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The Doctor Will Skype You Now

samzenpus posted about 6 months ago | from the take-four-red-capsules-in-10-minutes-take-two-more dept.

Medicine 97

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."

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Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627605)

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?

Re:Considering my doctor... (1)

redback (15527) | about 6 months ago | (#47627609)

It won't fix shit doctors.

I had a skype consult with a doctor on Monday and it went very well. Only problem is waiting for the prescription to come in the mail.

Re:Considering my doctor... (1)

93 Escort Wagon (326346) | about 6 months ago | (#47627653)

A lot of pharmacies nowadays use e-scripts, or another internet-based service. My doctor usually submits the prescription while he's still talking to me (person to person), and I can pick it up from the pharmacy on my way home.

Re:Considering my doctor... (1)

taustin (171655) | about 6 months ago | (#47627777)

That's a requirement under either ACA or a previous law. Not all doctors are up to date on it, but they are supposed to be. Most insurance companies insist, too.

Didn't we just see... (1)

fyngyrz (762201) | about 6 months ago | (#47628367)

...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?

Re:Didn't we just see... (1)

aix tom (902140) | about 6 months ago | (#47628651)

The major problem probably is people behind corporate or private firewalls, or on NATs, or behind proxies, or other things that prevent them from being a "server" that the other side can see directly over the internet.

So network-wise a "third party server" that has no such restrictions might always be necessary for those www-but-not-really-internet connected people so that their machines can talk to another. Of course if one of the participants is "really" on the internet that participant could run the server part.

Re:Didn't we just see... (1)

fyngyrz (762201) | about 6 months ago | (#47638729)

Thanks. So. If you hang behind a firewall/OtherWare you can't control, you lose a lot of choices overall. Protocols, ports, etc. But for the rest of us, the ones who are actually free to choose our options, no reason, then?

Re:Considering my doctor... (1)

Anonymous Coward | about 6 months ago | (#47627857)

It won't fix shit doctors.

At least the NSA etc will have a list of all the shit doctors and your conversations with them.

If something goes wrong you'll be able to submit FOI requests to get evidence and win your malpractice suit.

Re:Considering my doctor... (1)

Stan92057 (737634) | about 6 months ago | (#47630439)

There are doctors?? All I get to see are PAs and still have to pay full doctors office visit prices.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627631)

Exactly. I've never had a doctor agree to write a prescription in my forty-three years in this country. They know that if they help cure people then they will hurt their source of revenue. You're correct in thinking there's no logical reason to believe that they'll do what is morally right over Skype that they constantly refuse to do in person.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627693)

Why do you assume that the correct course of treatment/management is, in fact a prescription? I know it is fashionable in these parts to assume that formal education is meaningless, but have you ever stopped to consider that maybe the reason you're walking out of the office without a prescription is that one is not indicated?

Re:Considering my doctor... (1)

taustin (171655) | about 6 months ago | (#47627783)

Maybe he's only asking for/demanding prescriptions for narcotic painkillers. After all, people tend to see in others what they see in themselves, and what he sees in doctors is a desire to commit crimes for profit (though dead patients don't pay well, but hey, never expect logic from an addict).

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627937)

I'm the GP. I did ask for pain medication after my two accidents on a scooter. In one case I did a lot of damage to a BMW 750 after he rear-ended me at about 30 MPH, and in the other case a bus ran over my leg. In both cases I was denied pain medication. The doctors were so impersonal even in person in the ER that I can't imagine a Skype session via webcam would be any better.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47628717)

It's not the Doctors fault, the DEA are so strict with Doctors today that I know several Cancer patients that can't even get help with Pain. Blame the DEA not the Doctors. Disbanding the DEA is the only solution.

As for the topic, most Doctors want you in the Office and give about 15 minutes to each patient before moving on. This is why you don't see house calls anymore, it's about money and very few if any would do Skype calls. Knowing the FBI/NSA monitors Skype with Microsoft's permission, why would you want that anyway?. In the end they will tell you to come into the office as you can't be examined through Skype.

Pain management (1)

DrYak (748999) | about 6 months ago | (#47628739)

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.

