My New Telemedicine Gig

I’ve never had so many interviews in my life to land a job, but it in the end I was the lucky one and it has been well worth it. I signed the contract with a new telemedicine company and now I am officially one of their physicians.

There are a ton of telemedicine companies out there but I had a particular reason for choosing this company. Let me talk a little about the perks of the job and then I’ll talk about what’s unique about them.

The Contract

Thankfully they don’t require a long-term commitment. The contract states that either party can stop the employer-employee relationship at any time. This is a plus because neither of us would want to get stuck with a poor match.

It also means that I can work for other companies or pursue my own business on the side while employed by them.

Expectations

The contract expects me to work about 10-15 hours a week and they will pay me for any hours I work extra. There is no specific time in the day that I am expected to perform the work in, again another huge advantage for me.

As patients sign up on the app and ask their medical question I am expected to review the information they entered and come up with a management plan. It could be limited to triaging but it could also be diagnosing something and prescribing meds or ordering lab work.

My Income

My first paycheck arrived today, $1,047 after taxes. I will get a gross salary of $1k per week and $100 per hour for any extra work that I put in.

It’s hard to say how much my actual hourly income will be because I suspect that at first there won’t be much volume. Down the road as more patients start using the service I’m sure there would be a chance to renegotiate if appropriate.

Currently I spend about 30-60 minutes per day working on the app, seeing patients and giving feedback to the developers. That’s maybe 5-7 hours a week, not bad.

Unfortunately, No Benefits

I will be paid as a W2 employee but without benefits. No health insurance, no dental and no disability. However, they will pay for malpractice insurance.

As I’ve mentioned before, it’s important to get to a point where you can care less and less about the fluff and get down to the nitty gritty. I am looking for a job that satisfies me, it’s good that I’m in a position of not really needing the benefits.

There would be a slight benefit to receiving a 1099 income as an independent contractor versus a W2 but that’s a discussion for another day. I don’t care to set aside more money in a 401k even if I get a tax deduction for it.

Next, I want to highlight what I really like about this company versus the other telemedicine companies out there.

Artificial Intelligence

This is the first company to base their platform off of artificial intelligence. The point is for the computer to obtain most of the information and more importantly, to learn from the doctor’s input to constantly improve itself.

Imagine a patient comes online, asks about abdominal pains, fevers, anorexia and right lower quadrant pain and tenderness. The AI will guide the patient down the algorithm, ask all the pertinent positives and negatives and maybe even have the patient push on the RLQ. Voila! Appendicitis until proven otherwise.
>Chart gets sent to the doctor.
>Doctor agrees, tells the patient to go to ED for CT.
>Calls ED and gives them a heads up.

When the AI software or the doctor interact with the patient over text messaging, a chart is automatically created. There is no need to later go back and do an H&P or SOAP. I love this part!

Relationship With The Patient

I was trained in family medicine but have done mostly urgent care since leaving residency. I don’t think family medicine is hard but I don’t want to lose my touch. This company allows to me to have patients of my own and see them through for a long time to come.

On this particular platform, patients can choose the right doctor for them and that doctor will be their main healthcare provider. Sure, they will still need to go in for pap smears and other tests but I could be someone’s PCP, online. I think that’s kind of cool.

Ease Of Communication

Texting is nice and easy, not as easy to get emotions across but much easier to have a longer/in-depth conversation on. I can state something, wait for the other person’s reply, clarify, send links, images etc.

Ideally a text-based interaction with a patient would happen over a period of time. Maybe some initial questions/answers would be exchanged when both people are online. Then once the basics is out of the way a few other ideas are communicated and clarified.

I can send a prescription over text to a pharmacy using the iPrescribe app, quite easy to use and quite functional.

I can send patients for lab testing and imaging and even send referrals all by clicking buttons over text. Certain features are things we are still developing at this telemedicine company but the ability to do it is there.

My Intentions with this Company

I am very excited to see a company that is trying to make access to healthcare easier. I hope that in the future they start using this to provide medical access to the poor and maybe even allow PA’s who work remotely to be able to run things by doctors.

I want to learn more about how Artificial Intelligence can play a role in medicine. There are a lot of mundane tasks in medicine that can be taken over by robots. Some of the things nurses do are task-based, not analytical but simply tasks that need to be performed and its relevant data collected.

I don’t like working in a family medicine clinic seeing 20 patients in a day, the majority of whom don’t need to be there. It’s not about the money, it’s about my time being wasted. There is no need for an MD to tell a person what to eat and not to eat when it comes to diabetes. I shouldn’t have to tell a patient that their obesity is causing their sleep apnea, their hypertension and knee pain – their grandmother can and probably does do that already.

On this telemedicine platform I can be someone’s primary care doctor. Not because they want their hands held, not because they want attention from a doctor but because they are busy people and they need ease of access and are willing to view their doctor as an expert whom they consult for their health.

If the opportunity arises to move up the ranks I will jump on it. I would love to be able to take on some leadership and help guide the direction of such a company. It wouldn’t be as a C-level executive but perhaps a project manager or maybe even a marketing director.