As Bob Dylan sang, “The Times They Are AChangin’”… but it sometimes takes a little longer for change to occur in the healthcare world. Consider Skype, for example. Most people are familiar with Skype, and even grandparents are able to use it for video chats, but doctors have been slower to adopt it to their practices. Of course, fear of reimbursement, liability and HIPAA issues may be the cause of that, but slowly and surely doctors are turning to new technologies such as Skype, tablets, and apps to connect with their patients and, yes, even sales representatives.


According to Manhattan Research’s Taking the Pulse U.S. 2011 study, 7% of U.S. physicians use online video conferencing to communicate with patients. Dr. Jeffrey Spiegel, MD, Chief of the Division of Facial Plastic & Reconstructive Surgery at Boston University Medical Center, is one doctor who uses Skype almost every day. For him, Skype is great for new-patient screenings: They can get comfortable with him and see if he is a good fit, before they even consider an office visit. He also uses it for quick follow-ups with post-op patients who have a little area they want him to check out.

Dr. Spiegel also believes that Skype provides patients with a great level of service. He understands that people are busy and a “quick” 15-minute appointment can actually take up to three hours when you consider the time it takes to drive, park, register, and wait. Skype can turn those three-hour, 15-minute appointments into actual 15-minute appointments.

It also helps to expand a doctor’s practice. More than half of Dr. Spiegel’s practice comes in from out of state or even out of the country, including patients from Afghanistan, Iraq, Japan, China, Australia, and New Zealand. Of course, doctors cannot practice medicine in states or countries in which they are not licensed, which is just one of the reasons why Dr. Spiegel chooses not to charge for these Skype conversations, but that doesn’t mean he wouldn’t eventually like to.

“I think that doctors should be able to charge for these things. It is a patient visit, and the doctor is putting in the time and effort,” he says. “Anytime there is a new technology, it takes a while before payers recognize that this is a legitimate practice of medicine, whether it is the technology of surgery or a method of interacting with patients.”


Dr. Navin Singh, MD, a plastic surgeon in the Washington, D.C., metropolitan region, uses another new method to connect with patients—Trend Watch apps. ModYourBod is a free app available on the iPhone, iPod Touch, and iPad that lets you upload a picture of yourself and then modify different body parts to get an idea of how you would look after a nip and a tuck. You can send these virtual before and after pictures to Dr. Singh’s practice, Ivy Plastic Surgery, and request a quote or just schedule a consultation right through the app. The app also helps educate potential patients about plastic surgery with detailed explanations about specific procedures and various educational videos.

According to Dr. Singh, a handful of patients have found him strictly through the app, and he has had patients come in from up to three states away, including New Jersey, Delaware, and North Carolina.

“Patients expect surgeons—and plastic surgeons in particular—to be on the cutting edge of technology, both in and out of the OR,” Dr. Singh says. “They want doctors to be relevant and up-to-date, whether they are using lasers in the OR or iPads in the office.”


Both Dr. Singh and Dr. Spiegel use tablets in their practices. When patients walk into Dr. Spiegel’s office, they are handed a tablet to enter their medical history, reason for visit, how they are feeling, etc., and it is all uploaded to their electronic medical record. Meanwhile, Dr. Singh says, his office has pretty much eliminated all printed materials in the practice and replaced them with iPad apps, PDFs, and PowerPoint presentations.

This is another trend that is slowly catching on. According to Manhattan Research’s Cybercitizen Health U.S. 2011 study, 5% of U.S. consumers who have seen a doctor for a consultation in the past 12 months said their physician had shown them a video, picture, or other information on a smartphone or tablet during the consult.


Doctors are using this new technology to connect not only with their patients, but also with pharmaceutical sales reps. Twenty percent of ePharma Physicians* receive live one-on-one presentations with pharma (either by office sales rep, call center rep, medical science liaison, or key opinion leader), according to Manhattan Research’s ePharma Physician 2011 study. This includes presentations over the phone, VoIP, and video conferences, according to Monique Levy, Vice President of Research at Manhattan Research.

In their latest study, Manhattan Research broke eDetailing down into three categories: self-directed (or virtual detailing), webcasts or webinars (which are one-to-many), and one-on-one presentations. Levy said that interest, in general, looks high for all three types of programs, and they tend to be quite valuable.

“We see that physicians seem to be getting quite a bit out of these experiences, so if you look at their satisfaction on various measures, everything sort of indicates that these are useful and valuable sessions for them,” Levy says.

For the most part, the doctors would agree. Dr. Spiegel has yet to do a live one-on-one video conference with a sales rep, but he is not opposed to it, and he might even prefer it.

“I think that it is better than a phone call, and it can be more convenient for everybody,” he says. “I feel guilty when someone comes to visit us and I am behind with patients and they end up waiting 20 minutes for me. I don’t like that.”

He also said he would definitely prefer the video conference over self-directed programs and webinars, which can waste 30 minutes on the stuff he knows before getting to five minutes worth of new stuff. With one-on-one interactions, however, you can get to “the meat of the issue fast.”

On the other hand, Dr. Singh is not much of an eDetailing fan. “I think there is a level of commitment when you see someone in-person, in your office that I look for,” he says.

But still no one can deny that the times are a-changing, and doctors are beginning to establish themselves in this virtual world.—Andrew Matthius

*ePharma Physicians are the 87% of U.S. practicing physicians who already interact with pharma through digital channels. ePharma Physicians see 20+ patients per week, write 20+ Rx per week and have done at least one of the following activities: looked for pharma information online, visited the website of any pharma or biotech products in the past 12 months, visited the corporate website of any pharma or biotech company in the past 12 months, participated in electronic detailing programs from a pharma or biotech company in the past 12 months.


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