MAJOR Red Flag for Telemedicine | Antibiotic Overuse | Wednesday Checkup

čas přidán 18. 04. 2019
I've been saying for a long time that we NEED to recognize that telemedicine lacks the capacity to replace the traditional doctor's visit. I'm worried that the drive for profits will take center stage and proper healthcare will take a backseat. On this week's Wednesday Checkup we check out the new study out of the University of Pittsburg on the overprescription of antibiotics by Telemedicine providers.
Original study:
Other Study Mentioned:
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- Doctor Mike Varshavski
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  • Doctor Mike binge 2019 🖤

  • Is Dr.Mike wearing eyeshadow?

  • In Australia we have a government funded (free to use) 24/7 healthline where you can call and speak to a registered nurse. They assess your symptoms and advise you, basically, if you should seek emergency care or if you can wait to see a GP. They can also provide harm reduction advice to help until ambulance arrive/you can see a GP. However they never try to diagnose over the phone or replace a face to face doctors visit. That's what I think of when I think of telemedicine! However this form seems to place emphasis on profit over patient care which is disappointing and, frankly, alarming!

  • I am junior telecom engineer and i am really interested in telemedicine development, what doctors think that could improve telemedicine? Should it be used just for consultations?

  • Que bien me están tocando videos con subtítulos gracias Mike que tengas un excelente día Amore.

  • I get what you’re saying but I have had doctors who were so restrictive about giving me antibiotics that they refused to even when I obviously needed it. Once I had to go to 3 doctors to get treatment for an ear infection. Another time, I had a cough for over a month before a doctor gave me antibiotics.

  • Beowulf Blockchain Partners with MD24 House Call to Provide a Comprehensive Telehealth System. This partnership ushers in the new era of healthcare powered by the advanced telehealth system with real-time video consultation. Besides, this is also one of many more projects in the pipeline for us in pursuit of making health services accessible and affordable to every citizen of the world anytime, anywhere. For more details, you can follow this link:

  • This seems to be making a lot of generalizations. Is this just in the case of primary care docs? Isn't it just as bad for someone to overprescribe antibiotics in person as it is to the same in a telemedicine setting?

  • My mom subscribed to the Teledoc offered with her insurance, for a small fee (I think its like 10$ a month extra), but we thought it was a literal "tell me if i need to see a doctor or if it sounds like nothing" thing. I didnt know they can prescribe stuff as well. Eitherway, we would most likely use it like that (as more of a "consult a doctor first" thing). I prefer face-to-face with my health, because you never know what little things the doc might notice F2F that can totally change the diagnosis.

  • Antibiotics also destroy your gut flora don't they?

  • I agree

  • Idk if it's the same in the states, but the times I've had telemedicine appointments (usually using a walk-in clinic) a nurse does all the physical examination stuff and reports the findings to the doctor.

  • Had a videochat with my PCP for a letter of medical necessity I needed for a prior auth request - something that really didn't need a physical exam. But it took their office 4 months to bill it correctly so that my insurance paid the costs... So it initially was easier than going into the office, but the time spent afterwards to make sure it's paid for made me not want to use the televisit option anymore

  • Can you do a video on what all medical specialties do? PLEASE!

  • This is the only time I saw Dr. Mike not wearing a tight shirt or polo

  • I don't like telemedicine and my health insurance keeps sending me stuff about it and I keep throwing it away. My last doctor retired last year and he was an old school if you can tough it out he would make do so or if using over the counter was good enough he told you so.

  • CLONE HIGH!!!!!!

  • You should do a collaboration with DR Ed Hope, would be super interesting to compare the differences of UK health care system (NHS) and training to American. So many differences and similarities. Would be super interesting.

  • MRSA (multi resistent staphilococcus aerius) is rising in Hospitals these days (Europe, Hungary). It is a big issue! I am against antibiotics too, the problem is, that even if I have virus, because I have asthma in 90% of the time I have to take them, because of the second hand infections caused by bacteria! 😒

  • Its not the technology thats the problem, its the doctor like you, as a doctor you know your limitations, you know when to refer,..

  • SAY IT LOUDER!🙏🏼🙏🏼

  • Thank you for explaining this. I felt like I wasted my time going to the doctor a little over a week ago. I didn't understand why she just said keep up your fluid intake and what you're doing with drinking tea is great. I was like cool, I was already doing that... It was just a cold/flu so she didn't prescribe me anything.

  • I've had multiple MRIs, CAT scans, x-rays, and ultrasounds. Just wondering how many you can have before it affects you.

  • Love this channel! Dr. Mike is always so informative and fun to watch :) check out this lil salty moment too lol 4:25

  • Telemedicine is growing more popular bc the folks in charge care more about the bottom line than patient health a lot of the time.

