What can’t Virtual Primary Care do?

Sherpaa is one of those things where, once you experience a primarily online relationship with your own doctor, it’s hard to imagine going back to the old-fashioned “you can only talk to me during an increasingly expensive exam room visit.”

I talk a ton about how amazing Sherpaa is and why you should be primarily communicating and problem-solving with your own personal doctor online, but what can’t Sherpaa doctors do?

We can’t do physical exams.

But the physical exam is a surprisingly uncommon critical piece in determining a diagnosis.

We can’t do minor primary care procedures that some primary care doctors do (like burning off warts or suturing simple lacerations).

If you need something like this, if it’s time-sensitive, urgent care is best. If it’s not, a random PCP visit found via ZocDoc will suffice. Primary care procedures done by a traditional PCP in an office are quite uncommon.

We can’t (or, rather, actively decided not to) prescribe controlled substances like pain killers or ADHD meds.

To avoid any element of fraud and controlled-substances, Sherpaa’s internal policy is no controlled-substances and our EMR does not allow our doctors to prescribe these medications.

We can’t do simple in-office (CLIA-waived) tests.

These are things like rapid strep tests or UTI tests. Fortunately, many of these tests are increasingly being sold in Walgreens. And if the test is absolutely the vital missing piece of a diagnosis (which is relatively rare), a quick trip to Walgreens or even their retail clinic is far less expensive and more accessible than a traditional PCP office visit.

We can’t be in the same physical room as you.

Sometimes being able to read body language is a subtle piece of a diagnosis. But over the years we’ve found that reading how someone writes about their symptoms often provides similar clues. Also, because a Sherpaa visit isn’t a rushed 10-minute conversation, and you can respond to your doctor’s questions thoughtfully and without pressure or interruptions, our doctors all believe we get far better information from our patients.

Sometimes you’re dealing with something very serious and emotional and the physical presence of a compassionate doctor is comforting. This is a perfect example of when in-person visits are vital. Luckily, most health conditions in the working age population are common bread and butter health conditions that aren’t super serious, emotional, and life-threatening. By far the most common primary care issues in the folks who have graduated from their pediatrician but don’t yet need a geriatrician are acute and resolve with treatment or are chronic and are best managed with close communication and problem-solving between you and the ongoing relationship you have with your own personal doctor. Unfortunately, that relationship in today’s healthcare system has been decimated and has been replaced by urgent care centers and a revolving door of PCPs, nurse practitioners, and physician assistants who are increasingly powering all these local primary care practices.

In those extremely serious situations, your Sherpaa doctor’s role is to play real-time care coordinator to ensure you are in the same room as quickly as possible with the expert best trained in exactly what you need. This is best done via online communication so your doctor can best coordinate your entire situation, so you’re never left alone without a doctor advocate you can reach within minutes.

Other than those 5 things, by far, the best way to communicate with your own personal doctor is online and throughout your health condition until it’s resolved or is optimally managed. Health conditions are stories that evolve over time. Office visits are tiny 10 minute conversations at one small point in that story. You are the main actor in that story, but hopefully your doctor wins the “Best Supporting Actress” award.

So what can Sherpaa doctors do?

• Be the doctor you can depend on who’s available via message or phone within minutes, 24/7/365, for any and all of your health issues

• Proactively communicate with you throughout a condition with check-ins

• Order labs and imaging tests, receive the results, and take action

• Diagnose and monitor your progress with tests, photos, and biometric data

• Prescribe and refill the vast majority of medications

• Manage 1,500 acute and chronic conditions

• Arrange visits and procedures with local specialists and surgeons

• Ensure you avoid ~80% of office, urgent care, and ER visits

• Help you spend your money wisely on care by being cost-conscious on your behalf

• Help you find and arrange affordable procedures with preferred surgeons

• Practice conservatively by checking in regularly with you to see how your conditions evolve rather than prescribing the big guns because we don’t know when we’ll ever see or talk to you again.