First, let’s define “asynchronous” as “not real-time conversations.” Instead of oral conversations, it’s messaging you respond to when you have the time. Of course, jumping on a call or video is always an option when necessary. But we all know how many emails we send vs. how few out-of-the-blue calls we make in a given day.
Traditional healthcare has always been a real-time oral conversation in an exam room. But what if 95% of interactions with your doctor looked more like how we get real work done nowadays? We all use a ton of email, shared documents, photos, Slack, iMessages, etc. And meetings are (hopefully) reserved for big important things. Asynchronous conversations with co-workers, family, and friends has totally revolutionized our lives. So how would this affect how you communicate and problem solve with your doctor? Essentially, what are the advantages of asynchronous communication with your doctor vs. real-time exam room communication? After 7 years of pioneering the asynchronous practice of medicine, we’ve learned a ton. We know it’s important to work with the same doctor when working asynchronously, because knowledge of all the details of your situation over time is professionally the right, safest thing to do. And I believe both doctors and patients, when given a choice, choose relationships over transactions.
Ultimately, working primarily online, instead of primarily in an office, means a markedly new, different, and I believe, far better way to solve your health problems. Here’s what this means to you.
You don’t have to make an appointment. Just communicate whenever you want with whatever device you want, wherever you are.
You can answer questions and describe everything in your own words, without a single interruption.
You can take your time to respond thoughtfully to questions, instead of feeling pressured for time.
You can read and re-read if you forgot something your doctor said. Your entire conversation is available to you whenever you want. And since people forget 85% of what their doctor says in an exam room, this simple fact means the asynchronous communication of information is apples and oranges.
You can easily share photos with your doctor so you and your doctor can objectively assess your progress.
Your doctor can send a quick check-in super easily to ensure your condition is resolving as expected. Imagine getting an out of the blue message from your doctor, “Hi Jay, just checking in to see how you’re feeling.”
Even when your doctor is off or on vacation, her covering doctor can read all the messages and activity within your thread and profile and understand the entire situation.
Complicated concepts or jargon can be hyperlinked to the best online content.
If you forgot to ask a question or need any sort of clarification, you just send the question without having to make another appointment.
Your day doesn’t have to be interrupted to take a call or make an appointment.
You don’t have to travel to an office for an appointment.
You can quickly understand exactly what you need for your unique situation— can this be treated online or should I visit an urgent care center, ER, or a specialist?
You don’t have to find a quiet place to have a sensitive conversation. In the era of open offices, this is a real problem.
You don’t need to look someone in the eyes you don’t know and talk about embarrassing or sensitive issues.
You can be shown prices for things like tests or medications helping you shop and choose the least expensive place to buy them.
You can have expensive things like MRIs and procedures negotiated on your behalf prior to the test or procedure.
You can request a refill on a medication without the phone calls and the harassment to come in to the office so your doctor can get paid.
You can always pick up the phone or jump on a video when you need to have a real-time conversation. But the combination of messaging + photos is sufficient 95% of the time.
If you’re in the hospital or in the ER, you can send off questions to your doctor about your situation.
Your doctor can invite the most appropriate specialists, care navigators, and other experts into the online conversation to work with you to solve your health problems. Think of this as adding someone to an email thread.
Your doctor can do the research to determine who they want to refer you to, instead of just referring on a whim.
Your doctor can research your symptoms or the latest therapies instead of having to make time-pressed, split second decisions.
Your doctor can “call a colleague” when she needs help or guidance about your situation and then respond to you based on a consensus.
Your doctor can use standardized ways to ask you all the questions she needs to cover all bases and ensure she doesn’t miss any important details.
Your doctor can use standardized treatment strategies and care plans that offer the most up-to-date evidence-based treatments.