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How emerging models come close to making this reality
As emergency medicine doctors, we regularly give medical advice to family and close friends when they get sick or are injured and don’t know what to do. In a matter of moments, we triage, diagnose, and assemble a logical plan, whatever the issue may be. This skill comes from our training and years of experience in treating emergencies and also routine medical matters. The value proposition is clear.
Frankly, it’s a service everyone should have. Think about the potential time and money saved if this option for medical care and triage was broadly available. Overtriage would plummet. That’s when people run to the emergency department (ED) and wait endless hours, only to be reassured or receive limited treatment. Undertriage would also decline. That’s when people should go to the ED but, unwisely, wait. For example, this may occur when symptoms of dizziness end up being a stroke.
Why doesn’t everyone have an ED doctor they can call? The primary reason is that the current system mostly doesn’t support it. The most common scenario is that insurance companies pay us to see patients in an expensive box called the ED. Most EDs are situated within an even more expensive box, called a hospital.
Here’s the good news: Better access to emergency care and people who are formally trained in emergency medicine and routine matters of urgent care is increasing.
One example is telemedicine, where a remote doctor — either your own or a doctor through an app — conducts a visit. Telemedicine is more common since the pandemic, now that insurance pays for it. In emergency situations, it’s rare that your own doctor can see you immediately by telemedicine. By contrast, direct-to-consumer telemedicine (eg, Teladoc, Doctor On Demand, and others) connects you with a random doctor.
In many apps, it’s unclear not only who the doctor is, but more importantly, what their specific medical specialty or training is. It may be an ED doctor evaluating your child’s fever, or it may be a retired general surgeon or an adult rheumatology specialist in the midst of their fellowship, making an extra buck, who may have no pediatric training.
Training Matters
Clinical training and whether the doctor knows you matters. A recent JAMA study from Ontario, Canada, found that patients with virtual visits who saw outside family physicians (whom they had never met) compared with their own family physicians were 66% more likely to visit an ED within 7 days after the visit. This illustrates the importance of understanding your personal history in assessing acute symptoms.
Some healthcare systems do use ED physicians for on-demand telehealth services, such as Thomas Jefferson’s JeffConnect. Amazon Clinic recently entered this space, providing condition-specific acute or chronic care to adults aged 18-64 years for a fee that is, notably, not covered by insurance.
A second innovative approach, albeit not specifically in the realm of a personal emergency medicine doctor, is artificial intelligence (AI)–powered kiosks. A concierge medicine company known as Forward recently unveiled an innovative concept known as CarePods that are now available in Sacramento, California; Chandler, Arizona; and Chicago. For a membership fee, you swipe into what looks like an oversize, space-age porta-potty. You sit in a chair and run through a series of health apps, which includes a biometric body scan along with mental health screenings. It even takes your blood (without a needle) and sequences your DNA. Results are reviewed by a doctor (not yours) who talks to you by video. They advertise that AI helps make the diagnosis. Although diagnostic AI is emerging and exciting, its benefit is not clear in emergency conditions. Yet, one clear value in a kiosk over telemedicine is the ability to obtain vital signs and lab results, which are useful for diagnosis.
Another approach is the telehealth offerings used in integrated systems of care, such as Kaiser Permanente. Kaiser is both an insurance company and a deliverer of healthcare services. Kaiser maintains a nurse call center and can handle urgent e-visits. Integrated systems not only help triage patients’ acute issues but also have access to their personal health histories. They can also provide a definitive plan for in-person treatment or a specific referral. A downside of integrated care is that it often limits your choice of provider.
Insurance companies also maintain call-in lines such as HumanaFirst, which is also staffed by nurses. We have not seen data on the calls such services receive, but we doubt people that want to call their insurance company when sick or injured, knowing that the insurer benefits when you receive less care. Additionally, studies have found that nurse-only triage is not as effective as physician triage and results in higher ED referral rates.
