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TWO VIEWS : For a Fee, Health Answers May Be a Phone Call Away

It’s early morning and you’re wondering whether the itchy rash on your arm is a side effect of your new medicine. Or you’re debating whether to send your daughter, who woke up with a slight temperature, to day camp.

The answers are as close as the telephone, say proponents of two new 900 “telephone medicine” services. One is 900-77-DOCTOR, the Manhattan-based Doctors by Phone, which debuted in May. For $3 a minute, one of the 80 staff physicians will try to help.

There’s also 900-4200-ASK, the line for “Pharmacy Question? Ask the Pharmacist,” which began in February. For $1.95 a minute, one of 17 staffers or 62 pharmacists on call will answer questions. “We do not diagnose,” says pharmacist and founder Mary Lynn Bell.

Nor are the services trying to steal patients, say the founders. From nearly the first ring, though, there has been a swirl of controversy. Here are two views from a pharmacist and a physician:

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CHRIS LOMAX, director of pharmacy services, Childrens Hospital Los Angeles :

“Appropriate and timely drug information is important for anyone taking a medication. Often, pharmacists in the community setting do a very poor job of making this information available because of workload and other time constraints.

“But a phone pharmacist is not the answer entirely, either. A phone pharmacist will need to be careful not to overstep his or her boundaries. For instance, they might not know about other medications the patient is taking and not be able to warn them of potential interactions.

“One downside might be that you are not interacting with your own pharmacist. I am sure some of my peers (in community- or hospital-based pharmacies) will say this phone system is not a good system. But if pharmacists and physicians were better at providing information and education to their patients, these services would not exist.”

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IRVING ACKERMAN, internist, Kaiser Permanente, Los Angeles :

“I think these phone lines could be of use for general information. But the great majority will end up referring patients back to their own physicians.

“If a caller wants to know what the incubation period is for measles, the (telephone) physician should be able to easily answer. They can give general advice.

“But suppose a patient says he has a sore throat. A sore throat could be caused by a virus and need supportive care, like gargling. But a sore throat could be strep, which needs antibiotic treatment. And no one can tell over the phone.

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“Used cautiously, the phone services will serve a purpose. But they are not inexpensive.”


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