There is something a little disconcerting about the "on demand" doctor housecall models that have been popping up recently. As profiled in the New York Times, several companies are innovating apps or services for patients to beckon a doctor and pay a flat fee for basic medical care.
The usual concerns about the model probably aren't serious.
For instance, technology and careful backstops can prevent things like patients being seen by unlicensed professionals. That said, there are some possible issues. First, this type of service is only accessible to the wealthier among us -- so as resources become scarce in medicine, I worry about creating one tier of services for insurance-paid services and another tier for those who pay out of pocket. Another concern is the possible consequences of patients being removed from the context of a complete medical team. When people aren't being cared for by an integrated team of providers doing good medical collaboration, medical care is not nearly as powerful as it could otherwise be -- and crucial diagnoses could be missed or fumbled. (That said, these days, that is the reality of medical care only a portion of the time.)
On the whole, however, there is one reason I am really excited to see this kind of service:
The more we take responsibility for changing medicine -- as providers and as patients -- the more chance we have of a system that works.
I look at models like these and think of them as one piece of a puzzle. Imagine, for instance, a Heal doctor using iClickCare to collaborate with an integrated medical team for a patient who can't leave his home. Or a long-term care facility using Doctor on Demand for some of its less mobile patients but looping in the patient's other providers through an iClickCare or other telemedicine platform.
Ultimately, I cheer on people -- especially medical providers -- who are trying something new on behalf of their patients. So I'll be rooting for Heal, Doctor on Demand, and the others. I'll be cheering, even as I also advocate for strong healthcare collaboration to be in the mix.
Investigating how telemedicine can cut costs and improve care? Click to download our Quick Guide to telemedicine options: