This began before COVID-19, but the explosion of telehealth has really raised a lot of questions for doctors when it comes to what the future of their profession will look like. One of the cores to these changes is that if the visit is done using telehealth, do I really care if the doctor I see is part of my health system or not?
Ok, insurance still rules the day in a lot of ways, but many major telehealth companies can use your insurance or they already have a deal with your insurance company. At that point, a telehealth visit feels very much the same whether it’s through a telehealth only platform or with a doctor from a larger health system. Some people are taking this discussion so far as to say that these telehealth platforms are the new virtual health system and they’re going to replace the current health systems as we know it.
This is why we wrote previously about the potential for channel conflict between Enterprise Telehealth Solutions and Health Systems. With announcements like the Teladoc Health Merger with Livongo and now MDLive’s announcement that they’re looking at an IPO, you can see how these large telehealth companies really are going to be competitive with health systems. Sure, they’ll continue to cooperate in some ways, but their direct to consumer telehealth options are going to compete with an office visit at the health system.
Once an office visit is equalized using telehealth, do I really care if it’s with the health system or a large telehealth provider?
You may if you’re a chronic patient that needs coordinated care across a whole network of providers. Health systems may also try to make the case that staying within their system means that your health data is available to all your doctors. However, if you’re a relatively healthy patient, do you care about any of this? Especially if the direct to consumer telehealth company is more convenient? Convenience seems to rule the day in so many situations in healthcare.
As telehealth companies start to compete with health systems for patients, will they also start competing with them for doctors? While there are no doubt many doctors that are more comfortable with a larger health system, others are going to really embrace the opportunities and flexibilities that an all telehealth job can afford them.
In some ways, this reminds me of what happened with Netflix. At first, Netflix was really friendly with the movie studios since they were buying a lot of DVDs from the studios to make their business work. Even when they shifted to providing streaming services, they were still paying licensing fees to the movie studios. Eventually, Netflix has gone all in on creating their own content. They’re still working with the movie studios, but their emphasis is on their own content and they often find themselves competing with the studios for that content.
Sounds a bit like enterprise telehealth. At first they started offering their telehealth product to hospitals and health systems. Then, over time they also added the option for them to provide coverage to the health system that needed their telehealth company to see patients when their staff weren’t available. Eventually, you can see where the patient has more of an affinity towards an enterprise telehealth vendor who provides them convenient care and services without ever touching the health system. To make this a reality, telehealth companies will have to compete with health systems for the best clinicians.
Of course, no telehealth company will talk about this because they need to continue working with health systems. However, it’s not hard to imagine the day that doctors have to choose between working for a health system, going on their own, or working for a telehealth company.