Keeping Medicine at the Heart of Telemedicine

For years, I trained and worked as an ENT and surgeon at institutions like Stanford and Yale. Then, to the surprise of many, I left to join a telemedicine startup.

The truth is, I was growing tired of the traditional ways of doing medicine and wanted to do more. While the field of medicine is full of smart, driven and talented people, it’s easy to become myopic. As physicians, we tend to do things a certain way because that’s how they’ve always been done — without necessarily asking how they can be done differently.

Enter telemedicine.

The past decade has seen explosive growth in digital health and telemedicine services. In 2018, digital health startups raised $14.6 billion with a fourteen-fold increase since 2010. According to the American Hospital Association, 76 percent of hospitals now offer tech-enabled care to patients. Even insurers are embracing telemedicine: Cigna has committed $250 million to fund health care startups and emerging companies focused on digital health, care delivery and analytics.

Telemedicine is creating a new reality for how health care is delivered, but not without skepticism. Critics often question how these businesses are run. Specifically, how do digital health businesses ensure patient safety? How much is medicine really at the heart of these businesses?

As a clinical director at a telemedicine startup, my job is to provide a medical perspective on business practices and product development. This means using my knowledge of what happens in a doctor’s office and applying it online, such as providing the medical rigor for the dynamic online doctors visits, treatment plans, physician guidelines for practicing telemedicine, frequently asked questions for important safety information and more.

To deliver safe, high-quality care, it’s crucial that medical professionals are involved at the heart of the innovations that are changing health care in the 21st century. This is why I left full-time clinical practice to help build the next wave in health care technology. 

Entrepreneurs and engineers are great at building software and devices. However, we also need the professionals who have dedicated years to health care delivery and the practice of medicine, or else this transformative effort will be wasted on building things that do not adequately solve the problems the American health care system presents, such as cost and access.

In 2017, Merritt Hawkins conducted a survey that showed that the average wait time to see a primary care physician in major markets in the United States is 29.3 days. Through telemedicine, patients can avoid long wait times for appointments and skip the waiting room altogether.

For instance, 96 percent of patients who successfully complete Ro’s dynamic online visit hear back from their doctor within 24 hours. This can have a huge impact for people living in areas where physicians are scarce and for whom time is limited, such as hourly workers, single parents and patients with multiple dependents.

But that doesn’t even consider monetary cost. The average cost to see a primary care physician in America is $106, which would be 10 percent of someone’s monthly income on the poverty line. One of the reasons we’ve seen this surge in telemedicine use is that these companies offer price transparency and a low, flat fee to “visit” with a physician.

Low income or uninsured individuals are able to access high-quality physicians without breaking their daily routine or their bank account. On a macro level, telemedicine startups have the ability to take some air out of the system, easing federal and state budget spending on health care every year.

But what good will telemedicine do for patients if there are not enough physicians on the other side? The good news is a recent Doximity report found that in the past three years, the number of physicians who self-reported telemedicine as a skill doubled, increasing 20 percent per year. Physicians are using telemedicine to complement their brick-and-mortar practices as supplemental income to their full-time positions or as a full-time option for physicians who want more flexibility.

In addition to telemedicine platforms for general care, there are others that specialize in dermatology, depression, men and women’s health — the list goes on. By focusing on a small group of medical problems, physicians can become subject matter experts in a relatively short period of time.

Physicians also opt for telemedicine part time or full time as a result of the growing physician burnout in America. It’s no secret that rates of burnout, depression and  suicide are higher among physicians than the general public. In the 2018 Medscape National Physician Burnout and Depression Report, 42 percent of physician respondents reported burnout.

What’s worse, WebMd reported that a physician commits suicide in the United States every day, making medicine the profession with the highest rate of suicide. For some, telemedicine offers the opportunity to save careers for some doctors contemplating leaving medicine. For others, it may serve as a short-term bridge during a challenging time.

This is exactly why I work in telemedicine. This pioneering field has the ability to change health care as we know it, harnessing the power of technology and the expertise of medicine to bring quality, affordable care to as many people as possible. It also has the potential to ease the pressure on physicians in America.

Though it won’t fix all of the problems in our health care system, telemedicine can provide working solutions to some of our most common pain points.


Dr. Melynda Barnes, MD, is the vice president of Medical Affairs and Research at Ro and clinical director for Rory, Ro’s women’s health vertical, and she is also a double board-certified facial plastic and reconstructive surgeon and otolaryngologist.

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