Here are the 4 different types of acute care medicine:

#4 Bad care is giving a patient an antibiotic they don’t need for a 3- day cold.

#3 Marginal care is refusing an antibiotic for a 3-day cold and having a patient leave the encounter upset and angry about wasting time and money.

#2 Good care is talking to the patient about viruses, colds and antibiotics so they leave comfortable about this and future antibiotic decisions.

#1 Great care is a type #2 encounter PLUS recognizing they have an odd looking lesion on their wrist, getting it biopsies and removed, preventing an invasive melanoma and saving their life!

So here’s what I think will happen when Telemedicine for acute care goes mainstream.

Patients online will go to sites to get what they want (#4),  not what they need (#2). The type #4 sites will do a much better volume than type #3 sites, and type #2 sites, which could offer good care,  will have low volume and become increasingly rare.

Although I can’t guarantee it, telemedicine for acute care – which will be presented to everyone as a boon to patients because of convenience – will basically devolve into a high volume pill dispensary (#4).  (Think about it.  When people shop on Amazon.com, they have been trained to pay to get something physical in return.  That’s not going to change.)

But one thing is can guarantee: There will be no type #1 Telemedicine.