Most doctors have a license to practice medicine in just one state. Lindsey Mcilvena can practice in 26.
“I’ve lost track a little bit,’’ she said of all her medical licenses.
Mcilvena is a telemedicine doctor, one of a growing number of physicians who prefer to treat patients remotely, from the comfort of their own homes — perhaps even while still in their pajamas. They connect with patients by video chat, or through new apps where patients can use their smartphone to talk to a doctor about a cold or a prescription.
For Mcilvena, 35, it began as a side gig. She was fresh out of medical school, running her own one-woman practice in Encinitas, California. She started to take telemedicine appointments to help pay the bills as she expanded her brick-and-mortar practice. She liked it so much that in 2015 she made the leap to practicing remotely full time.
“I was a fan for the flexibility, for being able to work from home and set my own hours,’’ said Mcilvena, who specializes in lifestyle and preventive medicine. “Those things don’t apply to very many medical positions.’’
At first, she relished the ability to take an afternoon yoga class or grab a midday coffee with a friend. Nowadays, Mcilvena works full-time for the telemedicine startup HeyDoctor, which allows her to treat patients while still spending ample time with her 16-month-old son.
Telemedicine is still, by most accounts, a niche occupation. A study published in December in the academic journal Health Affairs combed 2016 survey results from the American Medical Association to find that only 15.4% of physicians worked in practices using telemedicine.
But that may soon change. Long heralded by the medical community for its potential to make health care more accessible and efficient, telemedicine now seems poised to go mainstream — and raise new questions about how medicine practiced through an app compares to a doctor’s office visit. Private health plans, Medicare, most state Medicaid programs, and the U.S. Department of Veterans Affairs all cover some virtual doctor’s visits. More than 35 states and the District of Columbia now have laws requiring private insurance companies to reimburse providers for care delivered remotely.
In telemedicine, tech-savvy doctors who are good communicators are the ones who thrive.
Those changes have led to a boom in well-funded telehealth startups like HeyDoctor, Roman and Hims, the Viagra-selling company that in January was valued at $1 billion. With slick apps and buzzy marketing, the companies are creating fresh opportunities for physicians and bolstering a marketplace anchored by telehealth stalwarts such as MDLive Inc. and Doctor On Demand Inc. And for some of those physicians, especially younger ones who grew up doing almost everything online, telemedicine is no longer a side gig: It’s a career goal.