While patients teleport to the doctor’s office, the pharmacy increasingly bypasses the doctor to teleport directly to the patient. Israel has joined the frenzy of foreign pharmacies cashing in on the high price of drugs foisted on US consumers, who don’t necessarily even need a prescription.

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Physician house calls in the US are staging a comeback. Last year there were more than 2 million, nearly 9 percent more than the year before. An article in the Los Angeles Times attributes the resurgence to “advances in medical technology, an increase in Medicare reimbursements and a growing recognition that house calls make economic sense for certain patients.” Older people with chronic illnesses, who make up only 5 percent of Medicare enrollees but consume 43 percent of the Medicare budget because they “end up cycling in and out of emergency rooms, hospital wards and nursing homes” in particular would benefit from house calls, as would their families and the taxpayer.

One small physician practice in California, that makes about 800 house calls a month, is able to perform procedures once possible only in offices and hospitals because the technologies now fit into a bag or the trunk of a car.

Home Teleheath

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A University of Florida engineer has built a working prototype of a portable Doppler radar system that can monitor a person’s breathing and heart rate and transmit the vital signs to medical personnel via cell phone or the Internet. Its primary purpose is to help the elderly avoid unnecessary visits to the doctor’s office for simple checkups.

The prototype is about the size of a cigarette carton, but the goal is to shrink it down to the size of a PDA and ultimately to incorporate it within a cell phone. Its radar waves detect the in-and-out movement of the chest and the motion of the heartbeat against the chest wall. Its inbuilt computer transforms the radar signals to breathing and heart rate, creating an EKG-like image on an oscilloscope or laptop. It takes accurate readings within about nine feet of the patient. Its mere 1 microwatt of radio frequency power poses no health risks.

The system may have other applications; for example, measuring the vibrations in a speech-impaired person’s throat and translating them into computer-generated speech.

TelaDoc

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Midway along the spectrum of personalized medical services, standing between expensive “concierge medicine” and inexpensive, nurse-staffed clinics in grocery supermarkets, is a new service called TelaDoc. For a US$18 joining fee, $4.25 a month subscription fee, and $35 per call, a patient can call and talk with a doctor in the TelaDoc nationwide network. TelaDoc guarantees a response within three hours, or the call is free. The company’s doctors will not prescribe narcotic painkillers and won’t treat patients under age 12. Allergies, colds, sprains and recurring urinary tract infections are examples of conditions TelaDoc doctors can treat over the phone.

The service is drawing the ire of some physicians and the approval of others.

Israeli Pharmacies

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US consumers now have an alternative to online Canadian pharmacies for medications cheaper than they can buy at home. Israeli companies www.MagenDavidMeds.com and www.IsraMeds.com are among those advertising lower prices in national Jewish newspapers and magazines.

Example: A dozen 70 mg tablets of Fosamax: $210.79 at Walgreens, $133.23 from Canada Prescriptions Plus, and $115.80 plus $9.99 shipping from MagenDavidMeds.

Israel, like Canada and many western European countries, controls drug prices.

Internet Pharmacies Unstoppable

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According to an article in the Detroit Free Press, federal authorities concede that Internet pharmacies that ship prescription drugs without a prescription have become a nationwide problem. The paper quoted Scott Burns, deputy director of the White House Office of Drug Control Policy, as admitting “We’re obviously trying to catch up,” and Drug Enforcement Administration chief Karen Tandy as recognizing that “The Internet has become an open medicine cabinet.”