Meet our writers

Health February 2013

Aid for Age

Getting Enough Doctors – Technology to the Rescue?

By Tait Trussell

These are medical services which connect patients in their homes with doctors by way of online video or telephone. Such services can bring a patient and a doctor together, if you have no regular family doctor. Few ill people want to go to an expensive, crowded emergency room.

Seniors’ fear of a severe doctor shortage is being lessened by innovations in the private sector.

The timing couldn’t be better. One in three physicians in the U.S. are over age 55. Bureaucracy and low reimbursements have driven many doctors out of practice. And many who still practice are no longer taking Medicare or Medicaid patients.

Medical schools, meanwhile, have failed to provide for the roughly 33 percent loss of the physician workforce. A number of studies have estimated that by 2020 the country will be short from 25,000 to 200,000 physicians, according to the Health Leaders Media Council.

The Census Bureau estimates the U.S. population over age 62 will increase from 46 million today to 83 million by 2030. The American Hospital Association estimates that by 2020 baby boomers will account for four in ten office visits to doctors, if they can locate a physician.

Young people coming out of medical school are becoming radiologists, anesthesiologists, and dermatologists with regular hours and more pay than primary-care physicians – the family doctors. The predictions also include a shortage of more than a half million nurses by 2020.

It’s not just the number of seniors that complicate the doctor shortage. The nation’s total population is growing by about 25 million people every decade.

So, how are innovations in the private sector addressing the problem? Enter “virtual doctor visits.” These are medical services which connect patients in their homes with doctors by way of online video or telephone. Such services can bring a patient and a doctor together, if you have no regular family doctor. Few ill people want to go to an expensive, crowded emergency room.

Wellpoint, Inc., the second largest health insurer in the country, for example, plans to offer a service to all of its employer and individual health plans. It will permit those it insures to consult with doctors using webcams (digital cameras that transmit images over the Internet) or video-enabled tablets or smart phones.

It will provide a system for accessibility and care for its clients, the company says. A growing number of large companies, such as Westinghouse Electric and Home Depot, Inc., offer virtual visit services — or remote consultations — for some of their employees.

Other insurance companies, such as Aetna, Inc., and United Health Group, Inc., also offer virtual-visit services. A survey by a branch of March & McLennan Cos. found that 15 percent of the largest companies now use some form of telemedicine and 39 percent are considering the medical technique.

General Electric Co. has been testing a virtual consult service and plans to make it more broadly available in 2013. The director of health benefits, Ginny Proestakes, is quoted as saying, “The ability to communicate with a doctor 24/7 via the Internet without an appointment ... is very appealing.”

The physician services typically use primary-care doctors for relatively minor, acute needs, rather than as a continuing source of chronic care. For example, Blue Cross and Blue Shield of Minnesota reportedly offers online and consult services for such problems as sinus infections, conjunctivitis and urinary-tract infections.

The digital-visit services could provide a new revenue source for doctors whose Medicare reimbursements have been slashed over the years. Virtual visits usually cost about $40 or $45, which is less than a normal office visit, more convenient for a senior patient, and certainly much less cost than a trip to an emergency room.

Digital consults are looked at with caution by some state regulators, who point out that remote visits can make sense when patients are communicating with their own doctor. But they say connecting with a physician in another city who may be unfamiliar with the patient’s case and health background may not offer the best care.

Currently, only 13 states allow a patient-doctor relationship where drugs are prescribed without at least an initial personal visit.

In any case, virtual doctor visits appear to be a growing and at least partial solution to the doctor shortage.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

Meet Tait