Never Go to the Doctor Again (for Most Things)
It started on Monday morning — I noticed a strange red rash emerge on my right hand. It itched a bit, but looked innocuous enough. A spider bite? A burn? An allergic reaction and a rash?
None of these seemed life-threatening, and I was sure that with a couple of days and a few rounds of coconut oil, this thing would be history. By Wednesday I was starting to worry. The red patch had darkened, the back of my hand was burning something fierce, and small hives were growing in the affected area.
I decided to put this one to my team: doctor or no doctor? I asked anyone who would listen, extending my hand and giving my colleagues a closer look:
“Oh my gosh what are you doing here—that looks infected! Get to the doctor before it gets worse and they need to amputate,” said one.
“That? You’re worried about that? I wouldn’t worry, looks like a rash that’ll disappear in a few days,” offered another dismissively.
“My mom’s a physician, do you want me to send a photo?” asked a third.
Bingo. Best case scenario. I could skip the wait, hassle, and cost of a doctor’s visit, but get an opinion quickly. Within minutes, my colleague’s mom, we’ll call her Dr. Awesome, had forwarded the photo to a dermatologist, we’ll call him Dr. Excellent. I was at once relieved, awed, and amused by what he said:
“Very interesting case — The pattern of erythema and scale suggests a phytophotodermatitis — squeezing limes is the usual cause. The lines going down the hand suggests a liquid outside job. It dries, then sensitizes the skin for UV exposure later. Fluocinonide cream 0.05% 2 x day will help with the symptoms, It will likely tan or be a little brown for a few months but will return to normal skin color.”
I know what you’re thinking: Inconceivable! How could I have lived X years and NEVER heard that I’m not supposed to squeeze limes in the sun. This seems like a serious lapse in the mom wisdom part of the “orientation” one gets when introduced into the world. I’m thinking something like, “Hi Jimmy, welcome to humanity! Here are a couple of friendly tips: don’t play with fire, you can’t breath under water, wash your hands after going to the bathroom, Haribo sugarless gummy bears may taste good but they cause intestinal chaos, and most importantly, don’t squeeze limes in the sun!”
Anyway, moments after reading my diagnosis, I was 15 images down in my google search for “phytophotodermatitis,” aka “Margarita Burn” aka “the Other Lime Disease.” What I saw wasn’t pretty. What I had ahead of me was likely some swelling and some burn blisters, which would be painful and HUGE.
But I was lucky — I saved time and money on a simple diagnosis that almost any dermatologist could nail at first glance. Most aren’t so lucky. According to the CDC’s National Hospital Ambulatory Medical Care Survey in 2011 (most recent ER survey), almost 1 million of the 136 million annual ER visits were for unidentifiable skin rashes. That’s about 2,700 per day. When the average cost of a visit to the Emergency Room is $2,598, that’s no good for anyone.
So what are the alternatives for those of us with non-emergency conditions who can’t find a physician to text a photo to? Telehealth. Yes. Using technology to do long-distance care. There are angels among us working to bring efficient, cost effective, accurate, convenient diagnoses to the masses. And chances are, you have access to them.
Estimated cost: ~$0-45 (Yup, this $45 figure is still cheap compared to ER, urgent care, or specialist co-pays, even for those with great health insurance.) Estimated time: ~20 mins
There are already 24 states that mandate that telemedicine be covered equally to “regular” medicine, or in-person visits. (American Telemedicine Association.)
If you live in one of the blue states, your insurance carrier likely already contracts with a telemedicine company like one of the below. If you don’t live in a blue state, your carrier still might, the way that Health Republic of NJ contracts with Teladoc. Some other examples of Telemedicine services below:
If your carrier doesn’t use one of the existing services out there, they might have a 24/7 Nurse Hotline, like the one that Highmark BCBS of PA established for its members.
Even if your carrier isn’t doing squat by way of telemedicine, you can sign up for your own service, rather than sitting at an urgent care clinic or emergency room. We recommend Doctor on Demand, as it’s very user friendly and has a large direct to consumer practice. Bonus for you, if you use the discount code STRIDE you’ll get $10 off your first visit.
Bumps, bruises, coughs and colds—these aren’t going away. What is disappearing is the need for diagnosis to be as much of a headache as the illness or injury itself. It’s up to us to be smart consumers; just as we’re conscientious about finding the cheapest, most efficient and highest quality goods and services elsewhere in the economy, we should feel empowered to do the same with our healthcare.