HealthTap: Telemedicine or Terrible Medicine?

The skeptical cardiologist  is evaluating an online medical service called HealthTap. I first started getting inundated with emails from Dr. Geoffrey Rutledge, Chief Medical Officer of HealthTap in 2013. They started off saying:
“I’m delighted to personally invite you to be featured for free as a Top Doctor on HealthTap, where you will be recognized for your experience, expertise, and compassion. All you have to do is sign up.”
Health Tap allows patients to submit questions online which are answered by some of the thousands of doctors signed up. In addition, patients can get a “virtual consult” for 99$. James Hamblin in the Atlantic has written a nice piece describing the experience of the virtual consult with HealthTap from the patient’s perspective.
Beginning in November, 2014, Dr. Rutledge told me via email
“You still have time to achieve Top Doctor Awards, but the deadline for participation is now just a few days away! Sign up for free today, and you can be recognized in just 4 days with prestigious Top Doctor, Top General Internist, Most Influential Doctor, and Thought Leader Awards in the Fall 2014 Top Doctor Competition. You are eligible for each of these awards at the national, state, and regional levels.”
How could I resist competing for one of these meaningless but prestigious awards? After all, as Dr. Rutledge told me

Winners of Top Doctor Awards will be featured on HealthTap+ to 64,000 U.S.-licensed doctors and many millions of patients who visit HealthTap+ each month. As an awardee at the state or national level, you will receive a certificate to display in your office that highlights your achievement to your patients, a prominent badge for display on your online profile, and a virtual plaque that you can post on your blog or website.

Over the Thankgiving break I signed up to become a HealthTap doctor. I’ve been evaluating it since then and have found it to be an extremely annoying and tiresome program which utilizes high pressure marketing schemes and motivational techniques that are reminiscent of a video game.
The first thing i did after signing up was to look at the questions that patients were posting on the website. I answered two questions that were cardiology related. On one of the questions the information I gave was incorrect. I had two doctors “agree” with my answer and got two thank you  clicks from patients.
I then went trough a training session via video with a person from healthTap on the use of the Virtual Concierge app. I have yet to utilize this to actually interface with a real patient.
docscorehealthtap trophiesAs a result of my actions my DocScore on HealthTap  has skyrocketed from 50 to 85!
I unlocked “The Catalyst Trophy”and “The Chain Reaction Trophy”!
According to HealthTap I have helped 3080 patients and my patient satisfaction score is 5.0!
Spending two minutes answering 2 questions online, one incorrectly, sure pays off in the world of virtual medicine! This is a lot easier than seeing real patients.
I usually get a couple of emails from HealthTap per day saying meaningless marketing things like :

This is a time of year for helping others, showing your gratitude, and taking on new personal initiatives for growth. HealthTap+can help you accomplish your goals. With the exciting launch this year of HealthTap Concierge, we’ve demonstrated a simple, yet powerful way you can benefit from the latest state-of-the-art technology to boost your income and enjoy the flexibility of practicing from anywhere, at anytime, with no cost, hassle or overhead. With HealthTap Concierge, you can grow your practice, or relieve the load on your already too-busy practice.

HealthTap really wants to me sign up my own patients and show them the “magic of virtual care.”  :

In celebration of the holidays, we are thrilled to partner with you to help your patients. From now until December 26th, we’ll waive all charges for initial Virtual Consults that you give to your patients if you’d like to share this gift.

Giving the gift of a free consult is a great way to welcome your patients to your new Virtual Practice and show them the magic of virtual care.  

Tell your patients they can see you for a free virtual consult if they visit your Virtual Practice and schedule a consult with you by December 26. All they have to do is enter this special gift promo code when they make their appointment: 

Since I can’t imagine how this will help my patients I haven’t solicited any virtual patients. I’m pretty sure, however, that, I could improve my DocScore and unlock a few more trophies if I did.

I could really improve my standing if I started handing out kudos to other doctors who in turn would give me votes for various things like my bedside manner or my skill in “eat healthier.”

healty eaterThis doctor is first in the St. Louis Region for “being inspiring” and 4th nationally for varicose veins based on 155 doctor votes. I wonder how many of those votes were from doctors that know anything about him. There is no way to know unfortunately.

This is reminiscent of liking somebody on Facebook . A lot of the attempts by HealthTap to motivate me to do stuff on their site reminds me of social media and/or video games.

When I play Rock Band it is always satisfying to unlock trophies and get higher point scores and on Facebook I’m pleased when a lot of people “like” my posts.

I don’t think such meaningless trophies and likes and high point scores translate to any meaningful guarantee of quality, expertise or knowledge in the world of medicine. It seems to me that those doctors who participate a lot in HealthTap must have a lot of time on their hands (perhaps because they have no real patients to see) and/or they are seeking to merge their need to play and succeed at video games with their medical training.

I’m sticking to my real practice of cardiology where I can touch and see my patients, listen to their heart and lungs, follow up on the recommendations I’ve made and get to know them over time. I find this to be very satisfying and fulfilling .

This particular style of telemedicine to me is terrible medicine.

If HealthTap is the future of medicine, count me out.


3 thoughts on “HealthTap: Telemedicine or Terrible Medicine?”

  1. Dr. Anthony, three years ago I had the opportunity to visit the offices and interview the staff of Health Tap in Palo Alto, where I too experienced a similar frisson of suspicion that docs who sign up there must have more time on their hands than any of the physicians I know.
    Since that visit, I often quote this actual, real-life Health Tap answer from an Indiana cardiac surgeon (no doubt one with many unlocked trophies) to a patient who submitted this question: “Why does your arm hurt during a heart attack?’ Here’s the trophy-loaded doc’s response (remember, this is a reply to a person who’s never been to med school):
    “The pericardium is innervated by C3,4,5 (Phrenic nerve). There may be some neuronal connections to the intercostobrachial nerves.”
    Whaaaaaat? How is this gobbledygook jargon even remotely helpful to your average heart patient? And why wouldn’t that same curious patient simply do a search on Up To Date or Mayo Clinic sites (for example) for a plain-English translation?
    My takeaway impression after my Palo Alto visit: this is not at all about providing sound medical care, it’s about flattering, seducing and recruiting physicians of varying abilities to marketing-based medicine.

  2. Great piece and really appreciate and respect your attitude and expertise. Keep doing it the way you are doing it. You’re already recognized as one of the 6 best in the world!
    Thank you .
    Paul and Andrea


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