A reptile lover calls a 900 number to ask about the antibiotic prescribed for his pet iguana. The pharmacist on the end of the line explains how to prepare the correct dosage.
You’ve heard of Dial-A-Joke. And Dial-A-Prayer. Now, thanks to the wonders of Ma Bell and modems, comes the controversial business of Dial-A-Remedy. With the public appetite for medical knowledge becoming increasingly voracious, doctors and pharmacists are tapping into high-tech methods of connecting patients with the health information they want. San Francisco-based InterPractice Systems provides answers to medical questions and do-it-yourself diagnostic capability to health-maintenance-organization patients via computer terminals. Doctors By Phone, in New York, offers medical advice–for $3 a minute-over a 1-900 telephone line. Want prescription advice? Ask the Pharmacist, a Chapel Hill, N.C., concern, charges $1.95 per minute for a phone-operated pharmaceutical-advice service. Promoters say the medicine-by-remote-control approach is a way to convey information quickly, but others question the advisability of some companies’ approaches. “I have concerns when people ask for medical advice the same way they dial a date,” says Richard Kessel, executive director of the New York State Consumer Protection Board. While the board has filed no complaints on the 1-900 companies, Kessel says, “I think we are treading on very dangerous territory.”
Most of the advice-by-phone companies stop short of dispensing formal diagnoses. Doctors By Phone is staffed by 80 physicians, many of them medical residents, who are paid $40 an hour to advise callers on everything from Lyme disease to chapped lips. Dr. Thomas Kovachevich, the service’s founder, says most who call aren’t experiencing emergencies but want general information. To avoid conflicts of interest, his phone does do not see the patients they talk to. Similarly, Ask the Pharmacist founder Mary Lynn Bell cautions that her service is meant as a complement to, not a substitute for, face-to-face discussions with a druggist. Like the iguana owner who phoned recently, she says, most of the dozens of callers each day want to talk about existing prescriptions.
Still, some experts worry about health professionals advising patients they have never met. “They say they are not practicing medicine,” says Dr. Sidney Wolfe, of the Public Citizen Health Research Group, “but the fact is they are listening to people’s complaints and making some sort of evaluation.” The Harvard Community Health Plan in Brookline, Mass., has avoided the problem by offering InterPractice’s program only to the HMO patients, whose records are on the computer. InterPractice CEO Dr. Albert Martin believes that by eliminating unnecessary office visits the program could cut operating costs by as much as 20 percent. Besides, it could turn hypochondria into an interactive sport: “The only complaint we’ve had so far is that people want more,” says Martin. Hippocrates for the computer generation? Take two aspirin and log on in the morning .