Re:Considering my doctor... (1)

ColdWetDog (752185) | about 6 months ago | (#47627707)

You're doing something wrong. You sure you haven't been visiting Chiropractors?

Re:Considering my doctor... (1)

thieh (3654731) | about 6 months ago | (#47627753)

I would imagine these are for the case where the patient can't get to the doctor's office frequently. Whether this raise privacy concerns would be open for interpretation.

Re:Considering my doctor... (2)

ShanghaiBill (739463) | about 6 months ago | (#47627921)

I would imagine these are for the case where the patient can't get to the doctor's office frequently.

Doctors' offices are full of germs. You are almost as likely to catch something else, as you are to be cured of what you have. Most health problems are routine, and a doctor should be able to diagnose them over the internet. Since there is no need for the doctor to be local, or even on the same continent, you can quickly be referred to a specialist if you have something complicated, This could replace 80-90% of doctor visits, saving people time, making better use of doctors, and preventing nosocomial infections.

Whether this raise privacy concerns would be open for interpretation.

I am confused. What would the privacy concerns be? I can't think of any.

Re:Considering my doctor... (1)

thieh (3654731) | about 6 months ago | (#47627985)

Then you probably has a whole lot of sophisticated stuff just to do what a normal stethoscope can do.
And the privacy concern: someone else may look over your shoulders for Skype calls? Like your estranged spouse/offsprings...

Re:Considering my doctor... (2)

The Snowman (116231) | about 6 months ago | (#47628047)

I would imagine these are for the case where the patient can't get to the doctor's office frequently. Whether this raise privacy concerns would be open for interpretation.

Or for follow-ups. I had an appointment with a specialist this last Monday. She prescribed some stuff, said to call back or come in (if necessary) in two weeks. What if I could Skype for five minutes and say how things are going, maybe show the affected area of my body on the camera for a quick look. Saves time all around. Then if I really do need to come in for a personal visit, we can schedule that.

Seems that often enough I just want to talk with a physician and do not necessarily need the hassle of driving there just to talk face to face. Yeah there are plenty of times I need to show up in person too, but this could be one more tool to save time and energy. I miss less work (or stay less late to make up the time), the physician gets to see more patients. It could be a win all around.

Re:Considering my doctor... (1)

bjwest (14070) | about 6 months ago | (#47627759)

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.

I think if you're still alive after 30 years, you probably didn't really need those meds after all.

There's a reason some medication needs a prescription from a doctor. They aren't supposed to give you what you ask for.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627855)

> you probably didn't really need those meds after all.

I'm the GP, and I'll admit you're probably right in most of the cases. But, I was in two bad accidents on my scooter, and the doctors didn't offer pain meds in either case. One time I hit the front of a BMW 750 hard enough to break the grill, dent the hood, break the windshield, and dent the top and the other my leg was run over by a bus. The total between the two ER visits was nearly $25k. In both cases the CAT scans were the most expensive items on my bill. In both cases the doctor was shocked I didn't break a bone. I thought I would have at least been offered something for the pain. The second time the doctor didn't recommend crutches so my insurance wouldn't pay for them. I had to buy them out of pocket.

Another time I was bitten by a stray dog, and the doctor didn't recommend rabies shots. I had to pay for that out of pocket. An Indian family owned the dog and sent it back to India so it was unavailable for testing. The total was $16k, and the hospital settled for $6k. Again, my insurance refused to pay because the doctor didn't recommend the treatment. I decided to do it because I had bad headaches, blurred vision, and a fever. Contracting rabies as a human is a death sentence so I didn't take any chances.

I can't imagine a doctor over Skype doing better because it is easier to refuse treatment in the impersonal setting of a webcam than it is to someone in person.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627913)

But, I was in two bad accidents on my scooter, and the doctors didn't offer pain meds in either case.

And there we have it. "I didn't get my free pills, waaaaah."

Why would the doctor recommend crutches if your leg wasn't broken? If the bone's not broken, there doesn't seem to be much value in using crutches, whose sole purpose is to take the weight off the leg - was he supposed to give you crutches so you could let the non-broken ends of your non-broken bones heal? Jesus christ, when I get punched in the arm, I don't demand an immobilizing sling.

