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Time for that check-up? Turn on the webcam!

By Sarah Klein

How would you like to get answers to all your medical questions by just tapping a few keys on your cell phone? A San Francisco start-up is hoping that dream will soon become a reality.

Truth On Call is a service that allows users to text a panel of physicians and get answers to pressing medical questions. While currently only open to members of the media, health care industry professionals and financial firms, the goal is to open up the service for regular patients in the not-too-distant future.

Sites like Truth On Call and NowClinic, a webcam consulting tool provided by insurer OptumHealth, are part of a general trend towards web-based services that aims to make doctors more accessible. Such services could be particularly valuable in developing countries, where people living in rural areas have limited opportunities for in-person care.

People without primary care physicians could also benefit, and text or web-based consultations may help relieve some of the pressure on emergency rooms.

But are "virtual" visits and hours of web surfing for self-diagnosis useful substitutes for regular face-to-face consultations?

"This is a pale imitation of a doctor's visit," David Himmelstein, a primary care doctor and associate professor at Harvard Medical School, told the New York Times in December. "It's basically saying, 'We're going to give up any pretense of examining the patient and most of the nonverbal clues that doctors use.'"

But others think this is just natural resistance to change and see virtual doctors' visits as a positive development.  "NowClinic gives you the ability to have that gut feel if something is wrong, in tone or facial expression or body language, that you have when you walk in the door with a patient," said Christopher Crow, a family physician, who tested the program in Texas.

A small 2008 study at Boston's Massachusetts General Hospital suggests consumers may agree. Eighty-six percent of the patients surveyed said they would recommend webcam visits to friends after having a virtual visit of their own.

Clearly webcam visits or text consultations aren't for everyone, but for people who would otherwise have little or no medical care, the virtual house call may be just what the doctor ordered!



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