Wall St Journal story about online diagnostic services...and more

Ruth Ryan ruth.ryan at IMPROVEDIAGNOSIS.ORG
Mon May 16 12:54:33 UTC 2016


Study of Telemedicine Finds Misdiagnoses of Skin Problems 

Online medical services are booming, but physicians remain concerned 


The JAMA Dermatology study involved 7 general medicine websites and 9
dermatology sites. Researchers created 6 secret shopper scenarios with skin
conditions, sent stock photos and provided more details for the patients to
give if asked. The study found failure to ask key follow up questions,
missed diagnoses, failure to warn of risks of meds prescribed, failure to
ask about PCP or send reports to PCP, and more. One such service when
queried for this article responded there was no doctor-patient relationship
established by the consultation (!).


In the same issue, May 16, the Letters to the Editor column reproduces
several physician responses to an earlier opinion piece I missed, Abraham
Nussbaum's May 9 Op Ed "When Doctors Stop 'Seeing' Patients".  The Op Ed
concerned the loss of facetime, literally, when clinicians stare at the
computer screen or make entries during pt appointments, missing key
observations and clues to diagnosis. One responder commented, "Until the
delivery of care is separated from the means by which it is reimbursed,
patents won't be 'seen' because physician have their eyes on the clock or
the EMR rather than on the patient."


Question: Is reimbursement a barrier to good diagnosis? Should or can it be
taken on as an issue to improve diagnosis and if so, how?

Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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