Dr. Marie Savard Answers: Does Telemedicine Work?
Thursday May 29, 2008
If you are looking for a diagnosis, should you go to one of the "Internet diagnosis" web sites to get medical advice? Dr. Marie Savard, a frequent contributor here at the About.com Thyroid site, and ABC Good Morning America's medical contributor, ran a test to evaluate some pay-for-advice medical Web sites to see how they would advise a patient, based on her stated symptoms.The patient was a 35-year-old woman with unexplained itching and fatigue. Three sites were used. The first site told her to have her thyroid checked. Another site told her to get tested for hypothyroidism and diabetes. And a third site told her she had urticaria (chronic hives).
According to Savard, "It's totally, totally upsetting. It totally reduces medicine to piecemeal work."
Find out what health problem the patient actually had, and how it would have been diagnosed. There is also accompanying video.
For more from Dr. Savard, read: Dr. Marie Savard: "Women Must Take Charge of Their Own Thyroid Health"
Photo: Marie Savard
Comments
What the article failed to do was then visit 3 doctors in person and see what the results were. From personal experience I find M.D.’s equally inept whether online or in person. If you don’t do your homework don’t expect help from docs. However, doctors are very good at reading test results. Best to advise doc what tests you want and then look up what results mean for yourself.
This wasn’t a very good piece of journalism, nor did Dr. Marie do a scientific study. GMA has a vested interested in getting the results they wanted since not only do they hire doctors for their health segments but the drug companies that are a huge revenue stream for them work predominately with doctors in in-person situations and the online and telemedicine doctors often offer patients more natural, less expensive treatments that cut into the drug companies profits.
If she wanted to do a real study she would have done a blind one where a third party controlled it and the sample size of doctors and patients in the study groups were larger. Then they would compare the live doctor results with the telemedicine (neither knowing what the actual patient issues were) and compare. I can guarantee the telemedicine averages would not be any significantly different than in person.
Enlarged lymph nodes would NOT have told an in-person doctor that the person had Hodgkin’s. My lymph nodes have been swollen since 1990 and every doctor has dismissed it and none tested me for Hodgkin’s. Swollen lymph nodes with rashes are common in thyroid and adrenal disease so the docs who suggested thyroid testing were very on target because most doctors test for the more common things first before assuming cancer. Being on the phone doesn’t change that approach. Only blood tests would tell them that which the telemedicine docs did suggest. GMA already knew what the patient had so it was a setup. I would like to see them do it blindly where they don’t know what the patient has anymore than the test doctors do.
From my experience it took 20 years of doctors who couldn’t even properly read my labs and I still could not get a diagnosis when I already knew much of what was wrong. It took an online doctor, first one, then two more to help me solve the puzzle. However, just like shopping for a doctor in person you have to choose the right doctor which means paying attention to how they respond to your questions as well as what type of questions they ask you. With telemedicine patients can send digital photos in advance, give more in depth written history to be reviewed before the actual phone call, and you get your doctor’s undivided attention unlike office visits where you pay $200 for 15 minutes of them barely looking at your file. In addition, the telemedicine doctors will often respond to you via email at no charge (several have helped me for free).
So in my personal experience, my in-person doctors have rated from the best being “C” to many “F;s” and my online and telemedicine doctors have been “B+ to C’s” so I am much more impressed with the latter. I also find the telemedicine doctors tend to be much more organized and more respectful of my time, likely knowing since I am paying by the minute or hour that I am also more conscious of it.