Dr. Amazon!

[audreyh1]

A good many of those (that aren't something you'd decide to initiate while traveling) are of the type where you just walk into the pharmacy in the country you're traveling in, and they give the medicine. The US is quite bonkers in some of the things they require prescriptions for, but entrenched interests prevail.

Right, overseas no problem in that a pharmacist often has the leeway to diagnose and prescribe medications for common problems. US works a little differently.

 

[Markola]

They’ve disrupted other bloated, rent seeking dinosaur industries, so why not US medical care? Good luck to them, I say.

 

[pacergal]

List of what conditions Amazon Clinic will handle.

https://clinic.amazon.com/?ref_=sf_hero_primary_cta#conditions

All of these are relatively easy to diagnos and treat with specific questions and criteria. The caveat being to end the visit and follow up with "see your PCP if things get worse or do not improve with treatment"
It's up to you to follow through with that.

Kaiser has the option to have an e-visit with an online provider. I have utilized it twice and I love it. Granted, they have access to my ongoing health record, but it does give you another option for receiving health care for minor things.

 

[badatmath]

Nope Amz knows enough about me and some of those things I'd not go to the doctor for at all or certainly not in a rush.

 

[MichaelB]

I’ve used an immediate care center a number of times for myself or visiting family members and find them helpful. Not a replacement for the family physician but definitely the preferred options when traveling. It helps to scout the local options before needing one, they are not all the same.

Two comments on the Amazon announcement. First, they use the term “clinician” instead of “physician”. Second, it would not be a surprise if, after using their clinic, to find Amazon product promotion tailored around whatever caused the clinic visit. That might also follow to FB and other social media.

 

[O2Bfree]

Nope Amz knows enough about me and some of those things I'd not go to the doctor for at all or certainly not in a rush.

Good point. It'd be interesting to see if users get hit with ads for relevant products.

I used Teledoc for a UTI a few years back, and it worked great. My appointment started on time, took less than 10 minutes, and I picked up my prescription a couple hours later. I suppose delivery is an option too. No need to look to Amazon for remote doctor appointments.

 

[disneysteve]

Two comments on the Amazon announcement. First, they use the term “clinician” instead of “physician”.

I’m a physician and I stopped using the term years ago in conversation. I now use “provider” because in most settings you may see a physician, a nurse practitioner, or a physicians’s assistant. At our urgent cares, doctors and NPs work side by side interchangeably. When you come in as a patient, you may get either one. It’s just based on who takes the next patient.

 

[audreyh1]

Fortunately when at home we can call our doctor’s office and see a nurse practitioner same day for minor issues that need to be treated right away.

 

[braumeister]

I belong to a concierge practice and can normally get a same day appointment to see my primary care doc. If it's something simple, that takes care of it. If it's more involved, I'll get a referral to the best specialist she knows. If it's really urgent, she wants me to go to an urgent care clinic. Around here, an urgent care clinic is usually called a "doc in a box" and they can handle quite a number of problems on the spot. If it's tougher than they want to deal with, they just tell you to go to the nearest hospital ER.

The concierge practice is expensive, but I feel it's worth it. It's also part of a nationwide system, so if I'm traveling I can call my own doc who will tell me of the nearest associated practice to where I am, and they will see me right away as a courtesy.

 

[Walt34]

I see lots up upsides and very few downsides. We're talking everyday aches, pains and allergies that lots of times would cure themselves by the time you get to a physician's office. This is especially good news for someone who has an hours-long drive to even a UC facility, let alone a hospital. I hope it works out for Amazon.

 

[jollystomper]

Just got this email from Amazon. Would you use Amazon Clinic?
...

Fortunately our family GP provides all of these services already online, so we do not need this. They also have their own immedicare walk-in hours for patients of their practice.

 

[disneysteve]

Fortunately when at home we can call our doctor’s office and see a nurse practitioner same day for minor issues that need to be treated right away.

That is super rare today. Most of our business at urgent care comes from patients who were not able to get seen by their PCPs.

 

[Koolau]

No. Just no. Imagine taking a complex or critical issue to someone that you never met who will e-mail you a plan and a prescription, based on some questions.

Yeah, I barely trust most doctors with my health (in person.)

I wonder how soon AI will be diagnosing us?

 

[Car-Guy]

Yeah, I barely trust most doctors with my health (in person.)

I wonder how soon AI will be diagnosing us?

I've used Teledocs a few times for something I already know the answer to but just need a prescription and I don't want to spend half a day going to and from my PCP. I don't trust any of my doctors (PCP/Specialist) 100%. They sometimes (not rare) give me conflicting information and I have to make my own decision or seek out a third opinion. Then make my decision.

 

[Northforker]

I guess I don't understand the age 64 limitation. The service is a cash transaction, therefore insurance or medicare are not involved?

 

[MichaelB]

I guess I don't understand the age 64 limitation. The service is a cash transaction, therefore insurance or medicare are not involved?

From the FAQ https://clinic.amazon.com/help

At this time, Amazon Clinic isn’t intended for beneficiaries of government payor programs, including Medicare and Medicaid.

I’m speculating, but even though this might be a cash transactions, Amazon might also be laying the groundwork for something more expansive that does involve insurance.

