© Michael OReilly

The virtual doctor has arrived

CyberDocs is a medical consultative service that provides care directly over the Internet by using a Web site and live one-on-one chat sessions instead of a traditional office. Although a short-lived Canadian operation provided a similar phone service that charged $4 per minute (see CMAJ 1997;157:433-4 [full text / en bref]), CyberDocs is billed as the first operation of its type to rely solely on the Internet.

Dr. Kerry Archer, a cofounder, says the service is a "quantum leap backwards" because every consultation is, in effect, a house call. "CyberDocs provides direct doctor­patient interaction in a secure, encrypted virtual-office setting that is highly convenient to patients having Internet access," Archer said when he launched the service. "We feel our patients appreciate the convenience of having a CyberDoc physician literally at the tips of their fingers, no matter where in the world they might be."

After completing an online questionnaire, users have a "real-time" chat with a physician at a cost of $50. "Patients" are led through the necessary medical history and personal-information forms and then asked to describe their current medical problem.

After this is done the patient enters the "doctor's office," where a cyber physician joins them via a text-based conferencing system. Using the keyboard the patient and doctor 'talk' about the problem and eventually arrive at a diagnosis or otherwise answer the patient's questions.

Archer said the system employs full encryption and secure computer servers that protect all medical, personal and credit card data. All patients are billed via their credit card.

The range of services includes acute medical consultations, second opinions, care for minor illnesses, medical referrals and emergency prescription refills. The cyber physicians will also answer questions and help patients interpret information found on the Internet.

"So far we've served hundreds of patients from 7 countries," said Archer. "Based on feedback questionnaires, people appear quite pleased with the services."

Archer said CyberDocs is not meant to replace traditional physician visits. Patients needing follow-up care are always referred to their regular physician. As well, he stressed that the service is not appropriate for all conditions: the company will not deal with potential life-threatening problems such as chest pains, shortness of breath or abdominal pains, and patients requiring close medical supervision will not be accepted. The company uses the web site to screen out these patients, and Archer said the system has worked flawlessly.

"Our role is to provide initial consultative medical care," said Dr. Steven Kohler, a CyberDocs cofounder, "and only on a provisional basis for simple medical problems, pending further doctor patient interaction in an office or hospital."

"Essentially we are taking care of generally young and health patients with minor medical conditions," added Archer. Problems discussed through the service have ranged from hair loss and acne to emergency medication refills and general medical questions.

The URL for the service, which is based in Woburn, Mass., is www.cyberdocs.com/.

CyberDocs, which treated its first patient in January 1997, now deals with 50 to 100 patients per month. "We currently have 2 physicians providing the real-time consultations, and about 10 specialists are on board to provide specialty services," Archer said. "We are actively recruiting and hiring more physicians."

He said the Internet service doesn't interfere with regular medical care: "I don't think we've taken any business away from traditional physicians." However, he thinks telemedicine, in its many forms, is going to have a major impact on medicine. Although Canada is already a world leader in telemedicine, Canadian doctors have yet to experiment with this type of Internet service.

In the future, Archer said CyberDocs will move beyond keyboard consultations and begin offering videoconferencing services. Information about the service is available from admin@cyberdocs.com. -- © Michael OReilly

CMAJ November 15, 1997 (vol 157, no 10)

JAMC le 15 novembre 1997 (vol 157, no 10)