The Concierge Option
Probably the closest thing to having your own personal emergency medicine doctor is concierge medicine, which combines personalized care and accessibility. Concierge doctors come in many forms, but they usually charge a fixed fee for 24/7 availability and same-day appointments. A downside of concierge medicine is its expense ($2000–$3500 per year), and that many don’t take insurance. Concierge medicine is also criticized because, as doctors gravitate toward it, people in the community often lose their physician if they can’t afford the fees.
Ultimately, remote medical advice for emergency care is clearly evolving in new ways. The inability of traditional care models to achieve this goal will lead to innovation to improve the available options that have led us to think outside of the proverbial “box” we refer to as the ED-in-the-case.
At this time, will any option come close to having a personal emergency medicine physician willing to answer your questions, real-time, as with family and close friends? We think not.
But the future certainly holds promise for alternatives that will hopefully make payers and the Centers for Medicare & Medicaid Services take notice. Innovations in personalized care that reduce costs will be critical in our current healthcare landscape.
Dr. Pines is clinical professor of emergency medicine at George Washington University in Washington, DC, and chief of clinical innovation at US Acute Care Solutions in Canton, Ohio. He disclosed ties with CSL Behring and Abbott Point-of-Care. Dr. Glatter is assistant professor of emergency medicine at Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He is a medical advisor for Medscape and hosts the Hot Topics in EM series. He has disclosed no relevant financial relationships.
A version of this article appeared on Medscape.com.
How emerging models come close to making this reality
How emerging models come close to making this reality
As emergency medicine doctors, we regularly give medical advice to family and close friends when they get sick or are injured and don’t know what to do. In a matter of moments, we triage, diagnose, and assemble a logical plan, whatever the issue may be. This skill comes from our training and years of experience in treating emergencies and also routine medical matters. The value proposition is clear.
Frankly, it’s a service everyone should have. Think about the potential time and money saved if this option for medical care and triage was broadly available. Overtriage would plummet. That’s when people run to the emergency department (ED) and wait endless hours, only to be reassured or receive limited treatment. Undertriage would also decline. That’s when people should go to the ED but, unwisely, wait. For example, this may occur when symptoms of dizziness end up being a stroke.
Why doesn’t everyone have an ED doctor they can call? The primary reason is that the current system mostly doesn’t support it. The most common scenario is that insurance companies pay us to see patients in an expensive box called the ED. Most EDs are situated within an even more expensive box, called a hospital.
Here’s the good news: Better access to emergency care and people who are formally trained in emergency medicine and routine matters of urgent care is increasing.
One example is telemedicine, where a remote doctor — either your own or a doctor through an app — conducts a visit. Telemedicine is more common since the pandemic, now that insurance pays for it. In emergency situations, it’s rare that your own doctor can see you immediately by telemedicine. By contrast, direct-to-consumer telemedicine (eg, Teladoc, Doctor On Demand, and others) connects you with a random doctor.
In many apps, it’s unclear not only who the doctor is, but more importantly, what their specific medical specialty or training is. It may be an ED doctor evaluating your child’s fever, or it may be a retired general surgeon or an adult rheumatology specialist in the midst of their fellowship, making an extra buck, who may have no pediatric training.
Training Matters
Clinical training and whether the doctor knows you matters. A recent JAMA study from Ontario, Canada, found that patients with virtual visits who saw outside family physicians (whom they had never met) compared with their own family physicians were 66% more likely to visit an ED within 7 days after the visit. This illustrates the importance of understanding your personal history in assessing acute symptoms.
Some healthcare systems do use ED physicians for on-demand telehealth services, such as Thomas Jefferson’s JeffConnect. Amazon Clinic recently entered this space, providing condition-specific acute or chronic care to adults aged 18-64 years for a fee that is, notably, not covered by insurance.
A second innovative approach, albeit not specifically in the realm of a personal emergency medicine doctor, is artificial intelligence (AI)–powered kiosks. A concierge medicine company known as Forward recently unveiled an innovative concept known as CarePods that are now available in Sacramento, California; Chandler, Arizona; and Chicago. For a membership fee, you swipe into what looks like an oversize, space-age porta-potty. You sit in a chair and run through a series of health apps, which includes a biometric body scan along with mental health screenings. It even takes your blood (without a needle) and sequences your DNA. Results are reviewed by a doctor (not yours) who talks to you by video. They advertise that AI helps make the diagnosis. Although diagnostic AI is emerging and exciting, its benefit is not clear in emergency conditions. Yet, one clear value in a kiosk over telemedicine is the ability to obtain vital signs and lab results, which are useful for diagnosis.
