Shirah Vollmer MD

The Musings of Dr. Vollmer

Uber for Doctors?

Posted by Dr. Vollmer on April 20, 2015

Imagine an application in which you want to reach out to a physician, and like searching for a ride on uber, you press on your phone, you pay $45.00 and you ask the doctor a question. The doctor, like the Uber driver, responds promptly, and the application and the doctor make a small amount of money, for a small amount of time, and little by little, there is money to be made, and health care to be delivered. The word delivered is key, as the changing face of medicine is changing what health care delivery means. This is our new world of “population health” where for most people, their questions can be answered and the “patient” or “user” feels reassured and can lower his/her anxiety, but very occasionally, a serious health problem will be trivialized and catastrophe will ensue. Those of us trained before Electronic Medical Records were trained to search for the serious problem, so as never to miss the rare, but serious, disorder. More recently trained physicians are taught how to make most people well and stay well, with much less concern for the “zebras” as we used to call them. This major shift from thinking about population to thinking about zebras allows health care applications to provide an Uber-like service, of almost instant gratification, for a relatively nominal fee. I can imagine that insurance companies would buy these applications and direct patients to an email conversation before making an appointment. I can imagine that most of the time that works extremely well, both cost efficiently, and time efficiently. Yet, some “users” will not be able to convey the seriousness of their symptoms, and in those time urgent medical situations, irreversible damage can happen, tragically, and preventable if the patient had been in an emergency room. The future of telemedicine has arrived with the introduction of the Apple watch on 4/24. Health care is a major selling point to the accessibility of the internet on one’s wrist. The watch will be able to transmit medical data to physicians electronically. Our society will slowly be trained that medicine can be done remotely and, again, most of the time this is true. I worry about the times which are not most.

2 Responses to “Uber for Doctors?”

  1. Shelly said

    What about people who don’t have iPhones or Apple Watches? They can’t do telemedicine, right? Just this morning I read about an Uber driver beating up and robbing a client: so too an Uber doctor could basically rob a potential patient by being a “quack.” There are no quick fixes in life, and so too I believe Uber doctors are not a good idea. Psychiatry does not lend itself to simply asking a quick question (unless it is a medicine question, but even then it isn’t really a “quick question” ever, is it?). Without basically knowing context and history, don’t you see this Uber doctor thing as being really harmful? With e-mail, one cannot “read” tone that you can hear in voices or in body language.

    • HealthTap, for example, is available on all platforms including androids and PCs. Yes, there are huge risks to internet medicine, or tele-medicine, as it is being called. Yet, at the same time, information from a well trained physician can be helpful. For example, I suffered from itchiness, which was non-specific. I emailed my doctor and she advised me to take an over the counter medication which relieved my suffering. I did not have to take time out of my day for an appointment and that was of tremendous value for me. Sure, my itchiness could have been the first indication of a more serious condition, but usually it is temporary and relief is simply obtained. So, the answer, as the future of medicine tells us, that for most people emailing is very useful and for some people, like the uber victim you mentioned, the results are catastrophic. The rule these days is you have to hope your problems are common because if so, medical care will do well by you. On the other hand, if you have a rare issue, then the likelihood of a poor outcome increases as physicians are trained to treat populations and not individuals. Thanks.

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