Rabies shots often are NOT given as a result of dog bites - they depend on where you were bitten, the severity of the bite, the clinical history of the dog in question, and the prevalence of rabies in the area you happen to live. You decided to do it because you got a headache? Congratulations, you're a moron - if you're taking prophylaxis once clinical symptoms have already started, you're probably dead anyway, you fucking tard.

All of these instances you've shared simply underscore the fact that you're a narcotics-seeking hypochondriac who thinks he knows better than a doctor, and really doesn't. If you were absolutely certain the doctor is wrong... why didn't you seek out a second opinion, as well? If the second opinion tells you "Yes, you should get these treatments," your insurance will cover them. if the second opinion won't recommend the treatments... you're a whining little bitch with no leg to stand on.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47627965)

Interesting to see someone completely ignore the "bus ran over my leg part." When I sprained my ankle after a motorcycle accident, I had to walk on crutches for nearly two months, and I didn't have any broken bones. It's also interesting to see someone that can't comprehend just because a bone isn't broken that you can't walk normally and can be in a lot of pain. If a doctor thinks a CT scan is required, it pretty much means you took a pretty hard hit.

To the rabies comment, I decided to get shots for my daughter after she got bit by a dog in Chennai. Death is pretty much guaranteed if you don't get shots and contract Rabies. My travel insurance covered a small portion of it, but my regular health insurance didn't because I didn't wait to take her to her regular pediatrician.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47628121)

the clinical history of the dog in question...you fucking tard.

Wat? You call the guy a tard for being concerned that a dog from India had Rabies? I see now why you posted as an AC. What a stupid comment.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47629049)

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?

Given that you're still around, I would say that your doctor did a good job and you had no need for a prescription anyways.

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47629445)

VSee (http://vsee.com) has been used for this long before Skype was fucked up by micro$oft

Re:Considering my doctor... (0)

Anonymous Coward | about 6 months ago | (#47632191)

We seriously need medical droids. Lucas was a prophet.

Butt (0)

Anonymous Coward | about 6 months ago | (#47627619)

How he gonna feel my balls through skype tho?

Re:Butt (2)

93 Escort Wagon (326346) | about 6 months ago | (#47627635)

I'm more worried about the rectal exam.

Re:Butt (4, Funny)

Barny (103770) | about 6 months ago | (#47627821)

How big is your camera?

Re:Butt (0)

Anonymous Coward | about 6 months ago | (#47628087)

Which part of "Microsoft product" did you not understand?

Re:Butt (0)

Anonymous Coward | about 6 months ago | (#47629075)

Which part of "Microsoft product" did you not understand?

The "rectal" part.... Thought it was already talking about that being a "microsoft product".

Prostrate Testing (0)

Anonymous Coward | about 6 months ago | (#47627621)

So who does a prostrate exam? Sticking your fingers in your own ass?

Re:Prostrate Testing (1)

antifoidulus (807088) | about 6 months ago | (#47627627)

So who does a prostrate exam? Sticking your fingers in your own ass?

Well, if you fork the feed then you may just be able to pay for the medical exam while performing it.

Re:Prostrate Testing (0)

Anonymous Coward | about 6 months ago | (#47627683)

Not your fingers, your cell phone.

Re:Prostrate Testing (1)

Rick in China (2934527) | about 6 months ago | (#47628375)

That'll be a common excuse, when caught.

*walks into room*.. *sees person with fingers in butt*.. "I'm in the middle of a medical exam, get out!"

Oh, yes, of course.

Re:Prostrate Testing (0)

Anonymous Coward | about 6 months ago | (#47629095)

"ProsTATE". ProstRate means something very different.

Good for embarrassing conditions (0)

Anonymous Coward | about 6 months ago | (#47627633)

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.

Or perhaps tomorrow or yesterday (1)

erice (13380) | about 6 months ago | (#47627659)

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.

NORTH Network and Telehealth (1)

number17 (952777) | about 6 months ago | (#47627677)

Telephone and video health services have been around since 1995 in Ontario and dubbed NORTH Network and Telehealth [wikipedia.org] .

