遠程醫療有它吹噓的那麼好嗎
Whenever I start to feel like I’m coming down with a cold, my initial response is self medicate with a mixture of echinacea, Airborne, and Mucinex. More often than not, I’m usually back at full speed within a couple of days.
For the times when my cocktail of over-the-counter medicine fails me, I submit and make a visit to my family doctor for a proper diagnosis. The only problem is: I hate going to the doctor. Don’t get me wrong; I think the world of him. I’ve been going to the guy for the last 25 years for everything ranging from the common cold to more severe ailments. It’s the amount of time a doctor appointment takes out of my day that leads me to squabble.
如果採用這些非處方藥進行的雞尾酒療法不起作用，我就會乖乖去找家庭醫生確診病情。唯一的問題是：我討厭看醫生。別誤會，我其實非常敬重他。25年來，不管是普通感冒還是大點兒的病，我都會去找他。讓我厭煩的是，預約醫生很麻煩，需要花費不少時間。We all know how this goes. You arrive and check in, only to wait in a waiting room full of other sick people sniffling and coughing. After anywhere from five minutes to an hour, a nurse finally calls your name and escorts you to the exam room. More waiting. In walks the doctor. Ten minutes later, you’re on the street with a diagnosis and an illegible prescription.
我們都知道這是怎麼回事。你到了醫院，掛上號，然後就得在人滿爲患的候診室等着，周圍淨是抽鼻涕和咳嗽的病人。五分鐘至半小時後，終於等到護士喊你的名字，並把你帶去診斷室。接下來又是等待。隨後醫生走了進來。十分鐘後，你就會帶着診斷書和難以辨認的處方回到大街上。
For awhile now I’ve wondered about telehealth, also called telemedicine, the new type of medical service that makes a doctor available at the push of a button on your smartphone. Think of it as Uber for doctors. If you’re into technology, you’ve no doubt read stories about it and wondered the same thing. (And yes, Fortunehas published its fair share.)
我對遠程醫療，或被稱作遠距離醫學，已經好奇一陣子了。只需按下智能手機上的按鈕，這種新型的醫療服務就能讓你看醫生。你可以把它視爲醫療版的打車軟件Uber。如果你關注科技圈，你肯定閱讀過相關報道，並同樣對此感到好奇。One particular company, Doctor On Demand, claims to be the largest provider of video visits in the 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 for common ailments. (Due to varying laws and restrictions, a medical appointment isn’t possible in Alaska, Arkansas, Idaho, and Louisiana.)
以Doctor On Demand公司爲例，該公司自稱是美國最大的遠程醫療服務提供商。藉助這項服務，你可以與經過職業認證，能夠診斷普通病症，並開具處方藥的本州醫生進行一次類似Skype或FaceTime的簡短通話。（由於各州法律法規不同，在阿拉斯加、阿肯色、愛達荷和路易斯安那州無法使用這項醫療預約服務。）I recently made a mock appointment with the service so that I was able to see just what it was like to video chat with a medical professional. Am I able to get a diagnosis with less hassle than an in-person visit? Is a video appointment less satisfying?
最近，我用這項服務進行了一次模擬預約，想親自體驗一下與醫學專家視頻通話的感受。比起親自就醫，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 different types 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, and current medications. At the end, it asked me to select the pharmacy to which I’d like to have any necessary prescriptions sent.
登錄演示賬戶後，我可以選擇三種不同的預約：內科疾病、心理疾病或哺乳諮詢。我選擇了“內科疾病”。隨後系統讓我填一份表格來詳細描述病情、症狀和目前使用的藥物。最後，它請我選擇將必要的處方送往哪個藥店。After entering payment information and agreeing to the price for an appointment, I was then placed into a queue of patients waiting for a doctor. Each 15-minute medical appointment will set you back $40. Should you run out of time, you can opt to double the appointment for another $40. (Compare that price to an urgent-care visit for $175 or a visit to the emergency room for $300 or more, based on my insurance policy.) It took about two to three minutes for 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 the appointment.
輸入支付信息，並確認預約價格後，我就進入了病人等待隊列。每15分鐘的內科疾病診斷需要花費40美元。如果診斷時間耗盡，你還可以再用40美元來延長一倍時間。（根據我的保險條款，緊急看護的價格爲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唐的內科醫生接受了我的申請。隨後，他仔細查看了我的症狀——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——並開始了診斷。I went into the appointment admittedly skeptical of the entire exercise; staring at a screen and talking to a doctor seemed too impersonal to me. But once I was connected and talking to a doctor, the familiarity of countless FaceTime calls I’ve held with loved ones quickly came back. This was easy. The tech faded into the background.
