Virtual Care

The telemedicine trend.
Dr. Al O’Neill, a retired physician in Grosse Pointe Farms, spends a few hours a week helping patients via telemedicine. // Illustration by Paul Tong

Dr. Al O’Neill thought he was ready for retirement and a life of travel in 2017, when he hung up his stethoscope after 30 years as a pulmonary physician at Beaumont Hospital in Royal Oak.

After visiting family on both coasts, taking bucket-list trips to Europe, and spending a
summer boating on Lake St. Clair, O’Neill, a Grosse Pointe Farms resident, realized he wasn’t quite ready to walk away from his profession.

A lifelong passion for dabbling in technology steered him to a fast-growing yet little-known area of health care — telemedicine — where virtual doctors provide advice to patients at a distance through video conferencing.

O’Neill is one of 700 physicians from coast to coast who have signed up with American Well, a telemedicine company in Boston started by two physician brothers in 2007. The service uses mobile and web technology for videoconferencing patient-doctor visits.

The telemedicine concept, not dissimilar to that of Uber, the ride-sharing company, is one that gives O’Neill the flexibility to keep his hand in practicing medicine while he’s mostly retired.

“If you wake up in the morning with cough and cold symptoms, instead of going to urgent care, or even your primary doctor — and definitely not the emergency room — you call American Well and, depending on where you’re calling from, they have a panel of doctors ready to take the call,” O’Neill says.

“From my end, I sign in any time I want. Just like Uber, I can check in or check out, I can do it for an hour, (or) I can do it for eight hours. They have round-the-clock coverage.”

Amwell, as the company is also known, sells its services to large companies, pitching them on handling the non-emergency primary care needs of employees. Once a call comes in, Amwell personnel screens a person for pertinent medical and personal information before linking them by video with doctors like O’Neill.

“Seeing the patient face to face doesn’t do a whole lot at this level because most of the patients are younger, 20 to 40 years of age, usually working, and can’t take the time off to go to the doctor. Few have a chronic disease,” he says.

If a drug prescription is necessary, O’Neill fills it online at the patient’s preferred pharmacy.
Insurance companies and Medicaid reimburse Amwell, which in turn pays doctors $50 to $60 for each patient consultation. For now, Medicare pays for patients in remote or rural settings.

From his perch at the kitchen table, laptop in hand, O’Neill says he believes technology growth will propel his virtual practice.

“There are efforts now to add stethoscopes that can transmit data through the internet via Bluetooth,” he says. “When (a patient) calls, I can put the stethoscope up to their chest, have them take a couple of breaths, and I might actually examine the heart and the lungs right through the screen.”