Walgreens offering digital doctor visits in 5 states

Pharmacy giant Walgreens is rolling out $49 digital doctor visits that will enable customers to connect via their computer or tablet with a doctor at any time of day or night.

Walgreens, which sees the service as an extension of its popular walk-in clinics, launched the program in five states last week and plans to add another 20 states, where such doctor visits are permitted, by the end of the year.

Walgreen aims to offer more convenience to its 6 million daily retail customers and 2 million daily online visitors, said Harry Leider, Walgreens chief medical officer. The service is intended to address medical problems that can be quickly resolved with a few questions, a straightforward diagnosis and perhaps a prescription – such as sore throats, colds, minor rashes and allergies, he said.

"It's really geared for people with acute, relatively minor illnesses," Leider said. "We don't want people with chest pains or concerns about heart attacks or strokes or serious illness using this service. [But] our own experience is that's not what's happening."

Dr. Robert Wergin, a family physician based in Milford, Neb., said he'd love to be able to communicate with his patients between formal visits, checking up on them via phone or video conferencing. "There's potentially real benefits to it," he said.

But Wergin, president of the American Academy of Family Physicians, said he's also concerned that appointments with a doctor who doesn't know or can't see a patient will lead to mistakes or missed opportunities.

Medical professionals at an urgent care clinic recently diagnosed one of Wergin's patients with sinusitis. When her symptoms persisted and Wergin saw her, he immediately recognized that she wasn't herself, and she ended up being diagnosed with a brain tumor.

In-person visits are also opportunities to check in with patients about a test they're due for or other problems they might have, Wergin said. Payments are also an issue. Right now, Wergin said, insurance companies won't reimburse him for virtual appointments.

"The only way for me to have a business model is for you to come in and have a visit," he said.

Other virtual providers have already met with success, albeit on a much smaller scale.

At two Harvard-affiliated hospitals, for instance, some patients can get virtual follow-up visits with their specialists, said Joseph C. Kvedar, vice president of Connected Health, the hospitals' telemedicine program.

Virtual care can work particularly well for follow-up mental health visits, Kvedar, a dermatologist, said. Providers get to see their patients in a more natural environment, he said, and patients can avoid what may be a very stressful, anxious trip to an office.

Because of its size, Walgreens' move has the power to transform the primary care market, said Randy Parker, CEO of MDLIVE, the six-year-old telemedicine company that will provide the virtual service for Walgreens.

Parker said he expects that eventually most or all doctors' practices will provide virtual visits to their patients, alleviating the need for about half of all in-person appointments.

To expand, however, Walgreens and MDLIVE will need changes in state regulations in the 25 states were such visits are not permitted.

Currently, doctors who make virtual house calls through MDLIVE are either staff members or trained by the company to follow a basic algorithm that determines who is a good candidate for a virtual visit, based on a few questions about medical history and symptoms. If the service is appropriate, the patient can speak with a doctor and will be charged $49 for the visit. Doctors will earn about $30 for each appointment, Parker said.

The price is intentionally set below what a normal doctor's visit would run as an incentive to use the service instead of a costly emergency room, he said.

Marc Adler of Ft. Lauderdale said he was skeptical about the idea of telemedicine until he started feeling ill on a trip to Gainesville a few years ago. He was able to request an MDLIVE appointment on his cell phone and within 90 minutes was talking to a doctor.

The doctor prescribed an antiviral medication, and by the time Adler drove to a nearby pharmacy, his prescription was ready and waiting.

"I found the entire process to be very quick and very pleasurable," he said. "It was a great experience."