 

[harley]

DW has recurring sinus infections. She gets them every winter if we're in a cold weather region. DD has had asthma for 33 years (since age 5). Both of them have to go see the doctor every year to get their prescriptions, despite the medical history. It feels like the docs are just forcing some billing unnecessarily. Having the option to use something like Amazon Health to just get the medication you know you need would be of great value to us. On the other hand, I would never use it since almost every time I go in it's for a standalone diagnosis. I think this could be a good thing.

 

[Koolau]

DW has recurring sinus infections. She gets them every winter if we're in a cold weather region. DD has had asthma for 33 years (since age 5). Both of them have to go see the doctor every year to get their prescriptions, despite the medical history. It feels like the docs are just forcing some billing unnecessarily. Having the option to use something like Amazon Health to just get the medication you know you need would be of great value to us. On the other hand, I would never use it since almost every time I go in it's for a standalone diagnosis. I think this could be a good thing.

Yeah, some meds really do need close monitoring. Most do not.

Assuming the "best" motives of the docs, they may simply be protecting themselves against law suits if something goes wrong and they hadn't seen the person recently.

 

[disneysteve]

From the FAQ https://clinic.amazon.com/help

I’m speculating, but even though this might be a cash transactions, Amazon might also be laying the groundwork for something more expansive that does involve insurance.

There are laws regarding charging Medicaid and Medicare patients cash. For example the amount a provider can charge a Medicare patient is limited. By not seeing Medicare recipients, they don’t have to deal with those limits.

 

[audreyh1]

That is super rare today. Most of our business at urgent care comes from patients who were not able to get seen by their PCPs.

Yes I’m very grateful for it. They even keep Saturday half day hours.

 

[athena53]

There are laws regarding charging Medicaid and Medicare patients cash. For example the amount a provider can charge a Medicare patient is limited. By not seeing Medicare recipients, they don’t have to deal with those limits.

I didn't know that. I'm a Medicare beneficiary and have been using the RequestaTest site for routine bloodwork done more frequently than Medicare allows. I pay by credit card on the site and show up at the lab. Never an issue and my birth date is in their records.

And what about GoodRx, which some Medicare beneficiaries use, bypassing Medicare and paying out of pocket?

 

[disneysteve]

DW has recurring sinus infections. She gets them every winter
have to go see the doctor every year to get their prescriptions, despite the medical history. It feels like the docs are just forcing some billing unnecessarily.

I can't even tell you how many times in the past 3 years a patient has come in for their "annual sinus infection" just wanting me to give them an antibiotic only to have them test positive for COVID.


Many patients come in certain they know what's wrong and convinced they know what they need only to be proven wrong when we actually evaluate them. Lots of conditions can present with similar symptoms. Just because it feels like something you've had before doesn't mean it is.

 

[disneysteve]

I didn't know that. I'm a Medicare beneficiary and have been using the RequestaTest site for routine bloodwork done more frequently than Medicare allows. I pay by credit card on the site and show up at the lab. Never an issue and my birth date is in their records.

And what about GoodRx, which some Medicare beneficiaries use, bypassing Medicare and paying out of pocket?

I'm not sure how GoodRx works.


The testing stuff is fine. There are just limits to how much they can charge. I think it's a certain percentage over the Medicare fee schedule.


Amazon for whatever reason has just chosen not to involve themselves with that, which is fine. Maybe they are charging more than they would otherwise be allowed to if they accepted Medicare patients.

 

[harley]

I can't even tell you how many times in the past 3 years a patient has come in for their "annual sinus infection" just wanting me to give them an antibiotic only to have them test positive for COVID.


Many patients come in certain they know what's wrong and convinced they know what they need only to be proven wrong when we actually evaluate them. Lots of conditions can present with similar symptoms. Just because it feels like something you've had before doesn't mean it is.

I'm not sure that testing positive for Covid negates the annual sinus infection. They usually occur after a cold or flu, so being positive for Covid might just be another avenue for getting it. If a person has other symptoms, definitely see a doctor. But if no other symptoms present and the sinus infection is there (and assuming it's bacteriological), the antibiotic is still needed.

Having said that, I'm not a fan of handing out antibiotics willy-nilly. But in DD's case, with her lifetime asthma issue, why should she need a doctor's visit just to get her inhaler prescription. It's not like she doesn't see a doctor for anything else.

 

[disneysteve]

I'm not sure that testing positive for Covid negates the annual sinus infection. They usually occur after a cold or flu, so being positive for Covid might just be another avenue for getting it. If a person has other symptoms, definitely see a doctor. But if no other symptoms present and the sinus infection is there (and assuming it's bacteriological), the antibiotic is still needed.

Not to go too far down this road, but the vast majority of sinus infections are viral, and coronavirus is one of many viruses that can cause them. So if someone comes it with sinus symptoms that started within the past few days and they test positive for COVID, they're not getting an antibiotic. Now if they've been sick for 6 or 7 days or more and symptoms have gotten worse despite conservative treatment, that's a different story and the antibiotic is probably warranted at that point.

in DD's case, with her lifetime asthma issue, why should she need a doctor's visit just to get her inhaler prescription.

I agree with you on that one. As long as she's been seen within the year, she shouldn't need a visit just to refill her medication. I hate when providers do that and I know that it's just to generate a billable encounter.


We have a lot of trouble at urgent care with PCPs (and others) sending their patients to see us for something simple that they could have handled without a visit but they won't do it because then they can't bill for it. Drives us crazy.


I definitely see both sides of these issues. Providers don't want to do a bunch of unpaid work but patients don't want to have to make an appointment for every little thing. For some of this, telehealth is a reasonable solution.