By this point, I imagine most of us are familiar with forums like the WebMD and Revolution Health, where consumers can get broad, carefully-couched responses to none-too-urgent health questions from resident MDs. It's safe to assume that consumers usually don't count on such provider responses as a last resort, since if nothing else, they don't usually get an instant response.
But lately, a new form of interactive forum has sprung up that makes it possible for a patient to have what could be termed an instant telemedical consult with a provider--immediately and on the spot. On JustAnswer.com Health, patients can pose question of just about any kind--and in exchange, are asked to pay a fee typically ranging from $9 to $15, on average.
Another site, LivePerson.com, allows the patient to have a live text chat or even a phone call with the provider right away, anytime of day or night, as long as the provider has made themselves available. LivePerson.com customers pay a per-minute fee of $2.99 per minute or more for an experienced specialist MD, or less than $1 per minute for some naturopathic and New Age healing practitioners. Users can consult directly with a pharmacist if they aren't comfortable with their meds, a social worker or psychologist if they're having a mental health crisis, or a cardiologist if they're having troubling cardiovascular symptoms (though one would hope, of course, that they'd go to the ED first!).
For those who are online-savvy, you'll see that these sites are a natural outgrowth of such efforts as Yahoo Answers, which gives users the chance to pose a question and pay a small fee if someone provided an answer they liked. But the extent to which real-live, on-demand medical information is being offered here is another beast entirely.
Now, as an analyst/observer, and not a clinician, I have no opinion as to whether this is clinically appropriate. (As a consumer, I've actually used these services--once to get a second opinion on a drug interaction issue--and found it to be quite satisfying.) But rightly or wrongly, I believe that these are platforms that will work serious changes into the way online medicine is delivered. What we're calling an "e-visit" now will pale beside the live text, voice and eventually web conferencing sessions doctors will be able to hold.
The only question is how to harness this force for good. Probably, some standards are in order, quickly, governing what practices are and are not appropriate in this new telemedical space.
And now, I open it up to you. Check out LivePerson and JustAnswer for yourself, then tell me: What will it take, if anything, to make them the most safe, effective form of medical help they can offer? Or do you think they shouldn't exist? Let me know what you think! - Anne