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Technology Brings Change to Doctor’s Visits

Lisa Love of Twin Falls in the western American state of Idaho has not seen her doctor of 25 years since she started using a healthcare service called telemedicine.

With telemedicine, a person can contact a doctor from wherever they are using a smartphone or other device and discuss their health concerns in a video conference.

Love no longer waits for the doctor’s office to open. She does not even have to leave her home. She used virtual visits last summer for help with a skin problem and returned for another small issue. She told the Associated Press she does not feel the need to seek care in the traditional way, especially since she also gets free health exams at work.

Last year, the Kaiser Family Foundation, a healthcare research group, found that about 25 percent of adults in the United States do not have one doctor they visit often. That jumps to 45 percent for those under age 30.

Some people like Love wonder how much they still need a regular doctor. “Telemedicine probably can’t do everything … but for most of the things I might ever have, I’m pretty sure they can take care of it,” she said.

Other people have moved to walk-in clinics and urgent care centers. And more medical services are using teams of professionals to keep patients healthy. They limit visits with a doctor to just the more serious cases.

Health care experts say the changing, disconnected nature of care is exactly why people still need someone who looks out for their overall health.

That has been the traditional responsibility of family doctors. They know patients’ medical histories. And they are trained to identify problems instead of just dealing with the symptoms that led to the patient’s visit. They also can make sure different medicines work together, as well as help make sense of information patients find with an internet search.

Sam Glick is an executive with the research firm Oliver Wyman. He said the idea of a family doctor as the single best solution for everyone is changing a great deal.

This change began years ago when drugstores started providing anti-flu injections and opening clinics that handle minor issues like ear infections. The two largest drugstore companies in the U.S., CVS Health and Walgreens, now run about 1,500 clinics combined.

More recently, employers have started adding work place clinics. And thousands of urgent care centers have opened around the country to treat emergencies that are not life-threatening. Then there is telemedicine.

Love said she loves the virtual visits. They only cost $42, or less than half the price of an office visit under her insurance plan.

“I like technology and I like new things and I like saving money,” Love said. “It was worth it to me to try it.”

On top of all the competition for patients, the field also is fighting a shortage of doctors as medical school students aim for higher-paying specialties.

Health care services have changed by adding physician assistants or nurse practitioners to cover yearly physical examinations and other minor care.

They are also creating teams that help them take a wider look at patient health. Those teams might include mental health specialists who look for depression and health instructors who can improve diet and exercise.

The idea is to keep patients healthy instead of waiting to treat them after they become sick.

“We want to do as much outside the walls of the clinic as we can,” said Megan Mahoney, a doctor with Stanford University in California. She noted that this push depends on insurers expanding what they will cover.

Doctors say the team-based services are changing their relationships with patients. Harvard Medical School professor Russell Phillips, also a doctor, often answers emails or questions from his patients. He also connects them with clinics for minor issues like urinary tract infections.

Phillips says health care is changing into more of a flowing, virtual relationship where patients have shorter visits with their doctors more often. Traditionally, patients would usually only visit their family doctor maybe two times a year.

“Getting medical care is such a complex activity that people really need somebody who can advise, guide and coordinate for them,” Phillips said. “People still really want a relationship with someone who can do that.” I’m Alice Bryant.

And I’m Pete Musto.