What is Virtual Primary Care?

January 11, 2022

Dr. Eric Bricker

Virtual primary care is the delivery of primary care services by a doctor or other healthcare provider to a patient via video or phone visits.

3 Components of Virtual Primary Care 

Virtual primary care is comprised of 1) 24/7 urgent care, 2) chronic care and 3) preventive screenings. 

Virtual urgent care addresses unexpected sick visits for acute illnesses such as coughs, bladder infections, nausea, vomiting, diarrhea and rashes. During the virtual visit, a doctor can prescribe medication to treat the illness and send that prescription electronically to the patient’s pharmacy of choice. 

Virtual chronic care can manage chronic conditions such as diabetes, hypertension and high cholesterol. Many chronic conditions require extensive counseling on nutrition, exercise and warning signs of complications. Virtual chronic care allows for easier, longer and more frequent visits to better accomplish this counseling by the doctor with the patient. Chronic care often requires lab tests such as hemoglobin A1c for diabetes and LDL levels for high cholesterol. These blood tests of course need to be performed in person. Fortunately, a virtual primary care doctor can electronically send an order to a local, cost-effective, lab facility such as Quest or LabCorp. There are over 4,000 Quest and LabCorp locations across the US. 

Virtual preventive screening falls can either be performed or coordinated virtually. For example, there are questionnaire-based screenings for depression and alcohol abuse that can occur directly with the patient during a virtual visit. Likewise, a virtual primary care doctor can refer patients to a gastroenterologist for a screening colonoscopy and women to a local imaging center for their screening mammograms. 

Why Use Virtual Primary Care?

Primary care has been shown to improve health and lower healthcare costs by identifying and treating diseases early such as cardiovascular disease and cancer. However, only 33%of people have seen a primary care physician in the last two years. People don’t go. 

Why? It’s inconvenient to travel to a doctor’s office, wait in a waiting room, take off work or arrange for childcare. It’s also expensive with many doctor visits costing over $100 on a high-deductible health insurance plan. 

Virtual primary care makes it easier and less expensive to see a doctor. Visits can occur wherever the patient would like — at home, at work or even in their parked car. It can be provided to employees at 0 out-of-pocket cost like an onsite clinic, near-site clinic or direct primary care. Virtual primary care reduces the barriers and increases access to care. 

Who is Delivering Virtual Primary Care?

Virtual primary care is provided by a variety of organizations. Multiple digital health companies provide virtual primary  care by contracting directly with employers to provide care for employees and their families. Onsite clinic companies that set up and run a doctor’s office at a factory or other worksite also now offer virtual primary care. 

Many traditional primary care doctor practices have moved to virtual visits during the pandemic. Historically, traditional primary care doctors required patients to be seen in the office because an in-person visit was required for billing, i.e., it was not clinically required for a patient to be seen in person, but it was for payment purposes. That payment barrier to virtual primary care has been removed in many instances with Medicare and many private health insurance companies are now paying doctors for virtual primary care visits. 

Finally, health insurance carriers offer virtual primary care to some of their members. As of 2021, the largest health insurance companies in America have all announced they will offer virtual primary care in 2022 and beyond. 

What Do Doctors Think About Virtual Primary Care?

Dr. Marshall Chin from the University of Chicago School of Medicine authored an excellent article in the October 28, 2021 issue of the New England Journal of Medicine describing how in-person-only care “doesn’t support optimal patient health and experience, especially for marginalized populations.” 

Dr. Chin adds, “When it comes to chronic diseases such as hypertension and diabetes, the U.S. health care system’s performance is inadequate.” 

As a solution, Dr. Chin and the National Academy of Sciences, Engineering and Medicine describe the following ways virtual primary care can help remedy the situation: 

  • Use video or telehealth to improve access, convenience, timeliness, monitoring and cost-effectiveness 
  • Use video or telehealth to improve access to emergency care and specialty services in rural and medically underserved areas 

In summary, virtual primary care is comprised of urgent care for sick visits, chronic care for ongoing conditions and preventive care coordination and referrals. Virtual primary care improves access to care that many patients would otherwise forego. Diverse groups provide virtual primary care, from digital health startups to traditional physician practices to health insurance carriers. Doctors themselves and their elite institutions see the benefits of virtual care and support its expansion. 

Virtual primary care is an innovation whose time has come. 

 

 

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Originally published Jan 11, 2022 2:00:00 PM.