远程医疗有它吹嘘的那么好吗？

    每次觉得自己要感冒时，我的第一反应就是用紫锥菊、抗感冒药和美清痰化痰片先进行自我治疗。通常情况下，我都会在几天内迅速好转。

    如果采用这些非处方药进行的鸡尾酒疗法不起作用，我就会乖乖去找家庭医生确诊病情。唯一的问题是：我讨厌看医生。别误会，我其实非常敬重他。25年来，不管是普通感冒还是大点儿的病，我都会去找他。让我厌烦的是，预约医生很麻烦，需要花费不少时间。

    我们都知道这是怎么回事。你到了医院，挂上号，然后就得在人满为患的候诊室等着，周围净是抽鼻涕和咳嗽的病人。五分钟至半小时后，终于等到护士喊你的名字，并把你带去诊断室。接下来又是等待。随后医生走了进来。十分钟后，你就会带着诊断书和难以辨认的处方回到大街上。

    我对远程医疗，或被称作远距离医学，已经好奇一阵子了。只需按下智能手机上的按钮，这种新型的医疗服务就能让你看医生。你可以把它视为医疗版的打车软件Uber。如果你关注科技圈，你肯定阅读过相关报道，并同样对此感到好奇。

    以Doctor On Demand公司为例，该公司自称是美国最大的远程医疗服务提供商。借助这项服务，你可以与经过职业认证，能够诊断普通病症，并开具处方药的本州医生进行一次类似Skype或FaceTime的简短通话。（由于各州法律法规不同，在阿拉斯加、阿肯色、爱达荷和路易斯安那州无法使用这项医疗预约服务。）

    最近，我用这项服务进行了一次模拟预约，想亲自体验一下与医学专家视频通话的感受。比起亲自就医，这样是否会少些麻烦？视频就诊的满意度会更低吗？

    登录演示账户后，我可以选择三种不同的预约：内科疾病、心理疾病或哺乳咨询。我选择了“内科疾病”。随后系统让我填一份表格来详细描述病情、症状和目前使用的药物。最后，它请我选择将必要的处方送往哪个药店。

    输入支付信息，并确认预约价格后，我就进入了病人等待队列。每15分钟的内科疾病诊断需要花费40美元。如果诊断时间耗尽，你还可以再用40美元来延长一倍时间。（根据我的保险条款，紧急看护的价格为175美元，而去急诊室则要300美元甚至更多。）过了两到三分钟，一位名叫伊恩•唐的内科医生接受了我的申请。随后，他仔细查看了我的症状——他说，在最初提交的表格上，病人通常会过度描述自己的病情——并开始了诊断。

    老实说，接受诊断时，我对整个就医流程都抱有怀疑态度。看着屏幕和医生对话让我觉得很没人情味。但当我联系上医生并与他开始对话后，我很快找到了之前与至爱亲朋无数次通过FaceTime交谈的那种熟悉感，感觉很放松。科技的冰冷感消失了。

    但对病人和医生来说，还有许多实际障碍需要克服。为了让医生检查你的身体，比如你的喉咙或是皮疹，你需要用手机和平板电脑拍下相应的照片，并通过医疗应用发给医生。我试图用台式电脑发送照片，但唐医生告诉我这项服务不支持非移动设备。这太让人失望了：你花了40美元，却不能做需要做的事。

    在面对唐医生的就诊过程中，我并没有匆忙的感觉，尽管这只是一次演示，不会有真正看病时的紧迫感和冷淡感。对普通的感冒来说，15分钟足够了。但对一些更为复杂的病症，分配的时间可能就会不够。

    如果我带着真正的病症来看唐医生，他可能会在切实掌握我的情况后作出诊断。Doctor on Demand公司首席医务官帕特•巴苏表示，95%的预约都在短时间内解决了问题，这意味着他们不需要再次看医生了（无论是亲自看，还是用Doctors On Demand进行后续预约）。剩下的5%则需要去急诊室，或是找主治医师做进一步的检查。

    在与Doctor On Demand的首席执行官亚当•杰克逊交流时，他明确表示：这项服务并不是试图取代你的家庭医生。（他把它比喻成现代的护理热线。）不过，Doctor On Demand也能给你当场治疗。

    在这次模拟预约之后，我给家庭医生打了个电话，看看他对病人偶尔使用这种虚拟服务有什么看法。他对此并不感兴趣，不过他也承认自己的思想有些老派。尽管如此，他并没有彻底回避这个问题。他主要是担心由于对身体检查不足，远程治疗可能会遗漏一些线索。

    他抓住了问题的关键。你有没有疑惑，为什么你每次看医生抱怨喉咙痛时，医生都会检查你的脾脏？脾脏增大和喉咙痛是单核细胞增多症的症状。你的小孩发高烧了？这可能是小问题，但也可能是脑膜炎发作。医生只有检查了身体才能确诊。

    但不可否认，在孩子生病或是出差感染鼻窦炎急需治疗时，有了Doctor On Demand这类虚拟服务，你只用按下手机按钮，就能得到医生的专业指导。这会让你内心安定许多——即便医生最终还是建议你去急诊室。

    我不想再次生病，但我确实期待着将来能有这一天，我只要解锁手机，按几个按钮，就能躺在自己舒适的沙发上享受医疗服务。谁知道呢，也许某天我的家庭医生也会出现在屏幕上。（财富中文网）

    译者：严匡正

    Whenever I start to feel like I’m coming down with a cold, my initial response is self medicate with a mixture of echinacea, Airborne, and Mucinex. More often than not, I’m usually back at full speed within a couple of days.

