  Your throat hurts, your nose is stuffy, and you have that "uh-oh" feeling -- as in "uh-oh, is this just a cold or allergy or am I coming down with that horrible flu?"
Should you see your doctor? What if your doctor has a full schedule the day you’re sick? Maybe you can get an appointment but then spend a frustratingly long time in a crowded waiting room surrounded by people who look and sound a whole lot sicker than you. Odds are, even if you don’t have a communicable disease when you arrive, you’ll be exposed to a nasty bug or two by the time you leave.
Another option is to stay home, search the Internet, and chat with friends on Twitter and Facebook, hoping to find somewhat accurate information about what to do about your symptoms. Or if you start feeling really bad, you can go to the ER or an urgent care center where no one knows your history and where, once again, you’ll have to wait surrounded by sick people and risk overburdening an already busy emergency care system.
Shouldn’t there be a better way to get timely health care in this high tech, computer-connected, information-dense age? Some doctors think so. In fact, they’re combining the friendly, personal touch of social network sites with the speed and convenience of e-mail, instant messaging (IM), online videos, and even -- if needed -- house calls. The result is a new style of responsive patient-to-doctor communication that could change the face of medicine.
A case in point: a group of physicians are using 21st Century technology to communicate and practice medicine under the banner of Hello Health (www.hellohealth.com). Founded by Jay Parkinson, MD, this consumer brand of neighborhood doctors is based in New York and admittedly takes more than a little inspiration from Zipcar, Netflix, and Facebook.
In his blog, Parkinson calls it a "‘consumer experience’ of having your own accessible neighborhood doctor who communicates the way we all communicate these days, via email, IM, video chat, and text messaging. Hello Health are neighborhood-based doctors for a Netflix-priced, monthly subscription fee, using our technology and a hyperlocal, neighborhood doctor’s office to change health care -- to rescue both patients and doctors."
 Parkinson came up with the idea in 2007, when he opened his first medical practice and posted this philosophy: "We communicate differently nowadays. So it seems to me we should use that communication to work with patients to deliver health care that keeps you and your bank account as healthy as possible."
He set up an on-line calendar allowing patients to make appointments, and a form to let them to tell him what was wrong. If they needed a house call, he’d go see them. The concept not only went over well with patients, but it struck a chord with the media, thousands of doctors who contacted him, and the general public. He had 7 million hits on his web site in the first month.
Three other doctors now work with him in his Hello Health practice. This summer, the Hello Health platform, which Parkinson describes as being as robust as Facebook, was launched throughout the U.S. Now, the fast communication health care model is available to doctors nation-wide who want to set up a storefront at hellohealth.com.
Here’s how it works from the patient’s end. You join Hello Health for a small monthly fee and choose a Hello Health doctor in your area whom you’ll initially meet in person. After you’ve established your doctor/patient relationship, if you are not feeling well or have a question about a medication or symptom, you simply go to the Hello Health website, tell your doc what’s wrong in your own words, then schedule an appointment via IM, email, phone, or in person.
"There’s no waiting room. You reserve a time with your doctor and, our doctors are paid by the hour for that amount of time. You can even do it on your lunch break," says Parkinson. "If you set up an IM session and the previous patient hasn’t finished up yet, your doc connects with you online, so that solves the issue of waiting. Patients have a doctor they can communicate with at all times."
Parkinson estimates this ease of communication can eliminate about 50 percent of office visits for things like medication adjustments and questions about symptoms. Parkinson also asserts that being able to directly and quickly reach your doctor results in safer health care. "We are not creating a telemedicine platform. It is very person-to-person. Right now, when most people need to talk to a doctor they are waiting and waiting, and often getting sicker. This is safer, more communicative medicine. And if a doctor picks up a red flag from a quick communication with a patient that something serious is going on, they can have the patient seen right away."
 Doctors are paid the same per hour fee they charge for the time spent with you, whether in person or online. According to Parkinson, a Hello Health consultation usually ends up being about $50 cheaper than your typical office-based physician visit. The savings can be particularly helpful to the 50 percent of Hello Health patients who are uninsured.
While many insurance companies cover Hello Health visits, some patients opt for his practice’s docs even if they have to pay out of pocket. "Having insurance doesn’t mean you have the access to your doctor when you need it. But our model provides access that saves a lot of people valuable time," Parkinson says.
Using the computer-based communication saves physicians an enormous amount of money and time. "The typical overhead for a doctor’s practice is about 70 percent. Each doctor normally needs to hire four and half people to maximize how many patients they can see and how quickly they can get paid. With our new model of health care, our overhead is about 25 percent with one person supporting three doctors. That’s a game changer," Parkinson says.
Another advantage for doctors: they can connect with other physicians through the Facebook-type platform. "It removes the issue of sort of practicing in a silo, yet they totally retain their independence. And they can communicate with other doctors and help each other out quickly," Parkinson notes.
The concept of using a social network-type access to reach your doctor may sound like a no-brainer to those who visit Facebook and Twitter daily. But will doctors climb on board? Parkinson says the medical community is, for the most part, surprisingly behind the times. "Forty-one percent of people over 65 use the internet every day but only 10 percent of physicians use computers in their practice. Doctors are behind the elderly in this regard. Computers are just expensive billing machines to a lot of physicians," he says. "Business models are stuck in the l980s. It is clearly time for a change."
E. Robert Schwartz, MD, professor and chair of family medicine at the University of Miami Leonard M. Miller School of Medicine, agrees it is necessary for Internet communication to become a part of contemporary health care. "Most of my colleagues around my age, 60, haven’t allowed this technology to become part of their practice. But after a while, if you use it effectively, it is enormously helpful," he says.
Moreover, Schwartz thinks the fast and direct communication of a social network-type platform could help patients with serious illnesses in under-served communities who otherwise rarely get the health care they need. He’s working now to get funding for a program to provide these patients with Internet connections and computers in their homes so they can be in direct contact with their doctor or nurse when needed. They’ll also receive information about their medications, instruction on managing their medical problems, and be able to ask questions about treatment and lab tests.
"We can’t treat via e-mail, but there’s so much we can do besides electronic medical record keeping," Schwartz says. "The connection between patient and doctor can be enormously enhanced by technology. It’s time to push the envelope."
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