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The Doctor Will Skype You Now
amkkhan writes Next time you need to go to the doctor, instead of making an appointment, why not just fire up your smartphone? New programs by companies such as Doctor on Demand and the University of Pittsburgh's AnywhereCare offer one-on-one conferencing with doctors, either over the phone or through video on your phone or computer – giving you all the medical advice you need without having to set foot in a doctor's office. This new breed of checkup, known as telemedicine, has the opportunity to revolutionize personal health, says Pat Basu, chief medical officer of Doctor on Demand and a former Stanford University physician. "Two of the most important skills we use as physicians are looking and listening," he says. "Video conferencing lets me use those skills and diagnose things like colds, coughs and even sprains in a manner more convenient for you."
won't listen to me in person or try to help me, why would Skype be any better? I haven't had a prescription in over thirty years. If a doctor refuses to do their job in person when you're looking them straight in the eyes, why would any logical person ever think they'd do their job over Skype?
How he gonna feel my balls through skype tho?
So who does a prostrate exam? Sticking your fingers in your own ass?
I've used telemedicine to get antibiotics for a UTI. Just called up, described my symptoms to the doc and she agreed it was an infection. Sent a prescription to the pharmacy. Much faster than going to see a doc in person.
But the last I knew The Doctor preferred/will prefer to use cell phones. It probably isn't important the device use Skype. It may not even be important that the device be turned on.
Telephone and video health services have been around since 1995 in Ontario and dubbed NORTH Network and Telehealth.
"You've got leprosy, goodbye."
You have been billed no refund for unused time
The future of medicine: http://artificial-intelligence...
Mr. Snowden begs to differ. Yet another benefit the NSA/Microsoft conjoined twins have fucked up.
Prove anything by multiplying Huge Number times Tiny Number
Usually telemedicine is bogus, for hypochondriacs, helicopter parents and women with bladder infections.
Prescriptions are limited to antibiotics for those with compelling easy diagnosis like the aforementioned women with bladder infection histories.
The ones I've seen advertised on HR bulletin boards at companies I've visited always say they won't prescribe any narcotics or other "controlled substances" (gee, aren't all prescription drugs controlled substances if you need a prescription?).
While this makes sense it also doesn't, since there are plenty of conditions that are extremely painful but neither life threatening nor worth a trip to an emergency room on a weekend. A 2-3 day supply of Percocet to ameliorate the pain of a back injury until you can see your regular clinician won't create or enable anyone's addiction.
Until telemedicine gets over its paranoia about drugs its just not worth the effort.
I have been playing doctor on skype for like 3 years
You're on a Mac that is...
Visit the Arcade Restoration Workshop @ http://www.arcaderestoration.com
that skype does not use alsa no more
as right now most doctors won't communicate by any means but an office visit - no fax, no email, no direct phone calls, everything else goes through an assistant. Puzzling seeing how personal medicine is.
"Win treats sysadmins better than users. Mac treats users better than sysadmins. Linux treats everyone like sysadmins."
So, without commenting on accuracy, precision, completion, mis-diagnoses, missed symptoms, bias, colour correctness, nor smell, I think convenience is the all-time most important part of a doctor's check-up.
Oh yeah, house-calls. Remember? That's where we started. We are where we are because we made it convenient for the doctors, not for the patients. Remember? The guy with the expertise gets the convenience. Remember? The guy getting paid gets to make the rules. Remember?
While continuing to raise premiums.
I have never, ever, ever been to a doctor's appointment, and not had my blood pressure, pulse and temperature taken, even for the most routine visit. Nor should I, ever, in the future. Yes, I could, in theory, do those things myself and tell him, but none of the home kits can hold a candle to the gear they use, even if used correctly by the patient.
If I go in for something specific, physical contact becomes more specific. How can a doctor palpitate my chest, or listen to my lungs, over Skype? Some doctors will favor this because it will let them spend even less time with each patient, and insurance companies will push it because it will cost them less, but I won't put up with it. And neither, I think, will my doctor, who is very good.
...who?
No. I like keeping my medical information private and I don't want people listening in on my the conversion like they can do with Skype.
But it was a random blood sugar test that diagnosed me T1 diabetes and a random blood pressure check that diagnosed me high blood pressure (and saved my life, if the 240/160 reading was anything to go by).
So no, I would have to say phoning it in would be as terrible an idea as... phoning it in.
...
Die owners of Windows XP and old Os-X's, die!!!
Skype is how a lot of doctors issue marijuana prescriptions in California...along with the prepaid 50$ fee for the "visit"
Now we can fire most of the doctors and outsource their positions to ones working in a diagnosis center in Mumbai. Just keep the doctors on staff that actually need to be physically present.
...is touching. But I'll bet you'll bill out at the same rate.
If it's good news I hope it's the 11th Doctor. If it's bad I think I want it from the 10th.
mostly ones that sign for medical canabis.
by TheSpoom (715771) Uncaring Linux user here. I have nothing to add to this but please continue. *munches popcorn*
...an article saying Microsoft had broken Skype for some platform(s) or something? Did I imagine that?