Another approach is the telehealth offerings used in integrated systems of care, such as Kaiser Permanente. Kaiser is both an insurance company and a deliverer of healthcare services. Kaiser maintains a nurse call center and can handle urgent e-visits. Integrated systems not only help triage patients’ acute issues but also have access to their personal health histories. They can also provide a definitive plan for in-person treatment or a specific referral. A downside of integrated care is that it often limits your choice of provider.
Insurance companies also maintain call-in lines such as HumanaFirst, which is also staffed by nurses. We have not seen data on the calls such services receive, but we doubt people that want to call their insurance company when sick or injured, knowing that the insurer benefits when you receive less care. Additionally, studies have found that nurse-only triage is not as effective as physician triage and results in higher ED referral rates.
The Concierge Option
Probably the closest thing to having your own personal emergency medicine doctor is concierge medicine, which combines personalized care and accessibility. Concierge doctors come in many forms, but they usually charge a fixed fee for 24/7 availability and same-day appointments. A downside of concierge medicine is its expense ($2000–$3500 per year), and that many don’t take insurance. Concierge medicine is also criticized because, as doctors gravitate toward it, people in the community often lose their physician if they can’t afford the fees.
Ultimately, remote medical advice for emergency care is clearly evolving in new ways. The inability of traditional care models to achieve this goal will lead to innovation to improve the available options that have led us to think outside of the proverbial “box” we refer to as the ED-in-the-case.
At this time, will any option come close to having a personal emergency medicine physician willing to answer your questions, real-time, as with family and close friends? We think not.
But the future certainly holds promise for alternatives that will hopefully make payers and the Centers for Medicare & Medicaid Services take notice. Innovations in personalized care that reduce costs will be critical in our current healthcare landscape.
Dr. Pines is clinical professor of emergency medicine at George Washington University in Washington, DC, and chief of clinical innovation at US Acute Care Solutions in Canton, Ohio. He disclosed ties with CSL Behring and Abbott Point-of-Care. Dr. Glatter is assistant professor of emergency medicine at Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He is a medical advisor for Medscape and hosts the Hot Topics in EM series. He has disclosed no relevant financial relationships.
A version of this article appeared on Medscape.com.
As emergency medicine doctors, we regularly give medical advice to family and close friends when they get sick or are injured and don’t know what to do. In a matter of moments, we triage, diagnose, and assemble a logical plan, whatever the issue may be. This skill comes from our training and years of experience in treating emergencies and also routine medical matters. The value proposition is clear.
Frankly, it’s a service everyone should have. Think about the potential time and money saved if this option for medical care and triage was broadly available. Overtriage would plummet. That’s when people run to the emergency department (ED) and wait endless hours, only to be reassured or receive limited treatment. Undertriage would also decline. That’s when people should go to the ED but, unwisely, wait. For example, this may occur when symptoms of dizziness end up being a stroke.
Why doesn’t everyone have an ED doctor they can call? The primary reason is that the current system mostly doesn’t support it. The most common scenario is that insurance companies pay us to see patients in an expensive box called the ED. Most EDs are situated within an even more expensive box, called a hospital.
Here’s the good news: Better access to emergency care and people who are formally trained in emergency medicine and routine matters of urgent care is increasing.
One example is telemedicine, where a remote doctor — either your own or a doctor through an app — conducts a visit. Telemedicine is more common since the pandemic, now that insurance pays for it. In emergency situations, it’s rare that your own doctor can see you immediately by telemedicine. By contrast, direct-to-consumer telemedicine (eg, Teladoc, Doctor On Demand, and others) connects you with a random doctor.