  • Aren’t more and more antibiotics being combined with Clavulanic acid to help with resistance?(based on my google search after I was prescribed augmentin)

  • The minute you said "can it cause diarrhea?" I thought C.Diff.

  • I used a telemedicine app for the first time they other day. I had more questions then anything there wasn't actually anything wrong with me so there was no prescribing of medication or anything but the NP I talked to was amazing. The 10 minute appointment me last 20+ minutes, she answered all of my questions and really put my mind at ease. I didn't feel rushed at all.

  • Telemedicine is about convenience, yes, but it is about convenience in under-served communities. Telemedicine is designed for parents who work 3 jobs to support their families, parents who have multiple sick children, and individuals/parents/children who might otherwise NOT go to primary care visits without telemedicine due to being unable to take off work (and end up using emergency rooms as primary care offices). Sure, it may not fully replace a doctor's visit, but it is one still experimental step toward bridging major gaps in healthcare that we see today. I don't disagree that telemedicine has issues. But I do disagree that it's about the simple convenience of millennials.


  • Tell me why he looks like an Italian gangster

  • I typically just use Doctor Google before going to my doctor if I don't think it's an Emergency. I'm a person who wants answer NOW and my GP cant be available around the clock like that and Id never expect him to be. The difference between me and the average person is that I have an educational background in science and clinical biology. This means I understand the body and how it works and I also know how to look at studies and understand them and know which studies are good and how to look at multiple sources and what questions I need to ask in order to get an accurate response from google and understand what hypothesis I can throw out based on it's signs and symptoms compared to mine that google might suggest.

  • “Treating a virus with an anti-biotic is like trying to fight a mountain lion with a fog machine. It doesn’t help and it does make any godd*amned sense” (can’t remember who said it, but I love it)

    • Kaytee O'Connell using antibiotics isn’t smart to begin with. You’re a slave to the pharmaceutical companies

  • that's it, his *pee-woop* is going to be my notification ringtone

  • I had a horrible experience with a teledoc. He thought I had a fatal blood clot when I really didn't. Called an ambulance to my house and everything. I was freaked out.

  • The question I have is am I able to reverse the effects of overuse of antibiotics? Like using probiotics, can it make my gut bacteria normal again and stop the diarrhea or am I stuck with perpetual runs? If I haven't used antibiotics for x amount of time will bacteria in my body become less resistant again?

  • I think I have that shirt 🤔

  • Here in New Zealand from the times I've been able to sit in on a telemedicine consultation, it is very specific when we do them. Usually it's reserved only for patients who live rurally and transport to hospital for an outpatient specialist visit would take way too long. The telemedicine is set up as video call between the specialist (eg: resp, diabetic etc.) and the patient at their Family doctor/General practitioner's office so that way, there's a doctor essentially at either end

  • It is important to note that these studies examine direct to consumer (DTC) telemedicine services -- commercial services intended only to treat common urgent conditions, where patients/families do not have an ongoing relationship with the physician they see. Telemedicine is used in many other ways, including as the equivalent of an office visit with an established PCP. Your headline is certainly click-grabbing, but it is inappropriate to suggest that the failures of DTC services apply broadly to all forms of telemedicine.

  • That may seems odd but as you mentioned it happen outside of that. Even other industries will do that as well such as up selling too.

  • I was on Sulfamethiaxiole for about 4 months after my liver transplant (Idk if I spelled it right) I'm super prone to infections now.

  • Doctor Mike is my spirit animal

  • It gets me a doctor note for school.

  • jesus fucking christ are people taking antibiotics for basically nothing? I would get prescribed a fuck ton for stupid shit as a kid from actual doctors and I wouldn't take it because I know I didn't need to I literally have at least 4 full bottles of antibiotics each from a different trip to the hospital everyone should at the very least know the history of antibiotics, aka before we had anything to stop bacteria, and what will happen when we use them too much when they are uncalled for, which is bacteria will grow immune to antibiotics leaving to strains of the bacteria that is FUCKING IMMUNE TO EVERYTHING WE FUCKING THROW AT IT FUCK THAT DUDE ARE YOU FUCKING SERIOUS YOU FUCKING RETARDS ARE GOING TO KILL US ALL BECAUSE DOCTORS DIDNT GIVE A SHIT AND WANTED TO MAKE MORE MONEY HOLY FUCK

  • I love my doctor. I called to make an apt a few months ago because I had some kind of nasty virus. They told me to wait it out first, then call back. To take in lots of liquids like broth, and Pedialyte

  • Could you give your thoughts on IV drip bars and drip therapy? It’s a new craze and I’m interested to see if you think it’s worth the risk and cost.

