Dr. Howard Stark moved his private practice from his original base in Washington to the Internet. Answering 14,000 e-mails since his online practice began two years ago, he is less a harried doctor and says he feels more like a small town family doctor.
Dr. Stark's practice allows him to provide answers to questions that used to be managed through phone calls and office visits. Through the use of e-mail, he feels he is better able to maintain a personal bond with his patients.
As reported at about this time last year, doctors were beginning to switch to the use of electronic prescriptions via the Web. Web-enabled prescriptions allowed for fewer errors in medications and dosing. At that time, the question was raised as to how much patient care would be provided via new technology as it became available. And how much would be too much, leading to degradation of patient services. Dr. Stark may be pushing that envelope.
He does not charge for answering an e-mail. "You have to come in one time a year for an annual exam," Stark said.
The rest is free — prescription refills, quick questions about medication, even questions about unusual stings.
"What do I get? A picture of the scorpion that bit the patient in Belize," Stark laughed. "I said, 'it would have been better to send me a picture of your leg.'"
Dr. Stark believes that the demand for a doctor's time is being pushed to the limit. Desk staff are double and triple booking the doctor's time, and the time that the doctor is able to spend with the patient averages ten minutes.
Working part time and leveraging technology, Dr. Stark is able to spend at least a half hour with each patient.
Patient security is managed through the use of a unique Web site designed by Dr. Stark and a couple of friends called DoctorsOnTheWeb.com. Through this site, any doctor can manage his or her practice as Dr. Stark is doing. And so far, three other doctors are signed up to use the site.
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The system works like a bank's Web site. To avoid putting confidential information in e-mails, patients work on a secure server. If Stark wants to contact them, they get an e-mail merely directing them to pick up a message at the password-protected site.
It allows patients to ask about their health as issues arise, instead of waiting for the annual exam. "If you have any questions, it's so nice to shoot an e-mail," Stark said.
He can direct patients to the emergency room, if appropriate, to see a specialist or set up an appointment for an examination. Stark stresses that he does not make medical decisions based on an e-mail.
But no one has to wait until business hours. "I'll refill your prescription from Barcelona," he said.
So, is this the wave of the future? I can think of many times that I have had to make, and pay for, an office visit just so a doctor could tell me that whatever I had been treated for is resolved. As a former ER nurse, I can recall numerous times that people spent many hours in Emergency for something that could have been resolved by phone. Is electronic medicine the right way to go, or are we trusting too much to technology?