You probably have heard about the recent study linking direct-to-consumer telemedicine visits to more downstream office and urgent care visits. This has got the insurance companies and government worried. Since we have a new telemedicine company hatching at a rate of every 7 minutes (I made this up) this is going to get interesting. So what is going on? For one, most of these telemedicine visits are for people who are antibiotic addicted or just have no relationship with a regular primary care physician. This article points out some of the other issues:

“These visits are most commonly performed by clinicians who work for national for-profit companies with whom the patient has no existing relationship and who lack access to prior medical records –  although many health systems and some practices now also offer on-demand visits for patients under their care.”

IMPORTANT POINT #1: No existing relationship.

“The additional follow-up care may result from concerns about the inability to conduct a physical exam or the quality of care provided by a telemedicine visit.”  

IMPORTANT POINT #2 and #3: Physical exams matter. Quality of care matters.

I am sure this next point is making the telemedicine world shake in their boots:

“Our findings suggest that as telemedicine use and growth are sustained, direct-to-consumer telemedicine by a third-party provider may lead to more downstream visits with associated increases in cost when compared with in-person care,” wrote the researchers in the study.  

IMPORTANT POINT #4: Increases in cost

Can we be honest for a second? How does any doctor believe that pure telemedicine is as good as in-person visits? I know the tech world thinks they can hack healthcare but they have failed over and over again. I know insurance companies and hospitals want to replace doctors but this is another fail. And lastly, many of those who do only telemedicine are suspect in their credentials or are pressured by the patient to treat them, which is poor care.

Obviously, no DPC doctors were included in this study.

The bottom line is that telemedicine is a disaster unless the doctor knows the patient and then it is a complementary tool that can work. Oh, add in that there should be no cost for the telemedicine visit to the patient and you are saving the system money. THIS IS WHAT DIRECT PRIMARY CARE DOES!