遠(yuǎn)程醫(yī)療有它吹噓的那么好嗎
每次覺得自己要感冒時(shí)，我的第一反應(yīng)就是用紫錐菊、抗感冒藥和美清痰化痰片先進(jìn)行自我治療。通常情況下，我都會在幾天內(nèi)迅速好轉(zhuǎn)。
For the times when my cocktail of over-the-countermedicine fails me, I submit and make a visit to myfamily doctor for a proper diagnosis. The onlyproblem is: I hate going to the doctor. Don’t get me wrong; I think the world of him. I’ve beengoing to the guy for the last 25 years for everything ranging from the common cold to moresevere ailments. It’s the amount of time a doctor appointment takes out of my day that leadsme to squabble.
如果采用這些非處方藥進(jìn)行的雞尾酒療法不起作用，我就會乖乖去找家庭醫(yī)生確診病情。唯一的問題是：我討厭看醫(yī)生。別誤會，我其實(shí)非常敬重他。25年來，不管是普通感冒還是大點(diǎn)兒的病，我都會去找他。讓我厭煩的是，預(yù)約醫(yī)生很麻煩，需要花費(fèi)不少時(shí)間。
We all know how this goes. You arrive and check in, only to wait in a waiting room full of othersick people sniffling and coughing. After anywhere from five minutes to an hour, a nurse finallycalls your name and escorts you to the exam room. More waiting. In walks the doctor. Tenminutes later, you’re on the street with a diagnosis and an illegible prescription.
我們都知道這是怎么回事。你到了醫(yī)院，掛上號，然后就得在人滿為患的候診室等著，周圍凈是抽鼻涕和咳嗽的病人。五分鐘至半小時(shí)后，終于等到護(hù)士喊你的名字，并把你帶去診斷室。接下來又是等待。隨后醫(yī)生走了進(jìn)來。十分鐘后，你就會帶著診斷書和難以辨認(rèn)的處方回到大街上。
For awhile now I’ve wondered about telehealth, also called telemedicine, the new type of medicalservice that makes a doctor available at the push of a button on your smartphone. Think of itas Uber for doctors. If you’re into technology, you’ve no doubt read stories about it andwondered the same thing. (And yes, Fortunehas published its fair share.)
我對遠(yuǎn)程醫(yī)療，或被稱作遠(yuǎn)距離醫(yī)學(xué)，已經(jīng)好奇一陣子了。只需按下智能手機(jī)上的按鈕，這種新型的醫(yī)療服務(wù)就能讓你看醫(yī)生。你可以把它視為醫(yī)療版的打車軟件Uber。如果你關(guān)注科技圈，你肯定閱讀過相關(guān)報(bào)道，并同樣對此感到好奇。
One particular company, Doctor On Demand, claims to be the largest provider of video visits inthe nation. The service offers what amounts to a brief Skype or FaceTime call with a board-certified physician located in your state who can diagnosis and prescribe medications forcommon ailments. (Due to varying laws and restrictions, a medical appointment isn’t possible inAlaska, Arkansas, Idaho, and Louisiana.)
以Doctor On Demand公司為例，該公司自稱是美國最大的遠(yuǎn)程醫(yī)療服務(wù)提供商。借助這項(xiàng)服務(wù)，你可以與經(jīng)過職業(yè)認(rèn)證，能夠診斷普通病癥，并開具處方藥的本州醫(yī)生進(jìn)行一次類似Skype或FaceTime的簡短通話。(由于各州法律法規(guī)不同，在阿拉斯加、阿肯色、愛達(dá)荷和路易斯安那州無法使用這項(xiàng)醫(yī)療預(yù)約服務(wù)。)
I recently made a mock appointment with the service so that I was able to see just what it waslike to video chat with a medical professional. Am I able to get a diagnosis with less hasslethan an in-person visit? Is a video appointment less satisfying?
最近，我用這項(xiàng)服務(wù)進(jìn)行了一次模擬預(yù)約，想親自體驗(yàn)一下與醫(yī)學(xué)專家視頻通話的感受。比起親自就醫(yī)，這樣是否會少些麻煩?視頻就診的滿意度會更低嗎?