In many apps, it’s unclear not only who the doctor is, but more importantly, what their specific medical specialty or training is. It may be an ED doctor evaluating your child’s fever, or it may be a retired general surgeon or an adult rheumatology specialist in the midst of their fellowship, making an extra buck, who may have no pediatric training.
Training Matters
Clinical training and whether the doctor knows you matters. A recent JAMA study from Ontario, Canada, found that patients with virtual visits who saw outside family physicians (whom they had never met) compared with their own family physicians were 66% more likely to visit an ED within 7 days after the visit. This illustrates the importance of understanding your personal history in assessing acute symptoms.
Some healthcare systems do use ED physicians for on-demand telehealth services, such as Thomas Jefferson’s JeffConnect. Amazon Clinic recently entered this space, providing condition-specific acute or chronic care to adults aged 18-64 years for a fee that is, notably, not covered by insurance.
A second innovative approach, albeit not specifically in the realm of a personal emergency medicine doctor, is artificial intelligence (AI)–powered kiosks. A concierge medicine company known as Forward recently unveiled an innovative concept known as CarePods that are now available in Sacramento, California; Chandler, Arizona; and Chicago. For a membership fee, you swipe into what looks like an oversize, space-age porta-potty. You sit in a chair and run through a series of health apps, which includes a biometric body scan along with mental health screenings. It even takes your blood (without a needle) and sequences your DNA. Results are reviewed by a doctor (not yours) who talks to you by video. They advertise that AI helps make the diagnosis. Although diagnostic AI is emerging and exciting, its benefit is not clear in emergency conditions. Yet, one clear value in a kiosk over telemedicine is the ability to obtain vital signs and lab results, which are useful for diagnosis.
Another approach is the telehealth offerings used in integrated systems of care, such as Kaiser Permanente. Kaiser is both an insurance company and a deliverer of healthcare services. Kaiser maintains a nurse call center and can handle urgent e-visits. Integrated systems not only help triage patients’ acute issues but also have access to their personal health histories. They can also provide a definitive plan for in-person treatment or a specific referral. A downside of integrated care is that it often limits your choice of provider.
Insurance companies also maintain call-in lines such as HumanaFirst, which is also staffed by nurses. We have not seen data on the calls such services receive, but we doubt people that want to call their insurance company when sick or injured, knowing that the insurer benefits when you receive less care. Additionally, studies have found that nurse-only triage is not as effective as physician triage and results in higher ED referral rates.
The Concierge Option
Probably the closest thing to having your own personal emergency medicine doctor is concierge medicine, which combines personalized care and accessibility. Concierge doctors come in many forms, but they usually charge a fixed fee for 24/7 availability and same-day appointments. A downside of concierge medicine is its expense ($2000–$3500 per year), and that many don’t take insurance. Concierge medicine is also criticized because, as doctors gravitate toward it, people in the community often lose their physician if they can’t afford the fees.
Ultimately, remote medical advice for emergency care is clearly evolving in new ways. The inability of traditional care models to achieve this goal will lead to innovation to improve the available options that have led us to think outside of the proverbial “box” we refer to as the ED-in-the-case.
At this time, will any option come close to having a personal emergency medicine physician willing to answer your questions, real-time, as with family and close friends? We think not.
But the future certainly holds promise for alternatives that will hopefully make payers and the Centers for Medicare & Medicaid Services take notice. Innovations in personalized care that reduce costs will be critical in our current healthcare landscape.
Dr. Pines is clinical professor of emergency medicine at George Washington University in Washington, DC, and chief of clinical innovation at US Acute Care Solutions in Canton, Ohio. He disclosed ties with CSL Behring and Abbott Point-of-Care. Dr. Glatter is assistant professor of emergency medicine at Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He is a medical advisor for Medscape and hosts the Hot Topics in EM series. He has disclosed no relevant financial relationships.
A version of this article appeared on Medscape.com.
