SMARTER STRATEGIES

The iPhone Doctor Debuts

John Jainschigg | Date: 06-18-09 | Comments

One family doctor takes her practice on the road, bringing back the house call�with the help of an iPhone. Do the pros outweigh the cons?

A recent squib in MobiHealthNews by Brian Dolan offers a hopeful new take on family medical practice enabled by technology. After 10 years in a conventional pediatric patient-mill clinical practice in St. Louis, Personal Pediatrics founder Dr. Natalie Hodge packed up her laptop and Palm and went mobile, working out of the back of her car and seeing just six or seven patients per day in classic house call mode. She structured the venture as a "concierge" practice: charging families a flat fee per child to cover house call services, pharma deliveries and other perks, including one checkup per child per year.

Along the way, with the help of third-party medical records software makers and consultants, Dr. Hodge evolved a digital tool kit that today lets her and other Personal Pediatrics affiliate physicians run their mobile practices on an iPhone, using the device to gain access (in HIPAA-compliant fashion) to patient medical records, forms-filing infrastructure for insurance, and a complete practice management system, plus e-mail, voice mail and other communications tools.

The technology is so efficient, she reports, that an individual doctor need hire, at most, one administrator, instead of the five that might normally be required to run records, phones, insurance management and other facets of a conventional practice. Thus fewer patients, less stress and more money in the doctor�s pocket at the end of the day.

I�m trying very hard to hate this idea. As recently as 30 years ago, house calls were simply what doctors did�something they still do, for nothing, in countries like France that have national health programs. As much as I esteem efficiency through technology, this particular iPhone upgrade seems to come at the cost of pink-collar jobs. And at $1,500 per child in addition to insurance, this health care option is aimed primarily at people of means�unemployed medical office workers will still need to drag their kids to the clinic.

On the other hand, as a parent, I can very easily see spending this kind of money (less, ultimately, than I spend on a mobile phone in a year, let�s face it) so as to never again sit in a doctor�s waiting room with an uncomfortable, feverish kid for 2 hours, only to gain 5 minutes of physician attention and a routine throat swab; and to help solve the enormous logistical problems a two-career household faces whenever a child is ill or needs routine medical care. Presuming the insurance is being covered by a benevolent and financially stable corporation, going out-of-pocket for this level of added flexibility (You mean, you�ll coordinate with my kid�s school to give them their checkup and DPT shot at school, in the nurse�s office? Really? I don�t have to take half a day off work? Really? Yes, really.) seems pretty much a no-brainer.

Further, it should be noted that Dr. Hodge�s experiment in iPhone-driven mobile efficiency doesn�t involve remote control of neuro-surgical robots on the Hubble Space Telescope�we�re just talking about a couple of Web apps and an e-mail client here. Her worklife, in other words, is now just like yours: She deals with simple online software tech directly and uses it to advance a process, communicate and solve problems. The fact that she�s achieved a 5-1 reduction in staffing and a 4-1 reduction in overhead thereby, while earning more money and providing better care, is pretty stark testimony to the effect that conventional medicine is badly, badly broken, and doctors are mostly living in a fantasy world 30 years out of date, where "professionals" have "staffs" to take care of "paperwork."

I dunno about you, but I like my fantasy�where doctors do house calls�a lot better.