Online consultation: What's it worth?

Rather than wait for insurers to set a price on communicating with patients online, some doctors are establishing their own fees.

By Tyler Chin, AMNews staff. June 10, 2002.

A couple of years ago, after some patients asked him to help evaluate health information they had found online, Dean Tomasello, MD, got the idea to start a Web site at which people could ask him questions and receive answers via e-mail.

The service didn't cost anything at first. But the Walworth, Wis., family physician last year started charging a fee after the volume of questions rose so much that he no longer could afford to answer them for free. Despite the change, consumers have been more than willing to pay $25 out of pocket to get their questions answered, Dr. Tomasello said.

"People are looking for health and medical information online, but they are a little overwhelmed, confused and anxious about what they find," he said. "They need a little bit more guidance, and we're here to help them sort through it and give them what they need as it applies to their or their family member's specific case."

Dr. Tomasello is part of an early wave of physicians who are finding that people are willing to pay for online consultations, though health insurers do not pay for them.

This month, for example, about 1,000 doctors, will begin offering fee-based online consultation service to established patients through a Web site operated by Medem Inc., which is partly owned by the AMA.

Online consultations are fraught with uncertainty and controversy because they are such a new development that medical organizations, professionals and others have divided opinions about what constitutes an appropriate, professional and ethical online consultation. [...]