Crafting an "Improved" Medical Practice Model

Mr. HIStalk, with his tongue inserted firmly into his cheek, has come up with what he refers to as an ideal medical practice model (boldface emphasis mine):

Here's my foolproof medical practice idea: just give cash-paying patients whatever they want since they're the ones paying. No one likes going to the doctor, so charge $1,000 a year for never allowing (much less requiring) the patient to come in, wait, undress, and fidget. No physicians, no preventive care, no ongoing monitoring. Just send that check and your prescriptions will come back in the mail in a Netflix-like practice model. By the time the patient figures out they were ill-served by not getting care, they'll probably be dead (or seeking another doctor, anyway).

The crux of his idea, at least from the physician's perspective, is very sound -- avoid medical malpractice by avoiding what we now view as medical practice. In addition, from the patient's perspective, one avoids time-wasting and risky exercises such as waiting to be seen by your physician in a room filled with sick people. But wait, let's take the nub of his proposal and run with it. It may be possible to develop a practice model where you never need to travel to your physician's office.

I have been intrigued by the TelaDoc Medical Services business model for delivering healthcare described by the company in the following way on its home page:

• Get personalized, non-emergent medical care on your own time without having to go to the doctor’s office
• Medical care is just a phone call away
• Prescriptions phoned to your local pharmacy 24/7

The basic concept is that you are linked via telephone to a licensed physician whenever you need help. Here's the price list for the TelaDoc standard plan. For a primary user, the cost is $18 for registration, $35 for each consultation, and a monthly fee of $4.25 for the single plan (primary user only). A relatively large number of people appear to be enthused about the program. The company web site notes that the company has just signed up its 1,000,000th member.

But let's further assume that such a plan is linked to one of the web-based direct access lab testing (DAT) programs (see: Adding a DAT Option to Corporate Wellness Programs) and perhaps even linked to web-based wellness and preventative medicine programs (see: Assessing the Value of the Annual Physical Exam). I believe that in many ways, stitching together such medical practice model could result in better health outcomes for some health consumers than they now experience at a much lower cost and greater convenience.