Online house calls click with doctors

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Online house calls click with doctors

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online4feb04,1,6443533.story?ctrack=2 & cset=true

By Costello, Los Angeles Times Staff Writer

Dr. Christy Calderon, a family physician at Kaiser Permanente's

Whittier office, conducts as many as half her appointments over the

phone or online with a 3-inch camera affixed to her desktop. " It adds

a more personal touch, " she says.

With insurers starting to cover them, virtual office visits for minor

ailments, follow-ups gain popularity.

By Consulting your family physician is finally moving into the 21st

century and out of the doctor's office.

Since the dawn of e-mail, patients have been pleading for more

doctors to offer medical advice online. No traffic jams, no long

waits, no germ-infested offices with outdated magazines and bad

elevator music.

There was always one major roadblock: Most health insurers wouldn't

pay for it.

Until now.

In recent weeks, Aetna Inc., the nation's largest insurer, and Cigna

Corp. have agreed to reimburse doctors for online visits. Other large

insurers are expected to follow, experts say.

These new online services, which typically cost the same as a regular

office visit, are aimed primarily at those who already have a doctor.

The virtual visits are considered best for follow-up consultations

and treatment for minor ailments such as colds and sore throats.

But some specialists, including cardiologists and gynecologists, also

see these e-mail tete-a-tetes as ideal for periodic checkups that

don't require in-person visits.

" People can wait a long time to get in to see their primary-care

doctor and longer for a specialist. . . . To have immediate access is

huge, " said Dr. Welch, Aetna's Northern California medical

director.

As more doctors move online, others are looking further ahead and

adding webcams to their online arsenal, even if the video quality

remains spotty.

Dr. Christy Calderon, a family physician at Kaiser Permanente's

Whittier office, conducts as many as half her appointments over the

phone or online with a 3-inch camera affixed to her desktop. " It adds

a more personal touch, " she said.

Although actual doctor visits aren't likely to disappear, the recent

moves are evidence that long-delayed efforts to bring American

medicine into the digital age may be gaining momentum, experts say.

" Paying doctors to do more patient care over the Internet is a small

but important step in a good direction, " said Cutler, a Harvard

University healthcare economist. " It increases patient access and

could significantly improve their satisfaction. "

If so, it comes at an auspicious time.

Doctor visits in the United States have surged 20% in the last five

years to more than 1.2 billion visits annually, according to the

Centers for Disease Control and Prevention. Even as the population

ages, the number of doctors is falling across the country, and

experts predict that office wait times will increase in the coming

years.

Meanwhile, at-home devices that remotely check patients' blood

pressure and diabetics' sugar levels are becoming cheaper, and tech

leaders Google Inc. and Microsoft Corp. are expected to introduce

products this year to simplify patient care and put medical records

online, although neither company plans to assist in online physician

appointments.

Some in the medical community envision a day when patients take their

vital signs each morning and send the results to their doctor by

computer.

But can a doctor really diagnose patients via pixels?

Critics, including many doctors, contend that online medical care

carries risks. Some worry that mistakes are bound to happen and that

the practice raises several hard-to-answer ethical questions.

" It's perfectly appropriate that we use 21st century technology in

the 21st century, " said California Medical Assn. President Dr.

S. enstein, an Orange County pulmonologist. " The concern

I have is that [online visits] are simply not a substitute for an

actual doctor. "