But Witherspoon, an executive assistant at
Instead, she dialed
"It saved me a lot of extra time and energy," Witherspoon said. She estimates she's used
Employees wish more of their workers would do the same. This fall, employees in
So far, employees haven't warmed to the idea, either because they don't understand it, don't know it's available or because they're skeptical of getting a doctor's opinion via telephone. Telemedicine accounted for only about 1 million of 1.2 billion outpatient medical visits last year, according to brokerage and consultancy
About 70 percent of large employers offered telemedicine as a benefit this year, but only 3 percent of employees at those companies used the services in the year's first half, according to a survey of 133 companies, each with at least 5,000 employees, released by the
But companies looking to lower their health care costs and boost worker productivity increasingly are adding it as a benefit. If it catches on broadly with consumers, telemedicine could change the face of health care, altering the relationship between doctors and patients seeking relief from common maladies.
Here's how telemedicine works: A patient requests a consultation either by phone or online. Some companies have agents who take patients' medical histories over the phone before they speak to a doctor, and other companies have patients submit their medical histories online. Patients then wait at least a few minutes for a doctor to contact them. The doctor listens to the patient describe symptoms and asks questions. At that point, the doctor can decide whether to offer a prescription or tell the patient to visit a doctor in person.
The service was just what
"She didn't have a doctor out there," Bollinger said. "It would have been an emergency room visit for a sinus infection. It's kind of silly to do that."
Many say telemedicine is a win for companies and employees alike. If a worker gets sick with a minor illness when the doctor's office is closed, or if the employee doesn't have a primary care doctor, telemedicine is an alternative to an urgent care facility or emergency room. That can mean less time away from work, and can sometimes save workers, insurers and their employers, cash.
The typical telemedicine visit costs consumers about
Insurers might pay for most of those in-person costs, leaving employees with just a copay. Or employees might be stuck with a big chunk, especially if they're on high-deductible plans, which have become increasingly common.
So given the cost and time savings, why aren't more employees in
"I think the first challenge is employees often don't know about it," said
Most employers that offer telemedicine don't require employees to pay the full consultation fees, instead requiring a copay equal to what they would pay for a primary care doctor visit, Khoury said.
A lack of awareness, though, may not be the only obstacle for companies to overcome. Employees may wonder whether a doctor can accurately diagnose them without seeing them in person.
According to a study published in peer-reviewed journal JAMA Dermatology this year, researchers examining 16 teledermatology services found major diagnoses repeatedly were missed and prescribed treatments were sometimes at odds with existing guidelines.
He's concerned that telemedicine services offered to employees and other consumers don't always allow patients to choose their doctors. Also, the telemedicine doctors often don't have access to patients' full medical records and aren't in communication with their regular physicians.
"I think we've got lots of examples out there of seeing it done very well and other examples where there's room for improvement," said Resneck, a professor and vice chair of dermatology at the
The AMA recently released new ethical guidance for doctors participating in telemedicine.
Telemedicine advocates readily admit that such services aren't appropriate for all types of medical issues. People with potentially life-threatening illnesses or injuries still should go to the emergency room, and those with chronic conditions should be monitored by physicians, Khoury said.
Providers also typically don't prescribe controlled substances such as opioid painkillers or many types of sleeping pills. Many don't prescribe so-called lifestyle medications, such as Viagra.
But many services tout the qualifications of their doctors and their usefulness when it comes to treating certain common conditions, such as pink eye, sinus problems and urinary tract infections. All of
Gorevic said most of
"We're usually gone from home Monday through Thursday, in one to three cities at a time, so trying to (visit) a traditional primary care doctor is next to impossible," said
Employers hope more workers take advantage of the benefit the same way.
"If it helps them, I would love for them to make that their first call," Sears said. But, she added, "some people are just more comfortable calling their doctor, and that's fine."
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