Doctor Patient Relationships - A Practical Reform Solution: Doctor-Patient Connectivity

Today I spoke to Ed Fotsch, MD, CEO of Medem.com. Out of our conversation came one practical solution to many of our health cost and effectiveness problems.


Ed used a hockey metaphor to make his point: skate towards where the puck is going. The puck is clearly headed toward health plan- pharmaceutical company- patient-doctor connectivity focusing on partnerships between the three.


Ed said the managed care wars (pay less to do less) are over, and a new market paradigm (pay doctors more to enlist patients in online programs) to coordinate care, promote wellness and prevention, and educate patients about drug compliance is gaining steam.


Think about it this way. If the typical primary care patient has 2000 patients in his/her network, and with help of health plans and drug firms, educates them online, reminds them online of dangers of drug non-compliance , and failure to take preventive steps or modifying behavior, health of patients will improve and costs will drop.


The key to this scenario is rewarding doctors financially for connecting with patients. This approach makes sense for all parties. Doctors make money for doing the right thing, patients get timely relevant information, health plans and pharma provide online informational tools to improve care, and liability companies can lower premiums with better outcomes.


It makes sense in other ways, too. In the Bridge to Excellence coalition, if doctors can show they have created a “medical home” through patient online connection links,they'e eligible for annual awards of $125 per patient. The medical home concept – backed by The American Academy of Family Physicians. American Academy of Pediatrics, American College of Physicians,l and American Osteopathic Association - engages patients having a personal physician. These doctors receives payments for leading a practice network that coordinate acute, chronic, preventive, and end-of-life care facilitated by online information. In a sense, this is what so-called pay-form-performance progams are about.


There are other possible benefits as well.


• Doctors can connect online with patients at minimal expense: no expensive electronic medical records system is required.


• No extra time is required by doctors, who can simply link to automatic online patient education, prevention, and educational programs.


• An automatic database is generated, allowing doctors to compare their patient outcomes and compliance to other doctors.

• Doctors can save time: company, Formedic.com, permits patients to generate their own medical history based on review of systems, chief complaint, and symptoms, which save 4 minutes per patient encounter.


• Medical liability companies have expressed an interest in lowering premiums proportionate to the number of patients in the doctors online network connections.

• Health plans and pharmaceutical companies become partners in promoting better outcomes and better health, rather than nettlesome micromanagers or aggressive drug vendors.



The age of internet medicine, focusing on positive doctor-patient relationships, aided by health plans and pharmaceutical companies, enhancing rather than disrupting those relationships, facilitated by Internet links, and improving care in the process, is poised for arrival.