Telehealth-Only Practices Offer Access To Hard-To-Reach Specialties

If you haven’t had to make an appointment with a high-demand specialist lately, be grateful. As for me, I’ve spent the six months going back and forth trying to get appointments with the right specialist and sub-specialists to treat a neurological condition.

Today I was overjoyed to connect with the office of one of the subspecialists — only to become a lot less excited when I found out they couldn’t see me till March. Given the circumstances, I accepted the March appointment, but to say I was exasperated was an understatement.

So what does this have to do with Health IT, you might ask?  Well, not to overstate the case, but a new breed of telehealth practice is solving the problem of how to get help while I wait, and I think it’s an approach everyone involved in the mechanics of delivering care should study.

Once I saw how long I would end up waiting for face-to-face specialist care, I hit the web in search of options. Because chronic pain is the most intrusive part of my condition, I sought out a web-based pain management service to see if it could at least bridge the gap in time before I could be seen in a brick-and-mortar setting.  My search brought me to Clearing, a web-only pain management practice.

Clearing, which just got $20m in seed funding, is one of a rapidly-growing list of hyper-focused web-based specialty practices popping up online. They seem to be designed to treat only a handful of the most common conditions seen within their discipline.

After registering for the site, I messaged the care team with a clinical question. To my delight, I got a note from one of the site’s pain management physicians in less than 24 hours.  The physician, Jacob Hascalovici, PhD, MD, who is one of Clearing’s founders, has continued to offer thoughtful answers to my many questions during my time as a site member.

As it turns out, managing my longstanding issues is probably beyond Clearing’s design. A meeting I had this week with a subspecialist suggests that standard first-line treatments usually thrown at my condition probably won’t get the job done.

However, having ongoing access to Dr. Hascalovici’s advice alone has been worth many times the price I paid to join the site.  In responding so quickly and carefully, he gives me the sense that he has nothing better to do than answer my questions. Sadly, that’s something other harried subspecialists I’ve met with usually can’t offer, for reasons well out of their control. (My guess is that Clearing clinicians won’t be able to offer this level of responsiveness either once the site’s patient volume climbs to a higher level, but I’ll take high-attentiveness mode while I can get it.)

This specialty practice model offers a terrific alternative to seeking help from a PCP or urgent care clinician, either of which would turn me away if I asked them for short-term help with ongoing symptoms. They just aren’t positioned to do anything about my condition at the moment.

Next week, I finally see an offline pain management specialist who’s in the position to tackle issues beyond what the Clearing model is designed to address.  Thanks to the site, however, I have had at least a chance to get some form of treatment, professional advice, and education while I wait for my appointment day to arrive. If my health system had offered this kind of short-term remedy I would have jumped on it.

About the author

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

2 Comments

  • Good luck with the condition, Anne. I suspect that telehealth offerings such as Clearing work best (even more than the traditional medical establishment does) for educated patients who can be self-advocates. Use of the services is predicated on identifying a problem, describing symptoms, and following through on advice. What is your observation?

  • Hi Andy,

    Thanks for your comments. Actually, I identified the problem a long time ago (5+ years) but I have had great difficulty getting to someone who will actually treat the symptoms. I’ve followed through on the advice of several specialists and keep getting sent back to pain management, which in turn keeps kicking me back to primary care for medication aspects of my care. (These days, many pain management practices simply don’t do medication management at all as they don’t want to face opioid prescription issues.)

    Dr. Hascalovici (my Clearing doctor) has speculated that I could have a condition called lateral femoral cutaneous neuropathy (LFCN), and I have jumped on this given that the description of LFCN squares with my symptoms. None of the other physicians I’ve talked with have suggested that diagnosis. So this seems to be an example of my willingness to find new resources, self-advocate, research and respond paying off. However, it’s notable that these same instincts didn’t get me far offline.

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