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Introduction & Part 1: How Healthcare is Trending

Written by S.O.

Posted on January 2, 2015 at 3:20 am

Why Telemedicine is changing the healthcare landscape and redefining the meaning of a Doctor’s “Office” visit.

By Steve Okhravi, MD, MBA, CPE

If you ask a patient what they think about the average Dr.’s office visit they’ll often tell you:

a) The don’t like to wait for the physician,

(1) The average Primary Care Physician’s in-office wait — prior to getting in front of the

Doctor after you’ve shown up for your scheduled appointment–can be an hour or more

(2) Patients are frequently put in the cue for an office visit that could take weeks to get an appointment on the Doctor’s Calendar

b) The cost of an office visit can be high (this affects insurance premiums and deductibles—out-of-pocket payments grow annually.

c) Travel to- and from- the medical office can be troublesome; and

d) If patient’s could — for certain non emergency ailments — they would much prefer to simply speak to the Doctor on the phone, describe what’s ails them, and get a response… particularly if the symptoms are:

(1) Not life threatening; and

(2) Simply because the patient does not feel “up to par.”

(3) More often than not, the patient just wants a healthcare professional’s opinion about therapy.

The Telemedicine concept is not new, and certainly has its pros and cons pending the actual circumstances and symptoms presented by the patient. However, and get this, as many as 70% of all Doctor’s office visits can be handled over the phone according to a recent study by the Affiliated Works Association. Given the pro’s of this statistic and the added efficiency in the global cost of healthcare in dollars and time spent there are many more reasons to be a proponent of Telemedicine, than not to be one. In fact, I’m so confident about using mobile technology to respond to that statistic that I’m creating a platform and a resource to do just that. I call it DocChat, there’s an APP for it!

And I’m betting there’s a huge market locally first, nationally second and globally third…in my phased rollout of the DocChat platform. While in its most basic sense, it will be Smart Medicine practiced on a Smartphone for those technologically savvy enough to embrace the idea and go for it.

Here’s why:

Traveling the healthcare world and chatting with patients and physicians alike reveals astounding insights about the future of medicine to treat certain symptoms.

Here’s the deal:

we think an office visit is the blueprint for treating patients one-on-one, but the reality reveals something quite different. I will share these insights in this paper, explaining what it means for the way we work as physicians and how to the technological trend towards “Democratizing Medicine” is a force that will move more to not leave the comforts of their current locations to get care anytime, AND anywhere they need it.


Links to sourced information are placed in the ‘Further Reading’ section, at the end of the final (No.7) section of this essay.


If you ask a patient in Ashburn, Virginia what their main struggle is, they will tell you that Doctor’s appointments are hard to come by. AND, that they have to wait to see the Doctor, when they finally show up for the scheduled appointment. The net result of many an office visit is to get a prescription filled. And, perhaps, requests to call the office back in 3-5 days to discuss how therapy is going. This is remarkably what a patient says in Los Angeles or Washington, DC or Warren, Michigan or Lady Lakes Florida, or Flower Mound, Texas for that matter.

If you ask a Primary Care Doctor in Argentina ‘how’s business?’ they will tell you that the main way they see patients is still through office visit’s–probably because they’re not wired into a Telemedicine solution despite the widespread knowledge of it’s existence. However, Doctor’s find that that the same applies in the Philippines.

In a conversation with a Greek patient on why patients travel to a Doctor’s office to get a treatment opinion for everyday ailments they say they would just as soon speak to a physician on the phone. Though she had no feasible answer as to why the old traditions prevail. Doctors and patients in Italy and Greece are somewhat baffled about whether a primary care office visit is necessary–most of the time–when Telemedicine can save all parties time, money and result in accessing quality care in a timely manner.

The list goes on. What’s happening here?

Let’s not cast our focus on the individual issues with a Doctor’s Office Visit by-phone.

Instead, let’s think about the pattern of behavior, which sketches a wider perceptional phenomenon.


“Telemedicine around the world is not only thriving. It’s growing in leaps and bounds…except for us.”

Humans love giving explanations.

We all want to explain why various phenomena occur, such as the lack of Telemedicine adaptation by patients locally despite an international trend of growth, success and widespread benefits as a collective consciousness sees this as a user-friendly way to treat common ailments. At the same time, we often hear news about success stories and viral acceptance from all around the world.

We urged to explain why this happens to them, but not to us. And it’s a reasonable thing to ask.

First things first, the urge to explain seems to be ingrained in our culture; we make snap judgments of people’s perceptions, habits and tendencies. So, that we can protect ourselves from potential encounters that embrace a sea change in the old way of doing things.

Resistance to change is a basic human survival mechanism. And, an explanation is helpful in cases where we have a basic desire to perpetuate predictable, repetitive behavior.

Once the usual explanation has been offered, we proceed to the rationalization process; we protect ourselves from any argument that changes us from our explanations. We seek signs of confirmation, while anything that opposes to our daily views is marginalized to be “for someone else to practice—not us.”

We’re only humans. We have and hold explanations for everything, including our healthcare even when we don’t seek the data to make informed, progressive decisions. It seems like a lifelong pursuit of “it worked last time, so why change”…despite the fact that there could be a far better way.

An explanation is nothing but a non-decision-making tool:

it helps us follow our pre-ordained instincts; it’s a way to keep track of our predetermined logic and go-forward plan to survive the latest aches and pains of this rash or that flu-symptom. But uninformed explanations keep us from moving forward, improving our quality of life—bringing all the consequences of repetitive, old-school patterns to bear the burden of stalled progress.

Why is this reference here?

We notice a common pattern in people’s perception around the world, a stereotypical notion that is allegedly accepted as true, even if it has not been researched so far. I’ve explored the online libraries for related research without merit.

It has long been thought that patients embrace office visit challenges (cost, wasted time, travel, long waits for appointments, etc.,) merely because of their rationalization that this

“is the way it is.”

It is believed, in other words, that there’s nothing really wrong with the current system (traditional office visits for common ailments) while other cities, countries and cultures may have considered Telemedicine as a viable source for healthcare. This would simply explain why there are a number of Telemedicine solutions reported on daily and additional participants coming into the fray predicting unprecedented growth in the months and years to come.

I’ve learned this trend is so because of my Metro NYC Urgent Healthcare Practice’s ( associations with Doctors, Practices, Hospital Systems, Payers and Patients the world over and, because of my travels and visits to culturally diverse areas. I also love discussion with Doctors and Patients and hearing their treatment stories. After numerous conversations–including those with local practitioners and patients–it is
undeniable to me that the majority faces the same problems. A local Patient in Philippines is hit by the same symptoms as one in Los Angeles. Parisian and Milanese Physicians come across the same basic treatment issues.

We suspect we’re all different, but really we’re much more alike than we consider.

What do patients actually believe that their main problems are? I can tell you, because I have asked them. (Cont’d on Part 2)


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