老實說，接受診斷時，我對整個就醫流程都抱有懷疑態度。看着屏幕和醫生對話讓我覺得很沒人情味。但當我聯繫上醫生並與他開始對話後，我很快找到了之前與至愛親朋無數次通過FaceTime交談的那種熟悉感，感覺很放鬆。科技的冰冷感消失了。There are stilllogistical hurdlesto overcome for patient and doctor alike. To allow the doctor to inspect a body part—your throat, for example, or a rash—you must take a photo with your phone or tablet and send it through the app for inspection. I tried to send a photo using the desktop 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 of you.
但對病人和醫生來說，還有許多實際障礙需要克服。爲了讓醫生檢查你的身體，比如你的喉嚨或是皮疹，你需要用手機和平板電腦拍下相應的照片，並通過醫療應用發給醫生。我試圖用臺式電腦發送照片，但唐醫生告訴我這項服務不支持非移動設備。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 demo and lacked the urgency or detachment that comes with a real ailment. For the common cold, it was enough time. For something more complicated, the allotted time may not have been sufficient.
在面對唐醫生的就診過程中，我並沒有匆忙的感覺，儘管這只是一次演示，不會有真正看病時的緊迫感和冷淡感。對普通的感冒來說，15分鐘足夠了。但對一些更爲複雜的病症，分配的時間可能就會不夠。Had I come to Dr. Tong with a real illness, he would have made a diagnosis after he felt he had a 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 5 percent are referred to the emergency room or a primary care physician for further examination.
如果我帶着真正的病症來看唐醫生，他可能會在切實掌握我的情況後作出診斷。Doctor on Demand公司首席醫務官帕特o巴蘇表示，95%的預約都在短時間內解決了問題，這意味着他們不需要再次看醫生了（無論是親自看，還是用Doctors On Demand進行後續預約）。剩下的5%則需要去急診室，或是找主治醫師做進一步的檢查。When I spoke with Doctor On Demand’s CEO Adam Jackson, he made it clear that his service isn’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的首席執行官亞當o傑克遜交流時，他明確表示：這項服務並不是試圖取代你的家庭醫生。（他把它比喻成現代的護理熱線。）不過，Doctor On Demand也能給你當場治療。After my mock appointment, I called my family doctor to see what he would think if one of his patients started using a virtual service from time to time. He wasn’t enthusiastic about the idea, but admitted that his way of thinking is probably a little old school. Still, he stopped short of shunning it altogether. His main concern? Missing clues because of the lack of a physical examination.
在這次模擬預約之後，我給家庭醫生打了個電話，看看他對病人偶爾使用這種虛擬服務有什麼看法。他對此並不感興趣，不過他也承認自己的思想有些老派。儘管如此，他並沒有徹底迴避這個問題。他主要是擔心由於對身體檢查不足，遠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 in complaining of a sore throat? An enlarged spleen combined with a sore throat are symptoms of mononucleosis. Have a small child with a high fever? It’s probably minor, but there’s a chance it it could be meningitis. And the way a doctor is able to tell is with a physical exam.
他抓住了問題的關鍵。你有沒有疑惑，爲什麼你每次看醫生抱怨喉嚨痛時，醫生都會檢查你的脾臟？脾臟增大和喉嚨痛是單核細胞增多症的症狀。你的小孩發高燒了？這可能是小問題，但也可能是腦膜炎發作。醫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 On Demand, you have a doctor available at the push of a button to give professional advice when a child is sick—even if that advice results in a trip to the emergency room. Or, when you’re on a business trip with a full-blown sinus infection and desperately need medication.
但不可否認，在孩子生病或是出差感染鼻竇炎急需治療時，有了Doctor On Demand這類虛擬服務，你只用按下手機按鈕，就能得到醫生的專業指導。這會讓你內心安定許多——即便醫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 the day when I’m able to unlock my phone, tap a few buttons, and receive medical care from the comfort of my couch. And who knows: Maybe one day I’ll find my family doctor on the other side of the screen.
我不想再次生病，但我確實期待着將來能有這一天，我只要解鎖手機，按幾個按鈕，就能躺在自己舒適的沙發上享受醫療服務。誰知道呢，也許某天我的家庭醫生也會出現在屏幕上。（財富中文網）