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<root generator="drupal.xsl" gversion="1.7"> <header> <fileName>166788</fileName> <TBEID>0C04E59C.SIG</TBEID> <TBUniqueIdentifier>MD_0C04E59C</TBUniqueIdentifier> <newsOrJournal>News</newsOrJournal> <publisherName>Frontline Medical Communications</publisherName> <storyname/> <articleType>2</articleType> <TBLocation>QC Done-All Pubs</TBLocation> <QCDate>20240201T113752</QCDate> <firstPublished>20240201T120100</firstPublished> <LastPublished>20240201T120100</LastPublished> <pubStatus qcode="stat:"/> <embargoDate/> <killDate/> <CMSDate>20240201T120100</CMSDate> <articleSource/> <facebookInfo/> <meetingNumber/> <byline>Jesse M. Pines, MD</byline> <bylineText>JESSE M. PINES, MD, MBA, MSCE, AND ROBERT D. GLATTER, MD</bylineText> <bylineFull>JESSE M. PINES, MD, MBA, MSCE, AND ROBERT D. GLATTER, MD</bylineFull> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType>News</newsDocType> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>As emergency medicine doctors, we regularly give medical advice to family and close friends when they get sick or are injured and don’t know what to do. In a ma</metaDescription> <articlePDF/> <teaserImage/> <teaser>From telemedicine consults covered by insurance to concierge care that is not, many can connect with non–emergency department emergency care. </teaser> <title>Why Everyone Needs Their Own Emergency Medicine Doctor</title> <deck>How emerging models come close to making this reality</deck> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>fp</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>im</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>mdemed</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle/> <journalFullTitle/> <copyrightStatement/> </publicationData> <publicationData> <publicationCode>pn</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term>15</term> <term>21</term> <term canonical="true">58877</term> <term>25</term> </publications> <sections> <term>27980</term> <term canonical="true">39313</term> </sections> <topics> <term canonical="true">38029</term> <term>279</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Why Everyone Needs Their Own Emergency Medicine Doctor</title> <deck>How emerging models come close to making this reality</deck> </itemMeta> <itemContent> <p>As emergency medicine doctors, we regularly give medical advice to family and close friends when they get sick or are injured and don’t know what to do. In a matter of moments, we triage, diagnose, and assemble a logical plan, whatever the issue may be. This skill comes from our training and years of experience in treating emergencies and also routine medical matters. The value proposition is clear.</p> <p>Frankly, it’s a service everyone should have. Think about the potential time and money saved if this option for medical care and triage was broadly available. Overtriage would plummet. That’s when people run to the emergency department (ED) and wait endless hours, only to be reassured or receive limited treatment. Undertriage would also decline. That’s when people should go to the ED but, unwisely, wait. For example, this may occur when symptoms of dizziness end up being a stroke.<br/><br/>Why doesn’t everyone have an ED doctor they can call? The primary reason is that the current system mostly doesn’t support it. The most common scenario is that insurance companies pay us to see patients in an expensive box called the ED. Most EDs are situated within an even more expensive box, called a hospital.<br/><br/>Here’s the good news: Better access to emergency care and people who are formally trained in emergency medicine and routine matters of urgent care is increasing.<br/><br/>One example is telemedicine, where a remote doctor — either your own or a doctor through an app — conducts a visit. Telemedicine is more common since the pandemic, now that insurance pays for it. In emergency situations, it’s rare that your own doctor can see you immediately by telemedicine. By contrast, direct-to-consumer telemedicine (eg, Teladoc, Doctor On Demand, and others) connects you with a random doctor.<br/><br/>In many apps, it’s unclear not only who the doctor is, but more importantly, what their specific medical specialty or training is. It may be an ED doctor evaluating your child’s fever, or it may be a retired general surgeon or an adult rheumatology specialist in the midst of their fellowship, making an extra buck, who may have no pediatric training.<br/><br/></p> <h2>Training Matters</h2> <p>Clinical training and whether the doctor knows you matters. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813291?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamanetworkopen&utm_content=wklyforyou&122723&adv=001205910413">recent JAMA study</a> from Ontario, Canada, found that patients with virtual visits who saw outside family physicians (whom they had never met) compared with their own family physicians were 66% more likely to visit an ED within 7 days after the visit. This illustrates the importance of understanding your personal history in assessing acute symptoms.