Dallas-based company, began providing over-the-phone medical care, including prescriptions, 24 hours a day, seven days a week.
The company, which has treated 40,000 patients so far, is trying to appeal to two groups of people: those who don't have the time to see a doctor and those who don't have the money.
The controversial service fields calls from patients, then guarantees that one of its doctors will call the patient within three hours or the service is free. The doctor spends a few minutes collecting a patient's medical history, then runs through symptoms as best as possible from afar. TelaDoc doctors can write prescriptions, except for controlled substances such as narcotics.
There's little doubt the new service is filling a need. Waits in doctors' offices have increased in recent years, studies show, and 45 million Americans are living without health insurance. More employees and their families are facing higher deductibles and co-payments for office visits -- which cost about $100 these days, compared with TelaDoc's $35-a-call fee.
Doctors and other experts worry such barriers are causing a growing number of people to skip basic medical care, which can lead to serious -- and costly -- problems down the road.
"We're not here to replace primary care physicians," said Rocky Dhir, TelaDoc's general counsel and spokesman. But "this is what consumers want. We can help them with 75% of reasons they go see a doctor."
Nonetheless, a significant segment of the medical community remains deeply skeptical that doctors can adequately treat a patient they have never seen in person.
The American Academy of Family Physicians strongly opposes the idea. The American Medical Assn. has expressed concern that patients who get treated over the phone could get shortchanged, even harmed. The Medical Board of California asserts that TelaDoc may be violating state law by allowing doctors to treat patients by phone. A spokesperson said the board may open an investigation into the company's operations.
Dr. David Goldstein, a physician and co-director of USC's Pacific Center for Health Policy and Ethics, called the TelaDoc idea "totally unethical and inappropriate."