Re: NORTH Network and Telehealth (0)

Anonymous Coward | about 6 months ago | (#47627823)

North Network was part of S.W.O.T.N. ( South Western Ontario Telehealth Network ) Care Connect and VideoCare wre the other two. They're all one network now, O.T.N. Ontario Telemedicine Network.

I'm a little surprised this is big news. I was part of a team that did mentored surgeries across videoconferencing more than seven years ago out of a small town called Stratford.

Politics seems to be the biggest hurdle to get this used more.

"You've got leprosy, goodbye." (1)

Joe_Dragon (2206452) | about 6 months ago | (#47627689)

"You've got leprosy, goodbye."

You have been billed no refund for unused time

Won't help me (-1)

Anonymous Coward | about 6 months ago | (#47627691)

I visit the doctor and give her a 1st rate gynecologist exam and her mouth is the container for my spooge.

Skype would be a serious downgrade. Next thing she'll want $5/min like some damn cam girl.

HIPAA Compliant? (4, Insightful)

Tokolosh (1256448) | about 6 months ago | (#47627699)

Mr. Snowden begs to differ. Yet another benefit the NSA/Microsoft conjoined twins have fucked up.

Re:HIPAA Compliant? (1)

Anonymous Coward | about 6 months ago | (#47629497)

I'm an software development intern at a health care software company. My internship project has been developing a WebRTC platform for telemedicine instead of the third party vendor we've tested so far. Open source and encrypted by default, so hopefully all the parties play nice and WebRTC won't be compromised.

Re:HIPAA Compliant? (0)

Anonymous Coward | about 6 months ago | (#47629991)

I am not an expert on this, but if it's the patient initiating the (possibly insecure) transmission, wouldn't that be ok? In other words, if I email some random person my personal health history, that's ok; if my doctor does it, HIPAA violation.

Bullshit medicine and antibiotics (2)

swb (14022) | about 6 months ago | (#47627709)

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.

Re:Bullshit medicine and antibiotics (1)

Sanians (2738917) | about 6 months ago | (#47628053)

(gee, aren't all prescription drugs controlled substances if you need a prescription?)

The difference is whether or not you can give some to your friends and not have to worry about being arrested if the police find out. E.g., you can share your antibiotics, or your blood pressure medicine, even most antipsychotics. It isn't a good idea, but there's no law against it. On the other hand, those pain relievers, and most anti-anxiety and ADD medications are controlled substances, and sharing them will get you in trouble. It's a similar big deal for the doctors, as there's a lot more oversight of prescriptions for controlled substances and they can get in legal trouble for over-prescribing them, whereas if they over-prescribe other drugs, nothing will ever come of it.

Nacrotics (1)

DrYak (748999) | about 6 months ago | (#47628781)

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. [wikipedia.org]

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)

Re:Nacrotics (1)

swb (14022) | about 6 months ago | (#47628927)

My working assumption is that, at least in the US, you're limited to the telemedicine providers your insurance company provides, so you'd be calling the same one who would have access to your medical history.

Skype doctor (0)

Anonymous Coward | about 6 months ago | (#47627719)

I have been playing doctor on skype for like 3 years

Unless.... (2)

ArcadeNut (85398) | about 6 months ago | (#47627725)

You're on a Mac [slashdot.org] that is...

Re:Unless.... (0)

Anonymous Coward | about 6 months ago | (#47627925)

Well, unless you're on a non-intel mac, you mean. Since Snow Leopard works just fine on any Intel mac released - i.e., any mac produced in the last 8 years.

But yeah, if you want to call the doc from your Mac SE, you'll have some problems - not the least of which is that you're stuck in 1983.

Re:Unless.... (1)

Anonymous Coward | about 6 months ago | (#47628185)

People on old Macs deserve what they get.

Re:Unless.... (0)

Anonymous Coward | about 6 months ago | (#47628459)

People on Macs deserve what they get.


'al sa'y (0)

Anonymous Coward | about 6 months ago | (#47627729)

that skype does not use alsa no more

Promising... (1)

jpellino (202698) | about 6 months ago | (#47627733)

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.