  • I have the Samsung Health app and it has this built in. Can't use it for another year though anyway.

  • I'm watching this at the funniest time. I have a sinus infection (I very, very frequently get them regardless of whether or not I'm sick) and every time I HAVE to get antibiotics and I don't want to live with the infection for more than I have to, so I do a telemedicine visit so I can get a prescription. They're always so resistant to giving me antibiotics but every time I get amoxicyllin, I get better within a couple days. A bit frustrating. Most want to go with some decongestant but I can never stress to them enough without straight up yelling at them that I need antibiotics. I've also been told that my deviated septum isn't bad enough to warrant surgery. I have asthma and, although I'm not an expert on the subject, this seems to be something that can help cause frequent sinus infections. It's all very tiresome to deal with :(

  • I’m really interested in “CYA medicine”. 👀 that explains my experience with psychiatry.

  • Explains why my parents don’t like the new walk in clinic in my town and kept dropping me at the er when I was sick though they kept saying it was viral when I needed a stomach medicine like panteloc which isn’t an antibiotic

  • I've had one telehealth (videochat) appointment before. I still had to go into the doctors office but sat in the room with a nurse while the doctor was.. elsewhere? It was really weird to me, not a fan. I can see the benefits of being able to do that from home or during travel though. Maybe the doctor was traveling? Who knows. I definitely see wanting to cover your ass being an even bigger issue with telehealth than an in person appointment. It was the first thing I thought of when you said antibiotic prescriptions were high.

  • Antibiotics aren’t that great for you because some of the bacteria that affect us are eukaryotic like us, which means, if it’s harmful to them, then it’s harmful to us. Like fungi. You could prescribe antibiotics for fungal infections, but, since they’re a eukaryote, the antibiotics to get rid of that fungus would actually do more harm to us than good. So, instead topical creams can be applied 😀

  • Hey Dr Mike, how bad is it to crack your joints frequently? #askdrmike #plsanswer

  • Are things like lasers and coolscupting safe? And do they work??

  • Where do you shop for your clothing dress shirts? Ur outfits are always on point and I must know! If you get from Walmart that’s cool too, save more. Lol let me know!

  • This actually happened to me. I have IBS and i had a very bad "flu" where i was very sick and throwing up and headache and stomach pain. The doctor asked me if i had a fever and i said i didnt know. He said it sounds like a bad flu he had and prescribed me cipro. CIPRO which in turn ended up destroying my gut flora and since he didnt even physically examine my he would have spotted a large impaction forming.... since i was missdiagnosed i ended up in the hospital and off work on disability for 6 months. The impaction ended up tearing my colon... leaving me with muscle damage... im soooo nervous about antibiotics now! Turns out i didnt need them and would have been alot better off with a physical exam! Love ya dr mike you help so much! I really enjoy your channel 😊

  • The problem with telemedicine is that the only things they can do anything about, so to speak, are the things they shouldn't be doing anything about. 99% of telemedicine patients are there because they have a cold or other viral infection. Over-the-counter garbage seldom works and often can actually make symptoms worse (See a URI patient taking nasal decongestants (in almost everything) which is going to loosen nasal mucus and drain it into the lungs while sleeping -- making the cough worse). But a patient doesn't want to spend their 50$ on an e-visit to be told "Drink Tea with Honey" or "Get plenty of rest". They want a prescription because they perceive that will fix it. Antibiotics should seldom be given without a positive culture being obtained. The challenge in getting the right antibiotic for the right infection requires lab work in many cases. A generic Cephalexin prescription may or may not even cure your bacterial infection. What antibiotics do is totally wreck your microbiomes and throw a body completely out of homeostasis. Sometimes this risk is worth it because the bacterial infection is severe (an abscessed tooth, for instance) and can cause permanent damage to critical organs. Most of the time, you're just shooting your immune system in the foot and making that antibiotic significantly less effective for both yourself and the rest of society. Wanna' be scared? Antibiotic-resistant bacterial strains have a scarily increasing mortality rate. We're not talking about statistically insignificant percentages of .002% -- we're talking 10%, ie. 1 in 10 people who come down with one of these infections won't make it out alive. And these bacterial strains are becoming worse due to obscene overprescribed ABs

  • What is your knowledge on cCMV (congenital Cytomegalovirus)? I work for an organization which is trying to bring more public awareness to this but has faced difficulties within the health care community BUT these same health care practitioners national associations are agreeing that this is a public health issue! Would love to hear your opinion 💕

  • Can you do a video on relationships in med school?

  • I want that shirt. Dr. Mike, where'd you get that shirt?