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April 2, 2014

Websites That Offer Care Over the Internet: Is There an Access Quality Tradeoff?

Author Affiliations
  • 1University of California, San Francisco School of Medicine, San Francisco
  • 2Consumer Reports Health Ratings Center, Consumers Union, Yonkers, New York
  • 3Philip R. Lee Institute for Health Policy Studies, The Center for Healthcare Value, Department of Medicine, University of California, San Francisco, San Francisco
JAMA. 2014;311(13):1287-1288. doi:10.1001/jama.2014.1026

Although health care is one of the largest industries in the United States, 73% of US residents who are ill have difficulty obtaining nonemergency care on nights, weekends, and holidays.1 The shortage of accessible primary care drives overuse of emergency departments for nonurgent conditions.

Commercial e-visit websites—companies without bricks-and-mortar clinics that use the Internet to connect patients to clinicians whom they never meet in person—may address the need for accessible, convenient care. These websites vary in cost and structure (Table and eTable 1 in the Supplement), but all provide a novel alternative to traditional care for low-acuity conditions such as bronchitis and urinary tract infections (UTIs). They offer convenience not only to patients but to clinicians. Most offer flexible hours, free malpractice insurance, and the opportunity to gain supplemental income for telephone and e-mail services that are often unreimbursed at traditional practices.