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Practice Commentary
Thomas C. Tinstman, MD
Arch Fam Med. 1995;4(9):804.
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As Drs Crump and Pfeil have noted, more than 60% of specialty evaluations can be done over distance, and multiple studies have shown that 90% of patients are satisfied when seeing a specialist using interactive video technology. To date I know of no published studies reporting health outcome results over time or cost-effectiveness. Thus, we have a mature piece of communications technology looking for its place in our health care system. In my opinion, consultations over distance will be used selectively until the incentives for the patient, the primary care physician, the specialty physician, and the health plan are all aligned. Currently, this would occur only when both physicians are compensated by capitation payments and the health plan is responsible for patient transportation. Today these criteria are fulfilled only in some military situations and prison health care systems using managed care concepts. I anticipate that these incentives will be
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Author Affiliations
University of Texas Medical Branch Galveston
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