After signing into the demo account, I was given the option to choose from three differenttypes of appointments: medical, psychological, or a lactation consultation. I chose “medical.”The service then asked me to fill out a questionnaire detailing my illness, symptoms, andcurrent medications. At the end, it asked me to select the pharmacy to which I’d like to haveany necessary prescriptions sent.
登錄演示賬戶后，我可以選擇三種不同的預(yù)約：內(nèi)科疾病、心理疾病或哺乳咨詢。我選擇了“內(nèi)科疾病”。隨后系統(tǒng)讓我填一份表格來詳細(xì)描述病情、癥狀和目前使用的藥物。最后，它請我選擇將必要的處方送往哪個(gè)藥店。
After entering payment information and agreeing to the price for an appointment, I was thenplaced into a queue of patients waiting for a doctor. Each 15-minute medical appointment willset you back $40. Should you run out of time, you can opt to double the appointment foranother $40. (Compare that price to an urgent-care visit for $175 or a visit to the emergencyroom for $300 or more, based on my insurance policy.) It took about two to three minutesfor a physician to accept my request, after which Dr. Ian Tong reviewed my symptoms—patients tend to go overboard on initial questionnaires, he said—and began theappointment.
輸入支付信息，并確認(rèn)預(yù)約價(jià)格后，我就進(jìn)入了病人等待隊(duì)列。每15分鐘的內(nèi)科疾病診斷需要花費(fèi)40美元。如果診斷時(shí)間耗盡，你還可以再用40美元來延長一倍時(shí)間。(根據(jù)我的保險(xiǎn)條款，緊急看護(hù)的價(jià)格為175美元，而去急診室則要300美元甚至更多。)過了兩到三分鐘，一位名叫伊恩o唐的內(nèi)科醫(yī)生接受了我的申請。隨后，他仔細(xì)查看了我的癥狀——他說，在最初提交的表格上，病人通常會過度描述自己的病情——并開始了診斷。
I went into the appointment admittedly skeptical of the entire exercise; staring at a screen andtalking to a doctor seemed too impersonal to me. But once I was connected and talking to adoctor, the familiarity of countless FaceTime calls I’ve held with loved ones quickly came back.This was easy. The tech faded into the background.
老實(shí)說，接受診斷時(shí)，我對整個(gè)就醫(yī)流程都抱有懷疑態(tài)度。看著屏幕和醫(yī)生對話讓我覺得很沒人情味。但當(dāng)我聯(lián)系上醫(yī)生并與他開始對話后，我很快找到了之前與至愛親朋無數(shù)次通過FaceTime交談的那種熟悉感，感覺很放松?？萍嫉谋涓邢Я?。
There are stilllogistical hurdlesto overcome for patient and doctor alike. To allow the doctor toinspect a body part—your throat, for example, or a rash—you must take a photo with yourphone or tablet and send it through the app for inspection. I tried to send a photo using thedesktop computer I was using, and Tong informed me that the service won’t allow it on a non-mobile device. That’s a huge frustration if you’ve spent $40 and can’t do what’s required ofyou.
但對病人和醫(yī)生來說，還有許多實(shí)際障礙需要克服。為了讓醫(yī)生檢查你的身體，比如你的喉嚨或是皮疹，你需要用手機(jī)和平板電腦拍下相應(yīng)的照片，并通過醫(yī)療應(yīng)用發(fā)給醫(yī)生。我試圖用臺式電腦發(fā)送照片，但唐醫(yī)生告訴我這項(xiàng)服務(wù)不支持非移動設(shè)備。這太讓人失望了：你花了40美元，卻不能做需要做的事。
I didn’t feel rushed at all during my appointment with Dr. Tong, though it was of course a demoand lacked the urgency or detachment that comes with a real ailment. For the common cold, itwas enough time. For something more complicated, the allotted time may not have beensufficient.
在面對唐醫(yī)生的就診過程中，我并沒有匆忙的感覺，盡管這只是一次演示，不會有真正看病時(shí)的緊迫感和冷淡感。對普通的感冒來說，15分鐘足夠了。但對一些更為復(fù)雜的病癥，分配的時(shí)間可能就會不夠。
Had I come to Dr. Tong with a real illness, he would have made a diagnosis after he felt he hada solid grasp on my condition. According to Doctor on Demand’s chief medical officer Pat Basu, 95 percent of appointments end with a short-term resolution, meaning no further visits(whether in person or follow-up with Doctors On Demand) are required. The remaining 5percent are referred to the emergency room or a primary care physician for furtherexamination.