    For the times when my cocktail of over-the-counter medicine fails me, I submit and make a visit to my family doctor for a proper diagnosis. The only problem is: I hate going to the doctor. Don’t get me wrong; I think the world of him. I’ve been going to the guy for the last 25 years for everything ranging from the common cold to more severe ailments. It’s the amount of time a doctor appointment takes out of my day that leads me to squabble.

    We all know how this goes. You arrive and check in, only to wait in a waiting room full of other sick people sniffling and coughing. After anywhere from five minutes to an hour, a nurse finally calls your name and escorts you to the exam room. More waiting. In walks the doctor. Ten minutes later, you’re on the street with a diagnosis and an illegible prescription.

    For awhile now I’ve wondered about telehealth, also called telemedicine, the new type of medical service that makes a doctor available at the push of a button on your smartphone. Think of it as Uber for doctors. If you’re into technology, you’ve no doubt read stories about it and wondered the same thing. (And yes, Fortunehas published its fair share.)

    One particular company, Doctor On Demand, claims to be the largest provider of video visits in the nation. The service offers what amounts to a brief Skype or FaceTime call with a board-certified physician located in your state who can diagnosis and prescribe medications for common ailments. (Due to varying laws and restrictions, a medical appointment isn’t possible in Alaska, Arkansas, Idaho, and Louisiana.)

    I recently made a mock appointment with the service so that I was able to see just what it was like to video chat with a medical professional. Am I able to get a diagnosis with less hassle than an in-person visit? Is a video appointment less satisfying?

    After signing into the demo account, I was given the option to choose from three different types of appointments: medical, psychological, or a lactation consultation. I chose “medical.” The service then asked me to fill out a questionnaire detailing my illness, symptoms, and current medications. At the end, it asked me to select the pharmacy to which I’d like to have any necessary prescriptions sent.

    After entering payment information and agreeing to the price for an appointment, I was then placed into a queue of patients waiting for a doctor. Each 15-minute medical appointment will set you back $40. Should you run out of time, you can opt to double the appointment for another $40. (Compare that price to an urgent-care visit for $175 or a visit to the emergency room for $300 or more, based on my insurance policy.) It took about two to three minutes for a physician to accept my request, after which Dr. Ian Tong reviewed my symptoms—patients tend to go overboard on initial questionnaires, he said—and began the appointment.

    I went into the appointment admittedly skeptical of the entire exercise; staring at a screen and talking to a doctor seemed too impersonal to me. But once I was connected and talking to a doctor, the familiarity of countless FaceTime calls I’ve held with loved ones quickly came back. This was easy. The tech faded into the background.

    There are stilllogistical hurdlesto overcome for patient and doctor alike. To allow the doctor to inspect a body part—your throat, for example, or a rash—you must take a photo with your phone or tablet and send it through the app for inspection. I tried to send a photo using the desktop computer I was using, and Tong informed me that the service won’t allow it on a non-mobile device. That’s a huge frustration if you’ve spent $40 and can’t do what’s required of you.

    I didn’t feel rushed at all during my appointment with Dr. Tong, though it was of course a demo and lacked the urgency or detachment that comes with a real ailment. For the common cold, it was enough time. For something more complicated, the allotted time may not have been sufficient.

    Had I come to Dr. Tong with a real illness, he would have made a diagnosis after he felt he had a solid grasp on my condition. According to Doctor on Demand’s chief medical officer Pat Basu, 95 percent of appointments end with a short-term resolution, meaning no further visits (whether in person or follow-up with Doctors On Demand) are required. The remaining 5 percent are referred to the emergency room or a primary care physician for further examination.

    When I spoke with Doctor On Demand’s CEO Adam Jackson, he made it clear that his service isn’t meant to replace your family doctor. (He likened it to a modern-day nurses hotline.) Still, Doctor On Demand has the ability to treat you on the spot.

    After my mock appointment, I called my family doctor to see what he would think if one of his patients started using a virtual service from time to time. He wasn’t enthusiastic about the idea, but admitted that his way of thinking is probably a little old school. Still, he stopped short of shunning it altogether. His main concern? Missing clues because of the lack of a physical examination.

    He’s got a point. Ever wonder why your doctor checks your spleen each time you go in complaining of a sore throat? An enlarged spleen combined with a sore throat are symptoms of mononucleosis. Have a small child with a high fever? It’s probably minor, but there’s a chance it it could be meningitis. And the way a doctor is able to tell is with a physical exam.

    But there is undeniable peace of mind in knowing that, with a virtual service like Doctor On Demand, you have a doctor available at the push of a button to give professional advice when a child is sick—even if that advice results in a trip to the emergency room. Or, when you’re on a business trip with a full-blown sinus infection and desperately need medication.

    I’m not looking forward to the next time I’m sick, but I do wait with great anticipation for the day when I’m able to unlock my phone, tap a few buttons, and receive medical care from the comfort of my couch. And who knows: Maybe one day I’ll find my family doctor on the other side of the screen.