Telemedicine A Critical New Approach To Primary Care

Telemedical treatment has been a tantalizing possibility for many years, for reasons including a failure of health plans to pay for it and too little bandwidth to support it, but those reasons are quickly being trumped by the need for quick, cheap, convenient care.

In fact, according to research by Deloitte, 75 million of 600 million appointments with general practitioners will be via telemedicine channels this year alone.

While one might assume that this influx is coming from traditional primary care practices which are finding their way online, that doesn’t seem to be the case.

Instead,a growing number of entrepreneurial startups are delivering primary care via smart phone and tablet, including Doctor on Demand and HealthTap, which offers videoconferences with PCPs, and options like Healthcare Magic and JustAnswer, which offer consumers the opportunity to get written responses to their healthcare queries from doctors.

Primary care doctors going into direct primary care are also joining the primary care telemedicine revolution; a key part of their business is based on making themselves available for consultation through all channels, including Skype/Facetime/Google Hangout meetings.

To date, most of the thinking about telemedicine have been that it’s an add-on service which is far to one side of the standard provision of primary care. However,with so many consumers paying out of pocket for primary care — and virtual visits typically priced far more cheaply than on-site visits — we may see a new paradigm emerge in which victims of  high-deductible plans and the uninsured rely completely on telemedical PCPs.

Rather than being merely a new technical development, I believe that the delivery of primary care via telemedical channels is a new form of ongoing primary care delivery.

It will take some work on the part of the telemedicine companies to sustain long-term relationships with patients, notably the use of an EMR to track ongoing care. And telemedicine PCPs will need to develop new approaches to working with other providers smoothly, as coordination of care will remain important. Health IT companies would be wise to consider robust, unified platforms that allow all of this to happen smoothly.

Regardless, the bottom line is that primary care telemedicine isn’t an intriguing sideline, it’s the birth of a new way to think about financing and delivery of care. Let’s see if traditional providers jump in, or if they let the agile new virtual PCP companies take over.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • MedLion, one of the nation’s largest Direct Primary Care companies, has taken a dive into telemedicine technology itself. The MedWand ( was invented by MedLion CEO Dr. Qamar, and allows patients to be examined remotely over secure internet connections. The handheld and affordable device will soon be available to all MedLion Direct Primary Care patients, but will also be licensed to existing telemedicine companies to advance the telehealth industry.

  • This is precisely the demand-based trending that led us to develop such applications as “PicSafe” and “MoleQuest”.

    The real limitation, thus far, to the “mobile technological fix” that is staring us directly in the eye, is the omnipresent proprietary nature (aka, profiteering and resultant “turf warfare”), demonstrated by the private healthcare sector players involved “in the discussion”, which serve to limit true, incipient, “out-of-the-box” thinking and innovation; particularly that component of innovation which relates to “clean connectivity” between existing systems (id es, sine middleman margins…). I would simply counsel caution on the parts of these well-ensconced players, as they are risking being left behind within their tiny eddying niches along the fast-flowing river of remote healthcare delivery.

    At the end of the day, however, the only ultimate outcome that matters (or should, anyway), is that we as a society can provide inexpensive yet effective methods by which to quantitatively and qualitatively improve our patients’ health outcomes. Really is just that simple.

    Dr Carner

  • Who does tele-medicine help more, the doc or the patient?

    I get it that rural areas may not have a specialist on site and tele is a great way to prevent the patient from having to drive hours to see a specialist, but this post doesn’t seem to focus on, or mention this.

    I personally would like the option to “see” a doc/nurse via phone or video, though I’m fortunate enough to have a healthy family that doesn’t require many trips to the doc.
    I do already have access to a nurse hotline and don’t recall actually using it.

    But back to my question: is this a way to better serve patients (if so how) or a way to increase revenue (by “seeing” more patients).

    I’m also curious as to how many virtual appointments turn into real visits – the higher number of real visit follow ups would seem to point to the virtual visits not being as economical as expected.

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