如果我?guī)е嬲牟“Y來看唐醫(yī)生，他可能會在切實(shí)掌握我的情況后作出診斷。Doctor on Demand公司首席醫(yī)務(wù)官帕特o巴蘇表示，95%的預(yù)約都在短時(shí)間內(nèi)解決了問題，這意味著他們不需要再次看醫(yī)生了(無論是親自看，還是用Doctors On Demand進(jìn)行后續(xù)預(yù)約)。剩下的5%則需要去急診室，或是找主治醫(yī)師做進(jìn)一步的檢查。
When I spoke with Doctor On Demand’s CEO Adam Jackson, he made it clear that his serviceisn’t meant to replace your family doctor. (He likened it to a modern-day nurses hotline.) Still,Doctor On Demand has the ability to treat you on the spot.
在與Doctor On Demand的首席執(zhí)行官亞當(dāng)o杰克遜交流時(shí)，他明確表示：這項(xiàng)服務(wù)并不是試圖取代你的家庭醫(yī)生。(他把它比喻成現(xiàn)代的護(hù)理熱線。)不過，Doctor On Demand也能給你當(dāng)場治療。
After my mock appointment, I called my family doctor to see what he would think if one of hispatients started using a virtual service from time to time. He wasn’t enthusiastic about theidea, but admitted that his way of thinking is probably a little old school. Still, he stopped shortof shunning it altogether. His main concern? Missing clues because of the lack of a physicalexamination.
在這次模擬預(yù)約之后，我給家庭醫(yī)生打了個(gè)電話，看看他對病人偶爾使用這種虛擬服務(wù)有什么看法。他對此并不感興趣，不過他也承認(rèn)自己的思想有些老派。盡管如此，他并沒有徹底回避這個(gè)問題。他主要是擔(dān)心由于對身體檢查不足，遠(yuǎn)程治療可能會遺漏一些線索。
He’s got a point. Ever wonder why your doctor checks your spleen each time you go incomplaining of a sore throat? An enlarged spleen combined with a sore throat are symptoms ofmononucleosis. Have a small child with a high fever? It’s probably minor, but there’s a chanceit it could be meningitis. And the way a doctor is able to tell is with a physical exam.
他抓住了問題的關(guān)鍵。你有沒有疑惑，為什么你每次看醫(yī)生抱怨喉嚨痛時(shí)，醫(yī)生都會檢查你的脾臟?脾臟增大和喉嚨痛是單核細(xì)胞增多癥的癥狀。你的小孩發(fā)高燒了?這可能是小問題，但也可能是腦膜炎發(fā)作。醫(yī)生只有檢查了身體才能確診。
But there is undeniable peace of mind in knowing that, with a virtual service like Doctor OnDemand, you have a doctor available at the push of a button to give professional advicewhen a child is sick—even if that advice results in a trip to the emergency room. Or, when you’reon a business trip with a full-blown sinus infection and desperately need medication.
但不可否認(rèn)，在孩子生病或是出差感染鼻竇炎急需治療時(shí)，有了Doctor On Demand這類虛擬服務(wù)，你只用按下手機(jī)按鈕，就能得到醫(yī)生的專業(yè)指導(dǎo)。這會讓你內(nèi)心安定許多——即便醫(yī)生最終還是建議你去急診室。
I’m not looking forward to the next time I’m sick, but I do wait with great anticipation for theday when I’m able to unlock my phone, tap a few buttons, and receive medical care from thecomfort of my couch. And who knows: Maybe one day I’ll find my family doctor on the otherside of the screen.
我不想再次生病，但我確實(shí)期待著將來能有這一天，我只要解鎖手機(jī)，按幾個(gè)按鈕，就能躺在自己舒適的沙發(fā)上享受醫(yī)療服務(wù)。誰知道呢，也許某天我的家庭醫(yī)生也會出現(xiàn)在屏幕上。(財(cái)富中文網(wǎng))
