Social Medicine: Would You Attend Interactive Group Therapy on YouTube?

Since Covid all manner of digital health enterprises have sprung up to take advantage of the growing popularity of telemedicine. Telemedicine websites make it easy to get a prescription for Viagra, hormone replacement therapy, and even primary care. However, The Healthcare Blog explains that digital health investments have not been profitable for investors. Indeed, numerous big companies that found primary care clinics not as lucrative as they had hoped.

I have my own theory on why convenient care and telemedicine has not panned out for investors. Family physicians earn about $275,000 a year. They probably can’t answer more than five calls or emails an hour. That works out to 10,000 patient encounters a year at $27.50 apiece just for the physician’s time. Many health plans don’t cover telephone consultations, and billing insurers would require several more people in an office, further boosting labor costs. While investors may forecast promising reimbursements of, say, $200 for each patient encounter, I’d be annoyed if my 10-minute call to request antibiotics for strep throat cost that much. Among health plans that pay for email consults, the average claim was $39 in 2021 (total patient and health plan shares).

Nonetheless, digital health has a huge following. I don’t mean tons of people willing to drop $200 for a 10-minute video chat with a physician. I’m referring to recent data that found about half of Generation Z turns to TikTok for health information. They follow health influencers on TikTok because it’s both convenient and cheap (free actually).

Surveys going back 20 years have consistently found that more than 100 million Americans search online for health information annually. Google reports there are roughly 70,000 health related searches every minute. One article even claimed doctors use Google and YouTube to learn about disease and conditions they treat. Speaking of YouTube, exact numbers are hard to come by but there are likely to be thousands of doctors posting content. Some of the best known YouTube doctors have millions of subscribers. Dr. Mike (Mikhail Varshavski) has 12.4 million YouTube subscribers and a total of 25 million across all his social media platforms. His 800+ videos have been viewed 3.5 billion times.

Patients can choose from among hundreds of thousands of YouTube videos on every medical topic imaginable, all for free. YouTube has different types of viewers. Most pay nothing, watch videos and do not bother to subscribe. Others subscribe for free to get notifications about new content. A few subscribers even pay for membership in return for exclusive content. There is also Patreon, a payment platform for patrons to pay YouTube content creators for additional benefits, including participation in live events. Up to this point all I’ve really talked about is entertainment. You watch a video because you’re interested and it’s free. YouTube has the potential to be more than just free entertainment, however.

In years past I wrote about interactive group therapy for medical care, including an article appeared at The Healthcare Blog and a brief mention in Anxious, Depressed? There’s an App for that. Google owns YouTube and is a huge investor in digital health. YouTube would be a great way to provide interactive group therapy. Hint: social media is about groups.

Any one of the thousands of physicians on YouTube could create interactive group practices. At various times patients could log on to participate in video chats or live events on different health topics. One hour it could be hypertension, another about high cholesterol. Instead of one-on-one discussions about birth control with your doctor (resulting in a prescription accompanied by a $200 fee), maybe 100 women would attend a video chat or virtually event, where they can ask questions and listen to the answers along with other attendees. If each viewer needing a prescription paid a nominal fee of, say, $20, the revenue would be $2,000. Of course, monetizing the group medical services would need to be worked out, and practices would not all have to work alike. Would people be willing to pay for a group video consult? I bet they would, especially if it results in both better knowledge of their health and a prescription. The alternative would be an expensive in-office physician visit.

Some old school medical boards will probably say this sounds like unmitigated quackery. A decade ago, the Texas Medical Board (TMB) ordered TelaDoc to stop providing telemedicine to patients without a prior in-person doctor/patient relationship. TelaDoc sued and TMB ultimately lost.

Leveraging the power of social media to provide interactive group medical care is a way to get patients convenient access to a lot more care at prices far lower than they currently pay. That’s probably reason enough for some in the medical establishment to oppose it.