Private doc does "e-visits" by email or webcam

Jay Parkinson is a private physician practicing in Williamsburg, New York. In addition to house and office calls, he'll examine your boo-boos by emailed photos or webcam and let you know whether you need stitches, cream, or a pat on the head and a lollipop.

An e-Visit is a rapidly emerging concept that uses communication technology to manage health and disease. Many doctor visits can be avoided by simply talking with your doctor, or emailing photos, or video chatting face-to-face. Nearly every young adult has a digital camera or phone camera. Video chatting is becoming increasingly more common. I believe in harnessing these ubiquitous technologies to optimize your health. It's the wave of the future for affordable healthcare.

Link (via Apophenia)

• [Josh Michtom]

  Teresa: Fair enough (and you win my non-Williamsburg-but-very-much-Brooklyn-native heart by dissing Queens).

• [David B]

  Meh. If it’s not Manhattan, it’s not NYC.

• [dculberson]

  David B., my brother had an MRI and the initial billing (before the insurance-negotiated reduction) was $1900. The insurance co. negotiated rate was $950. So if you get an MRI without insurance, you’re gonna pay a hell of a lot more than $800-$900, skewing it even more in the favor of your scenario.

  I think the “negotiated rates” are the biggest scam present in the health care system today. The exact people that can’t afford to pay for health care (the uninsured) pay the most for services. Why is that okay? Ohio was discussing a law requiring fixed rates for all services (equal between all patients regardless of payment type) and hospitals cried that they would be run out of business. Bunk. If they can afford to do an MRI for $950 paid by an insurance company, they can afford to do it for $950 paid by an individual.

• [Josh Michtom]

  I hate to pick nits, but Williamsburg, although trendy, has not yet attained the status of meaningful political subdivision. It is just a neighborhood and should not be allowed to shrug off the storied borough in which it is situated. Therefore, please refer to the place where this doctor practices as “Brooklyn, New York,” or “the Williamsburg neighborhood of Brooklyn,” if for no other reason than to avoid further muddling non-New Yorkers’ conception of the city’s geography. Thanks.

• [Teresa Nielsen Hayden/Moderator]

  Josh Michtom (1): Yeah, but if you said “Brooklyn” someone would ask which part, and then you’d wind up saying “Williamsburg” anyway.

  Could be worse. Could be Queens.

• [David B]

  This post piqued my interest, and I checked out the site. Seems to be an intelligent guy who honestly cares about reducing healthcare costs for young folk, but his math is a bit fuzzy. This is all based off of having PPO insurance.

  I’m a young healthy professional living in NYC who is married to a doctor. I get BlueCross PPO through my employer for 45 bucks a month, or $540 a year, and my wife gets her insurance from the hospital she works at. Office visits and prescription drugs cost $10, and I don’t need referrals to see a specialist because I’ve got PPO and not HMO insurance. I would also like to note that I don’t make a ton of money, and that even at 22, working for a non-profit straight out of college, I still had PPO insurance.

  Dr. Parkinson is a huge fan of high-deductible healthcare plans which, as he explains on his site, have the individual pay for the first $2500 of care by themselves. While he might offer unlimited “e-visits”, only providing two face-to-face appointments per year seems a bit stingy. There are literally thousands of things that could happen to you during the course of a year, and not just things that happen to the old and sick, that require doctor’s visits or minor surgery or bloodwork. I will concede that lots of problems can be solved over the phone or via email, but not everything. And if you’re using one of your two allotted annual appointments for a physical, as everyone should, then that leaves you with only one appointment a year.

  Back to my insurance costs – $540 a year. I see a doctor for a physical once a year, $10. The bloodwork is free. I get a rash a few months later, I see a dermatologist for $10 and get a prescription for $10. I get headaches that won’t go away and I see my GP for $10, a neurologist for $10, and get an MRI for free. Let’s say I hurt my knee – this one actually happened to me this year. I see an orthopedic surgeon recommended to me by a friend for $10. I get an x-ray there for free. He tells me to start on physical therapy. Once a week for two months. $10 times 8 is $80.

  Add all these things up, things that could possibly happen in a single year, and you pay $680.

