Is there no point in 3G Doctor unless insurance covers it? Are we really that out of touch with patients in the USA?

This comment by Iltifat Husain MD, Editor of iMedicalApps, has me really confused. Is it possible that there really isn’t a point for a patient to use a service like 3G Doctor in the US unless insurance covers it?

In the UK and Ireland we’re not consistently covered (some will, some might and some won’t) by insurers/employers but a big advantage of the service is that it’s low cost enough (£35 inclusive) that it’s attractive to those who appreciate the convenience of being able to access a Doctors informed advice anytime anywhere without the usual waits, time off, travel to a clinic, etc that they would associate with a consultation with a Doctor.

We’ve also got lots of on the job training that enables us to add value to patients who want to talk about online content (increasingly important when you appreciate the difficulty patients face when they want to discuss something like a YouTube video during an in-person Doctor consultation) or someone else’s health (eg. most people will find it difficult to arrange an appointment with their Doctor to discuss their mothers/partners health).

I thought:

> There are nearly 30 million people in the US that don’t have health insurance.

> Millions of patients in the US have to make a copay to access the advice of a Doctor even though they have health insurance.

> Not all US Health Insurers reimburse patients for the time they have to take off work and costs (eg. taxi/transit/fuel) they spend when visiting a Doctor (and in addition to this about 14% are self employed)

> The vast majority of patients in the USA can’t interact online with their Doctor.

> The majority of internet users in the USA access healthcare information online but find it difficult/inconvenient/impossible to share this with their Doctor.

> There are billions of $’s worth of vitamins, healthy foods, gym memberships, training gear and accessories, etc bought in the US by consumers aren’t reimbursed for by their health insurers

> 50% of US citizens have a smartphone and of the more than $1 Billion that was spent last year on AppStore content none of it was reimbursed by medical insurers.

> Not all health insurance covers second opinions.

> Not all Doctors provide patients with written documentation of their reported history, consultation and advice.

> There is a growing shortage of primary care Doctors in certain areas of the USA and whilst this isn’t being helped by increasing levels of medical school student debt or career choices (eg. interest levels in specialist careers) it’s increasingly impacting on the ability patients have to access a Doctor.

Am I wrong?

Is there really no point to the advice of a registered Doctor unless it’s covered by a healthcare insurer?

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4 Responses to Is there no point in 3G Doctor unless insurance covers it? Are we really that out of touch with patients in the USA?

  1. Iltifat Husain says:

    Nope, you’re not wrong, you took what Iltifat Husain (myself), said out of context within the larger post — which was focused on patients with insurance. Please read the original post to see the focus of it:

    • Hi Iltifat,

      Thanks for the comment. Quoting from the article you start by stating:

      “how the iPhone 4′s FaceTime video conferencing feature could be used by physicians for patient care”

      My point is that we’re not at the stage where we have to consider if this “could” be used. It is already being used by physicians to care for patients.

      “The big problem with implementation in the US has been reimbursement for patients”

      What I’m suggesting is that this might not be the problem going forward and that it may be a problem that exists because until recently there hasn’t been widespread access to such reliable video endpoints in the US market.

      Your larger post also highlights the use of a custom video conferencing terminals by including a picture of the Cisco HealthPresence terminal and connected medical accessories. Check out this passionate TedXDiringo talk in which Dr. Rafael Grossmann Zamora (a Trauma Surgeon at the Eastern Maine Medical Center) reports on the value they’re finding through use of inexpensive mobile video endpoints in critical care situations despite the availability of such more expensive terminals:

      • Iltifat Husain says:

        Right, I think it’s mostly in semantics David. I think you might have forgotten to see the date of the article — it’s written in 2010. And even then, the article references an even older post.

        The main point of the post was that insurance companies appeared to be finally catching up with the great technology we have — such as the technology you use.

        I’ll have to be more careful next time I comment on posts. Didn’t know the world is watching my every word so closely! We must be doing something right at!

        Thanks for the comments David, much appreciated as always, and continued success with your efforts in the mobile ecosystem.

  2. Perhaps dependence on insurers is something we’ll have to unlearn for mHealth to reach it’s potential?

    “We must be doing something right at!”

    Absolutely! I wouldn’t be commenting if I didn’t think:

    1) You are doing something very interesting and worthwhile there

    2) We need more Doctors participating in such online dialogue so that this important stakeholders point of view can be better appreciated by others

    3) This is the exactly the type of debate that really needs to take place for mHealth to generate even wider engagement from mobile and healthcare industry participants.

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