We still need a true peer to peer video conferencing application that doesn't depend on third party servers, or embed in a browser, or otherwise embody great fragility. Seems like it shouldn't be all that difficult, unless OS webcam APIs are horrid. Displaying moving graphics and moving them over the net is so simple as to be no barrier at all. Is that the problem? OS Webcam APIs?
I've fallen off your lawn, and I can't get up.
A classical article on the subject, quite old now, has concluded that approximately 80% of diagnoses can be made from the history (ie a structured interview) with a further maybe 10% from physical examination and maybe 5% from additional investigations (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1673456/). Obviously, the requirements for modern medicine and the available means are a bit different. Nevertheless, any serious doctor will tell you that the history taking and the physical examination are the most important parts of an encounter with a patient.
This is a direct result of Bayes theorem: the interview and physical define the "prior" probability for any diagnosis and any further investigations will only serve to modify it by a certain degree (confirm or exclude). With the exception of some quite aggressive diagnostic methods, like a biopsy or laparoscopy, which will never be recommended upfront, most investigations are generally not sufficiently sensitive or specific enough to give a conclusive diagnosis.
Finally, the physical (which cannot be done via Skype) is also a very important component of the physician and patient relationship. An encounter without physical examination seems, in my humble opinion, quite superficial. Patients are generally more satisfied if you take the time to carefully examine them.
That being said, Skype can be a decent solution for people living in remote areas where transportation can be a real problem. Skype for people living in major cities is a bit silly, I think.
PS. I am physician, but I am curious to hear what you think about the value of physical examination.
Damn... When I saw the title I thought it was talking about Dr. Who and got all excited!
1. Use telemedicine to handle chemical abortion, in states where there are few or no clinics left that will carry out elective abortion due to intimidation and harassment.
2. Watch as those states pass bills (Some already have) to ban telemed abortion, while claiming that they are just trying to outlaw a dangerous procedure that kills women.
3. Watch as courts strike down those laws as placing an undue burden and thus violating Wade, pointing out that the claimed reason is clearly only a pretext as non-abortion telemedicine is not prohibited.
4. Watch as states pass new bills to outlaw telemedicine completly.
I assume that the visit during which you were declined pain medication, wasn't the visit to the ER room right after the accident, but a visit sometime afterward because the pain was still there.
Two things:
- Some doctors are very suspicious of patient asking for pain medication regarding an old accident. Lots of pain meds are addictive and should not be taken long term. You might have been an addict simply trying to persuade the doctor to prescribe your next hit.
- Pain management is complicated. What works in the short term, doesn't necessary on the long term. Morphine-class pain medication (like the codeine depicted in the TV-Show "House") are addicting, you can use them short-term (the emergency response team will give you a shot), but you won't be prescribing them constantly over the several-month-long recovery. There are other drugs used for longer time during the recovery that would be more appropriate: anti-inflammatory drugs and similar class (acetaminophen/paracetamol). There are different drugs helping with some chronic pain (corticoids).
There are some completely different way to treat constant chronic pain (some alternate use of low-dose anti-depressors can actually be benefic against chronic pain). etc...
Some handling of pain might not even include drugs at all: several weeks/months after an accident, what will help the most could be physiotherapy.
I'm not justifying that your doctor behaved like an asshole, I'm simply saying that there are valid reasons (both subjective and objective) not to give drugs.
Now, in your specific case, if you're still having pains a long time after the accident, I suggest you see some pain-management specialists. And/or some orthopedist or rhumatologist: maybe there have been some permanent damages after your accidents.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
A 2-3 day supply of Percocet to ameliorate the pain of a back injury until you can see your regular clinician won't create or enable anyone's addiction
Actually, it's a nice example of something that would help the addiction:
the drug you mention, Percocet, contains a substance called oxycodon. This one is an opioid. A morphine-class substance. It *is* a narcotic.
So you see the scheme:
- call some tele-doc. pretend to have an episode of intense backpain, pretend to be on a work trip in this city, and being in a hurry. you just need 2-3 days supply of percocet, until you go back home and see your family doctor for an appointment.
- get a presciption. get it from the pharmacy.
- repeat the procedure calling a different skype-doc.
after a while you have a good supply of opioids.
The only way this could be prevented:
- that there exist a reliable electronic patient file
- that there an easy way to access it securily, some chipcard serving as security token (it's doable using the chips on the EU insurance cards, for example).
- that the patient is physically present in the doctor's office so that the doctor can get the security token (chip) to quickly access the patient's file, and notice that the patient has consulted 20x time during the last week with the same story.
But physical presence of the patient is required to transmit the security token.
Otherwise you would need a system, were a doctor can open your file, simply by looking up your name, while you skype him. I.e.: very low security system where anybody could find your file without your consent.
It's a balance between the convenience of a system (just call the doctor), and its abuseability (get any drugs, access any medical information)
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
If I go in for something specific, physical contact becomes more specific. How can a doctor palpitate my chest, or listen to my lungs, over Skype?
Then you're not the target audience for this service.
