Mount Sinai Health System in New York is starting to offer video visits for primary care patients. In Philadelphia, Jefferson University Hospitals now lets patients have video follow-up visits with internists, urologists, and ear, nose and throat specialists. The difference now is that patients can be wherever they want and use their own smartphones or tablets for the visits, which are trending toward more basic care. While telemedicine consultations have been around for decades, they have mostly connected specialists with patients in remote areas, who almost always had to visit a clinic or hospital for the videoconference.

Health systems, facing stiff competition from urgent care centers, retail clinics and start-up companies that offer video consultations through apps for smartphones and tablets, are increasingly offering the service as well. But many more states are embracing the new world of virtual house calls, largely by updating rules to allow doctor-patient relationships to be established and medications to be prescribed via video. Legislatures and medical boards in some states are listening carefully to such criticisms, and a few, led by Texas, are trying to slow the rapid growth of virtual medicine. Some doctors assert that hands-on exams are more effective and warn that the potential for misdiagnoses via video is great. Medicare, which often sets the precedent for other insurers, strictly limits reimbursement for telemedicine services out of concern that expanding coverage would increase, not reduce, costs. “This feels empowering: You just click a button and the doctor comes to you.”īut telemedicine is facing pushback from some more traditional corners of the medical world. “I’m terrible about going to the doctor, just because of the time it takes,” Ms. DeVisser, fluent in Skype and FaceTime and eager for cheaper, more convenient medical care, are trying them out. Health systems and insurers are rushing to offer video consultations for routine ailments, convinced they will save money and relieve pressure on overextended primary care systems in cities and rural areas alike. The same forces that have made instant messaging and video calls part of daily life for many Americans are now shaking up basic medical care. DeVisser, a stay-at-home mother, had an antibiotics prescription called in to her pharmacy. He looked her over, asked some questions and agreed she had sinusitis. She typed in her symptoms and credit card number, and within half an hour, a doctor appeared on her screen via Skype.

She sat with her laptop on her living room couch, went online and requested a virtual consultation. One night, when her face turned puffy and painful from what she thought was a sinus infection, Jessica DeVisser briefly considered going to an urgent care clinic, but then decided to try something “kind of sci-fi.”

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