  Now, if you paid for Dr. Parkinson’s services, you give him $500 to become a patient. The physical is free appointment number one. Let’s say that later on you get a rash. He diagnoses it over videochat even though he’s didn’t have a dermatology residency and writes you an Rx. You have to pay for the prescription. In all likelihood it’s a generic, so even without insurance maybe you’re lucky and only pay $20. Not so bad. You get headaches. He wants to take blood pressure and do bloodwork, so he visits you. That’s your second and final free visit. He refers you to a neurologist who will charge you $300-$400 for the visit, not including the $600-800 charge for the MRI. God forbid you hurt your knee. He can’t see you, you’ve used your visit. That’s $150 per additional visit. Or maybe he referred you to the neurologist earlier without seeing you. Say you have the one visit left but still have to pay $200-300 to see an orthopedic surgeon and pay $100 for the knee x-ray. Physical therapy? My physical therapist, who was good but certainly not the most expensive in the city, charged $155 an hour.

  You don’t even have to add up the numbers. Unless you’re lucky and you never need any sort of screening, or a prescription for a patented medicine – he also mentions acne on his site, retin-a micro is patented – then you’ll most likely end up spending far more money with him than you would with a traditional healthcare PPO plan.

• [David B]

  This post piqued my interest, and I checked out the site. Seems to be an intelligent guy who honestly cares about reducing healthcare costs for young folk, but his math is a bit fuzzy. This is all based off of having PPO insurance.

  I’m a young healthy professional living in NYC who is married to a doctor. I get BlueCross PPO through my employer for 45 bucks a month, or $540 a year, and my wife gets her insurance from the hospital she works at. Office visits and prescription drugs cost $10, and I don’t need referrals to see a specialist because I’ve got PPO and not HMO insurance. I would also like to note that I don’t make a ton of money, and that even at 22, working for a non-profit straight out of college, I still had PPO insurance.

  Dr. Parkinson is a huge fan of high-deductible healthcare plans which, as he explains on his site, have the individual pay for the first $2500 of care by themselves. While he might offer unlimited “e-visits”, only providing two face-to-face appointments per year seems a bit stingy. There are literally thousands of things that could happen to you during the course of a year, and not just things that happen to the old and sick, that require doctor’s visits or minor surgery or bloodwork. I will concede that lots of problems can be solved over the phone or via email, but not everything. And if you’re using one of your two allotted annual appointments for a physical, as everyone should, then that leaves you with only one appointment a year.

  Back to my insurance costs – $540 a year. I see a doctor for a physical once a year, $10. The bloodwork is free. I get a rash a few months later, I see a dermatologist for $10 and get a prescription for $10. I get headaches that won’t go away and I see my GP for $10, a neurologist for $10, and get an MRI for free. Let’s say I hurt my knee – this one actually happened to me this year. I see an orthopedic surgeon recommended to me by a friend for $10. I get an x-ray there for free. He tells me to start on physical therapy. Once a week for two months. $10 times 8 is $80.

  Add all these things up, things that could possibly happen in a single year, and you pay $680.

  Now, if you paid for Dr. Parkinson’s services, you give him $500 to become a patient. The physical is free appointment number one. Let’s say that later on you get a rash. He diagnoses it over videochat even though he’s didn’t have a dermatology residency and writes you an Rx. You have to pay for the prescription. In all likelihood it’s a generic, so even without insurance maybe you’re lucky and only pay $20. Not so bad. You get headaches. He wants to take blood pressure and do bloodwork, so he visits you. That’s your second and final free visit. He refers you to a neurologist who will charge you $300-$400 for the visit, not including the $600-800 charge for the MRI. God forbid you hurt your knee. He can’t see you, you’ve used your visit. That’s $150 per additional visit. Or maybe he referred you to the neurologist earlier without seeing you. Say you have the one visit left but still have to pay $200-300 to see an orthopedic surgeon and pay $100 for the knee x-ray. Physical therapy? My physical therapist, who was good but certainly not the most expensive in the city, charged $155 an hour.

  You don’t even have to add up the numbers. Unless you’re lucky and you never need any sort of screening, or a prescription for a patented medicine – he also mentions acne on his site, retin-a micro is patented – then you’ll most likely end up spending far more money with him than you would with a traditional healthcare PPO plan.

• [Anonymous]

  The guy is also a fantastic photographer. http://flickr.com/photos/darkshapesprowl/