Re:Promising... (1)

sl149q (1537343) | about 6 months ago | (#47628253)

Depending on where you are of course...

But in many places your Doctor can only bill your insurance if they actually see you in the office. They cannot bill or can only bill less if they talk to you over the phone.

Re:Promising... (1)

alphatel (1450715) | about 6 months ago | (#47629299)

Depending on where you are of course...

But in many places your Doctor can only bill your insurance if they actually see you in the office. They cannot bill or can only bill less if they talk to you over the phone.

Indeed! Our insurance company which costs a mighty fortune has made it clear they will cover no such "remote visits"

"convenience" (1)

holophrastic (221104) | about 6 months ago | (#47627741)

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?

Another excuse to reduce care levels, and costs (3, Insightful)

taustin (171655) | about 6 months ago | (#47627801)

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.

Not the target audience... (4, Interesting)

DrYak (748999) | about 6 months ago | (#47628849)

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).

Re:Not the target audience... (1)

dasacc22 (1830082) | about 6 months ago | (#47630927)

Uh huh, and what if I want to get a referral for a neurospecialist and not drive all the way there to have some doc up-sell me on the latest drugs he's pushing for a kick back? Not everything is about broken limbs or missing kidneys.

Re:Not the target audience... (1)

Headrick (25371) | about 6 months ago | (#47632765)

The problem I see with this service, at least in the US with the litigious nature of its society, is that it's almost to the point that if you say a common housefly landed on your arm and you are worried they will tell you to come in to the ER or urgent care. I know of no one who has called any level of their heath provider with any concern who has not been told to come in.

The last thing they want is for someone to call in with something seemly trivial and have it turn out to be something quite serious. That's a lawsuit waiting to happen when "I called my doctor and he said I was fine." and then "My doctor said I'm fine but then I lost a limb.".

Re:Another excuse to reduce care levels, and costs (1)

thegarbz (1787294) | about 6 months ago | (#47634545)

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.

And that is actually part of the problem. There are many people out there who go to the doctor, get the whole 9 yards when all they really need is for someone to tell them they are fine. We have a service hear called 1300HEALTH. You call the number explain what you're seeing / what has happened and a qualified nurse will tell you if you actually need to see a doctor.

There are people who go to the doctor because they have a pimple, a stubbed toe, or in the case in our country need a medical certificate because they have a cough and don't want to go to work. You don't need those people clogging up the system.

Doctor.... (1)

Anonymous Coward | about 6 months ago | (#47627807)


nope (2)

BradMajors (995624) | about 6 months ago | (#47627825)

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.

Re: nope (2)

Rick in China (2934527) | about 6 months ago | (#47628379)

If someone wants your medical information, do you really think they'd have a harder time getting it from your doctor's office than say, eavesdropping your encrypted skype chat?

Re: nope (1)

Stan92057 (737634) | about 6 months ago | (#47630423)

Yes.. Criminals are lazy they wouldn't waste the time breaking and entering and then look through ALL them folders. For what to steal some guy or girls medical info??lol come on man are you really that non street smart?

Re: nope (0)

Anonymous Coward | about 6 months ago | (#47630499)

You are a moron. Medical records are electronic these days, even in rural Alaska. More to the point, you don't even have to steal them, you can just buy the data outright if you like.

Have you ever considered not posting? Your process of vomiting stupidity onto a screen is not so interesting that it bears any repetition. Seriously, get the fuck off this site, you're too dumb to be here.

Re: nope (1)

Rick in China (2934527) | about 6 months ago | (#47644997)

Street smart? How about technologically outdated and lacking any sort of insight into how the world actually works? I never said B&E. If you are *targetting* someone's medical records, what's more likely: find their/their doctors skype IDs, find the systems or networks they connect from, and somehow track/decrypt their encrypted skype conversations...and listen to what they are *talking about at the time*, which ultimately means a very small amount of insight to what you're obviously trying to get ahold of....

Or, accessing a MRDB and capturing some data?

I'd change your signature, I would only agree with the latter half.

