It’s happened to nearly every parent: the child with the borderline temperature and the amorphous symptoms, prompting the classic should-we-or-shouldn’t-we dilemma. Does this call for a visit to the pediatrician, or not?
There’s (cue the phrase) an app for that. In fact, there is more than one app for that. Among the newest (and among the free-est) is First Opinion, which matches users with a doctor who will return texts about medical questions within nine minutes or less, 24 hours a day, seven days a week (when an individual doctor is unavailable, another doctor will respond). No “single form to submit,” the site promises, but a continuing text dialogue with a doctor who “will never forget about you.” First Opinion doctors “balance their daily load with the importance of building long-term friendships with their existing members.” For now, up to 100 texts a month are free. For a fee of $9 a month, users can guarantee a faster response time, send unlimited texts and also send pictures.
A science writer, Emily Waltz, tried the app, and reported on her experience for IEEE Spectrum. It’s a company, she wrote, that is getting a lot of venture capital at the same time as it raises “some skeptical eyebrows” in the medical community.
The doctor on the other end of her texts responded to her questions (which she created based on a real medical issue her family had recently experienced) with similar responses to those of the triage nurse at her pediatrician’s office. But despite that, Ms. Waltz has doubts about the service. Her reporting suggests that there is little or no accountability for First Opinion doctors, most of whom are not licensed to practice in the United States. First Opinion says it does not take responsibility for the “quality, reliability, timing, legality, integrity, authenticity, accuracy, appropriateness … or responsiveness of the information” provided by the doctors. “Yikes,” Ms. Waltz writes.
Most doctors’ offices, academic hospitals and many health insurance companies offer “do I need to see a doctor” services of varying kinds, Ms. Waltz notes. So why download an app for a service that is often already available, and in an accountable form?
As a parent, I see a number of answers to that. An app offers convenience (no waiting for the end-of-the-day call from the harried nurse with a whole list to work through before quitting time), and, in the case of First Opinion, back-and-forth dialogue (how many times have you hung up with that nurse and realized exactly what you forgot to ask?). It’s also available to parents who don’t have access to those triage services, because they aren’t aware of them or because their pediatric care hasn’t been consistent enough to make them feel that they know who to call.
But should First Opinion be your first choice? If the idea of an app, or any form of virtual medical advice appeals to you, First Opinion is scarcely the only game in town — and many of the other players appear to offer the accountability (or at least the United States licensed practitioners) that First Opinion lacks. The UrgentCare app connects you with a registered nurse for a $3.99 fee, who will, if necessary, connect you with a doctor who may even be able to provide a prescription. HealthTap allows users to ask a question of a doctor and wait for a reply free, or get an expedited reply for a small fee. Both services offer a large database of health information as well. HealthTap also offers virtual doctor’s visits, as does Doctor on Demand (both for a fee in the range of $40).
In researching this piece I found that many large health insurers offer variations on these services. Mine does, although doctors in the program my insurer uses cannot provide prescriptions in my state (New Hampshire). I had no idea, or that it would be so simple to use. I went through the process of signing us all up, so the next time a mysterious rash appears, we will be replacing the usual call to our long-suffering emergency room doctor friend with a virtual visit to a doctor who is “online now.”
Would you try First Opinion, and have you tried an online doctor’s visit yet?