The decade that began with Covid is the decade of telemedicine, and we’re not even halfway through the 2020s. One outcome of Covid is that more and more people became comfortable talking to a doctor on the phone. Also, more health plans and Medicare began to accept telemedicine as a normal way to consulting with physicians. Prior to Covid, Medicare did not reimburse telemedicine in most cases. Beginning March 6, 2020 the Trump administration announced telehealth services would be available to seniors across the country. John Goodman recently wrote about it in the post, “What Difference Has Telemedicine Made?”
TelaDoc, founded in Dallas in 2002, is the largest telemedicine provider in the country. When the firm was founded talking to a doctor on the phone was uncommon. Having a consultation on the phone, rather than a follow-up, was almost unheard of. TelaDoc was careful to say their physicians were not a substitute for your personal primary care physician. Rather, their doctors were for those times when you could not get in to see your doctor. Nonetheless, the business model upset the stodgy medical establishment. The Texas Medical Board went after TelaDoc in 2011, ultimately deciding that telemedicine was only legal after a face-to-face office visit. The New York Times described it this way:
The Texas Medical Association and other groups representing doctors in the state strongly supported the new restrictions, citing concerns about patient safety. In a letter to the board, the association said it “supports the use of telemedicine that can provide safe, high-quality, timely care,” but that safeguards must be in place “to protect patients and ensure telemedicine complements the efforts of local health care providers.”
The restrictions were really an attempt to protect brick & mortgage physician practices from competing with doctors practicing medicine from a home office with a phone. TelaDoc ultimately won the battle. That victory paved the way for the expansion of telemedicine nationwide. Nowadays TelaDoc has dozens – if not hundreds – of competitors. Even large companies like Amazon and Walgreen advertise virtual care.
During and after Covid something else happened. Entrepreneurial providers and investors began looking for newer and more novel ways of using telemedicine. Mental health apps sprung up to take advantage of smartphones. Therapists and their patients could (in theory) converse from anywhere. I wrote about it in “Anxious, Depressed? There’s an App for that.”
In addition to mental health, other specialty or narrow scope telemedicine practice models came about. The most common new telemedicine practice type appears to be for erectile dysfunction. A short phone call (more likely an email) results in a prescription and sometimes a mail order subscription for generic Viagra. Some examples are Blink Health, Friday Plans, Hims, Keeps, Lemonaid Health, RexMed, RocketRx, Roman, Sesame Care, ZipHealth, etc. I could go on and on. Some of these offers little more than Viagra while most have a narrow but somewhat broader practice area. There are similar telemedicine providers who make it easy to obtain birth control, like Alpha Medical, Hers, Lemonaid Health, NuRx, Optum Perks, Pandia Health, The Pill Club, and many others.
A recent development that is especially encouraging are virtual practices that specialize in neglected segments of patient care. For example, Hims & Hers specializes in men’s and women’s health. Firms like Alloy, Pandia Health, Interlude Health, ThriveLab, and many others specialize in women’s health and hormone replacement therapy. It’s easy to dismiss websites that dispense Viagra to men filling out a form and paying a nominal fee as pill mills. Yet the $30 to $40 fee is cheaper and far more convenient than a traditional office visit to a primary care physician (assuming the men even have one). Something that is much harder to dismiss are firms that specialize in balancing women’s post-menopausal hormones. An online search finds few traditional physicians’ practices that specialize in hormones. Those that do are often concierge practices that charge thousands per year in fees. I found numerous telemedicine practices that manage hormones and ship them to your door for fees that are only a fraction of concierge practices.
Something else that telemedicine has done is blur the lines between doctors and drugstores. Many telemedicine firms not only prescribe medications but also sell them and ship directly to you.
When I began writing this post I planned to list as many of the telemedicine firms as I could find. I quickly discovered there are so many that listing them all would be impossible. Indeed, finding them all among the veritable plethora of firms would be a huge endeavor. I even ran across one called, “JoePill.com.” The age of telemedicine has finally arrived.
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