Re: nope (1)

Stan92057 (737634) | about 6 months ago | (#47648061)

I stand by my comment! have a great day

All well and good (2, Insightful)

Barny (103770) | about 6 months ago | (#47627829)

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... (0)

Anonymous Coward | about 6 months ago | (#47627949)

Die owners of Windows XP and old Os-X's, die!!!

Even cheaper... (1)

hsthompson69 (1674722) | about 6 months ago | (#47627975)

...test the placebo effect. Put people in white coats with stethoscopes, have them nod knowingly, and give diagnoses based on whatever comes up in google first :)

Marijuana Prescriptions (0)

Anonymous Coward | about 6 months ago | (#47628019)

Skype is how a lot of doctors issue marijuana prescriptions in California...along with the prepaid 50$ fee for the "visit"

Dr. Gupta Will See You Now (0)

Anonymous Coward | about 6 months ago | (#47628137)

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.

And the most important skill... (0)

Anonymous Coward | about 6 months ago | (#47628191)

...is touching. But I'll bet you'll bill out at the same rate.

the Doctor? (0)

Anonymous Coward | about 6 months ago | (#47628241)

If it's good news I hope it's the 11th Doctor. If it's bad I think I want it from the 10th.

There have been Skype Doctors in Canada already (1)

future assassin (639396) | about 6 months ago | (#47628299)

mostly ones that sign for medical canabis.

Value of physical examination (1)

ponos (122721) | about 6 months ago | (#47628389)

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.

Re:Value of physical examination (1)

ComputerGeek01 (1182793) | about 6 months ago | (#47630233)

The physical examination should never be dispensed with in the long run. But in the case of a routine checkup for someone like myself, mid 20's non-smoking male, it seems like one of those things that is done just because I happen to be there anyway. Maybe the frequency of a physical visit could be cut down to once a year, or every 18 months with this system. It would mean one less potential scheduling conflict for the both of use without completely ignoring my health and if I could double book and have a check-up interview while I'm already away on vacation with the family then I'm all for it. The pointed questions that a doctor asks are the really valuable part of the check-up because something that sets on gradually, like my carpel-tunnel, isn't something that I would ever have noticed until it was far too late. But since my doctor knows what I do for a career and asked that one direct question; I can start to take steps to mitigate the problem before surgery is even a consideration.

Re:Value of physical examination (1)

nbauman (624611) | about 6 months ago | (#47632239)

You are correct. Thanks for the citation.

Kevin Pho wrote about this on his blog.

http://www.kevinmd.com/blog/20... [kevinmd.com]
A virtual office visit for your cold is not a good idea
Kevin Pho, MD | Kevin's Take | February 10, 2013

But something is lost through these virtual connections. There is value to face-to-face interaction, where a provider talks to and examines a patient in person. For example, I’ve seen a patient convinced that he had a sinus infection only to find that he had a tumor inside his nose. Another complained of minor ear pain, but after examining her, I saw that it had spread to the point where she needed to be hospitalized for intravenous antibiotics. Both of these diagnoses would have been missed had I only treated them over the Internet.

Without the ability to talk to and examine patients in the exam room, many doctors play it safe and reflexively prescribe drugs, whether patients need them or not. A recent study from the Journal of the American Medical Association http://www.medpagetoday.com/Pr... [medpagetoday.com] found that patients who were treated through Internet-based virtual visits had higher antibiotic prescription rates for their sinus infections, compared to patients whom were seen in the office.

That's actually Archives of Internal Medicine (now JAMA IM).
"Physicians ordered fewer tests, but prescribed antibiotics more often, when they evaluated patients for sinusitis and urinary tract infections (UTIs) via Internet-based virtual office visits versus in-person visits, a study of four primary care practices showed," as MedPage Today put it. Mehrotra A, et al "A comparison of care at e-visits and physician offices visits for sinusitis and urinary tract infection" Arch Intern Med 2012; DOI :10.1001/2013/jamainternmed.305.