</p> <p>Some healthcare systems do use ED physicians for on-demand telehealth services, such as Thomas Jefferson’s <a href="https://www.jeffconnect.org/">JeffConnect</a>. <a href="https://clinic.amazon.com/">Amazon Clinic</a> recently entered this space, providing condition-specific acute or chronic care to adults aged 18-64 years for a fee that is, notably, not covered by insurance.<br/><br/>A second innovative approach, albeit not specifically in the realm of a personal emergency medicine doctor, is artificial intelligence (AI)–powered kiosks. A concierge medicine company known as Forward recently unveiled an innovative concept known as <a href="https://www.axios.com/2023/12/08/carepod-forward-doctors-office-telehealth-telemedicine">CarePods</a> that are now available in Sacramento, California; Chandler, Arizona; and Chicago. For a membership fee, you swipe into what looks like an oversize, space-age porta-potty. You sit in a chair and run through a series of health apps, which includes a biometric body scan along with mental health screenings. It even takes your blood (without a needle) and sequences your DNA. Results are reviewed by a doctor (not yours) who talks to you by video. They advertise that AI helps make the diagnosis. Although diagnostic AI is emerging and exciting, its benefit is not clear in emergency conditions. Yet, one clear value in a kiosk over telemedicine is the ability to obtain vital signs and lab results, which are useful for diagnosis.<br/><br/>Another approach is the telehealth offerings used in integrated systems of care, such as Kaiser Permanente. Kaiser is both an insurance company and a deliverer of healthcare services. Kaiser maintains a nurse call center and can handle urgent e-visits. Integrated systems not only help triage patients’ acute issues but also have access to their personal health histories. They can also provide a definitive plan for in-person treatment or a specific referral. A downside of integrated care is that it often limits your choice of provider.<br/><br/>Insurance companies also maintain call-in lines such as HumanaFirst, which is also staffed by nurses. We have not seen data on the calls such services receive, but we doubt people that want to call their insurance company when sick or injured, knowing that the insurer benefits when you receive less care. Additionally, <a href="https://www.cochrane.org/CD004180/EPOC_telephone-consultation-and-triage-effects-on-health-care-use-and-patient-satisfaction">studies have found that nurse-only triage</a> is <a href="https://pubmed.ncbi.nlm.nih.gov/30633669/">not as effective as physician triage</a> and results in higher ED referral rates.<br/><br/></p> <h2>The Concierge Option</h2> <p>Probably the closest thing to having your own personal emergency medicine doctor is concierge medicine, which combines personalized care and accessibility. Concierge doctors come in many forms, but they usually charge a fixed fee for 24/7 availability and same-day appointments. A downside of concierge medicine is its expense ($2000–$3500 per year), and that many don’t take insurance. Concierge medicine is also criticized because, as doctors gravitate toward it, people in the community often lose their physician if they can’t afford the fees.</p> <p>Ultimately, remote medical advice for emergency care is clearly evolving in new ways. The inability of traditional care models to achieve this goal will lead to innovation to improve the available options that have led us to think outside of the proverbial “box” we refer to as the ED-in-the-case.<br/><br/>At this time, will any option come close to having a personal emergency medicine physician willing to answer your questions, real-time, as with family and close friends? We think not.<br/><br/>But the future certainly holds promise for alternatives that will hopefully make payers and the Centers for Medicare & Medicaid Services take notice. Innovations in personalized care that reduce costs will be critical in our current healthcare landscape.<br/><br/></p> <p> <em>Dr. Pines is clinical professor of emergency medicine at George Washington University in Washington, DC, and chief of clinical innovation at US Acute Care Solutions in Canton, Ohio. He disclosed ties with CSL Behring and Abbott Point-of-Care. Dr. Glatter is assistant professor of emergency medicine at Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He is a medical advisor for Medscape and hosts the <a href="https://www.medscape.com/index/section_10438_0">Hot Topics in EM</a> series. He has disclosed no relevant financial relationships.</em> </p> <p> <em>A version of this article appeared on <span class="Hyperlink"><a href="https://www.medscape.com/viewarticle/999917">Medscape.com</a></span>.</em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>