It's targeting:
- The anxious people ("Doctor, the tip of my nose is itchy a bit, am I gonna die ?!") where 99% of the time all you need is to ask them and make sure that there are no other worrying symptoms and reassure them and ask them to come to the office if it persists longer than a week ("Has half of you face melted? No? Then it's definitely *not* Noma, no need to panic. Come see me if next week if it still does persist").
- The very simply common disease that are basically just about renewing the supply of self-medications ("Why do you bother coming here for a common cold?", "But doctor, I'm out of acetaminophene.", "ah, okay. here's your prescription.")
- The recurring simple infection that are actually damn easy to diagnose (e.g.: women who have often bladder infections can very easily recognise them. No new alarming symptom that wasn't there last time? It will probably go away with a simple drug) (e.g.: boyfriend has some bacterial STD? girlfriend needs a prescription to protect her too, and if she doesn't have any symptoms at all, she doesn't require an actual visit to the doctor beyond a few question about allergies).
If you break your leg in an accident, there's no way that a skype conversation will help you.
Well, actually speaking about what you said (needing to listening the lungs, etc) it might work the other way around: there are some people (call them "hyper"-chondriacs if you will) that tend to downplay symptoms because they don't want to bother loosing time going to the doctor's and think that the symptoms will wear of. If you provide them with a phone-line maybe some of them will think giving a call isn't that much bothersome, and will at least call the doctor. That also means that doctor can take the opportunity to explain to them that the thing is a little bit more serious than they've taught and persuade them that maybe it would be good to drop by the office for a more thorough check (or directly rush to the ER).
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
This is going to be commonplace in the next few years in the field of Community Paramedicine. I'm an EMT and work on a 911 ambulance. A very large percent of our calls are for patients that can easily be treated in place, but our scope of practice does not allow us to "treat and release". So we use the most expensive method of transportation (an ambulance) to take a non critical patient (with a problem not an emergency) to the most expensive destination, an emergency room.
A very common example (like DAILY): Mr. Smith is a 72 year old male with congestive heart failure. He was admitted a week ago for treatment and was discharged yesterday morning. He does not have adequate family support, may not have understood his discharge instructions, may not have the ability to obtain or manage his medications, and may not recognize changes in his signs/symptoms that indicate recurrence. Yes, he can obtain SOME in home care, like a visiting nurse, but they are not typically available 24/7 and cannot typically do things like a 12 lead EKG in the field. Any one of the gaps I listed could cause Mr. Smith to be readmitted for the same problem.
Under the Affordable Care Act, if Mr. Smith is readmitted within 30 days, the hospital will not be reimbursed by Medicare. This is HUGE. There is a tremendous financial incentive for hospitals to invest in telemedicine like facetime and Skype to manage these chronic patients (CHF, pneumonia, elder falls, etc) to avoid readmission penalties.
Privacy, have you heard of it?
Can doctors get any idler?
Anyways, stupid idea. Sick people want to share with a real person. Hard enough to do with a flesh and blood arse giving you 12 minutes of his/her time, let alone a 'remote presence' (as if that even makes sense). The only circumstance where the scenario is a necessary evil, is true remoteness eg. medical advice for people in very remote locations like the Arctic.
Next profit idea: don't even use a real doctor, instead, an avatar with AI that is 'really good at listening and looking'.
"Consensus" in science is _always_ a political construct.
... and what about the sleeze buckets?
"Yes, dear, I have been assigned to you. Now, if you'll just slip out of the robe ..."
It little behooves the best of us to comment on the rest of us.
Better than not seieng a Doctor at all, but I doubt I would go for this situation. For one thing, there are the security issues. Is the conference encrypted? Is it being stored? How doe sthis mesh with HIPPA? I'll keep going to the office.
I saw a notice on my company's intranet last week advertising this program. As a pilot, it was offering free "visits" (PCP visits are free under the regular program.) Tuesday morning, I needed to leave on a business trip just after lunch, and I had my colon acting up (nothing disgusting, just inconvenient.) Several years ago, the same thing happened and an Rx for Hyocyamine fixed the issue. I didn't have time to see even a Doc-in-a-box, much less my PCP.
In a few minutes, I registered for the program, picked one of the four physicians currently online, and after about a five minute wait, she popped onto the screen. She went through a quick history, had me prod various parts of my abdomen to make sure it wasn't some serious organ problem causing my colon issue, and sent the Rx to the K-Mart across the street. She reminded me that she was no substitute for regular physical exams, and that if the problem continued I should see my regular doctor. I cannot imagine a doc-in-a-box visit for the issue would have been very different.
In short, this is exactly the sort of issue telemedicne works for. It saved me the hassle and time of a doctor's visit, it worked for my employer since I didn't have to cancel my business trip, and it worked for my primary doctor, who didn't have to work me in at the last-second.
Really, I think it's best for the sort of issues that you'd handle yourself if the drugs you need to treat it were OTC, but for whatever reason, are not. It ain't going to make a whole lot of sense for most problems.
I see this as one way to prevent picking up other bugs while waiting at the doctor's office.
But... Doctor Who?
So say we all
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