It's frustrating to see how they keep prescribing antibiotics for sinus infections. You can't do a quick strep test on Skype (not that a negative strep test will stop many inappropriate prescriptions for antibiotics). JAMA IM had 2 articles lately about patients who got inappropriate antibiotics for sinusitis, and went on to Clostridium difficile, one of them fatal. It's interesting to see the answers doctors give when you ask them, "Why are you giving me antibiotics for a viral infection?"

Oh, you wanted to know what I thought of the value of a physical examination. I told my doctor, "I want whatever the U.S. Preventive Services Task Force says I should have." I want him to follow the guidelines, whenever there are guidelines. You can't do a lot of the stuff in the guidelines over Skype.

I'm not sure that you can do much more on Skype than you can over the phone. And my doctor (and his covering doctors) are not willing to do much over the phone, I think not because of the money but because they don't feel confident diagnosing someone over the phone. I'd like to be able to discuss things over the phone, with the understanding that I'd follow up with an office visit when appropriate. But doctors don't do that.

Last time I went to the doctor, it was because some nurse on the phone told me that, based on my symptoms, I might have heart failure. (It was ridiculous.) So there you go: standard exam for heart failure. In addition to listening to my history, my doctor listened to my chest, observed my neck veins, and ordered blood and urine tests. You can't do that on Skype.

Skype sounds like a gimmick, which may be appropriate in rural Alaska or Africa, but not in developed countries. Typical American marketing: You can do something equally well with a simple, cheap phone call or a fancy hi-tech teleconference. Which do you do?

There were studies which found that telephone psychotherapy was as effective as in-person visits. I wouldn't be comfortable with that, but if they have good published evidence for it, I'll go along with it.

Dr Who? (0)

Anonymous Coward | about 6 months ago | (#47628513)

Damn... When I saw the title I thought it was talking about Dr. Who and got all excited!

Easily stopped. (2)

SuricouRaven (1897204) | about 6 months ago | (#47628641)

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.

Prehospital Paramedicine (1)

superid (46543) | about 6 months ago | (#47629097)

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.

What I would like to ask these doctors: (1)

TranceThrust (1391831) | about 6 months ago | (#47629417)

Privacy, have you heard of it?

Dumb Profit Seekers (1)

fygment (444210) | about 6 months ago | (#47629423)

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'.

HIPAA will have a major cow ... (1)

CaptainDork (3678879) | about 6 months ago | (#47629449)

... and what about the sleeze buckets?

"Yes, dear, I have been assigned to you. Now, if you'll just slip out of the robe ..."

Better than Nothing (1)

robstout (2873439) | about 6 months ago | (#47629715)

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 tried it a couple days ago; I liked it (2)

sirwired (27582) | about 6 months ago | (#47629889)

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.

Re:I tried it a couple days ago; I liked it (1)

Stan92057 (737634) | about 6 months ago | (#47630335)

Was she a real doctor or a P.A? I have to tell ya many P.A do not tell you they are not doctors They wear whites just like the real docs. it really pisses me off because I am paying to see a doctor. if im being pushed off to a P.A then I should be paying half price...

May help us to not get sicker (0)

Anonymous Coward | about 6 months ago | (#47630125)

I see this as one way to prevent picking up other bugs while waiting at the doctor's office.

The Doctor? (1)

Zaatxe (939368) | about 6 months ago | (#47630139)

But... Doctor Who?

Symbian. (1)

Steve Barker (3478629) | about 6 months ago | (#47631453)

Not on my 808 Pureview! E-mail received today: Skype apps for Symbian are permanently retiring We've noticed that you are, or previously were, signed into Skype on a Symbian phone, and we're sorry to inform you that we are now permanently retiring all Skype apps for Symbian phones. As a result, within the next few weeks, you'll no longer be able to sign in and use Skype on any Symbian phone. You can still stay in touch with friends and family using Skype on an Android device, Nokia Lumia phone or desktop computer. You can sign into them all using the same Skype account. The latest versions of Skype for all your devices are available at http://www.skype.com/download [skype.com] . Do you have a Skype calling subscription? If you want to cancel your subscription please follow the instructions on this FAQ. Requesting a refund To see if you are entitled to a Skype Credit or subscription refund please contact customer support for more information. We apologize for any disruption caused, Skype
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