It starts out like any other visit to the doctor for a sore throat. First we have to wait 15 minutes. Then we meet the doctor, a grandmotherly type who asks us about medications and how long we’ve had our hacking cough. Finally, she asks us to open wide—and things get a little weird. She is, after all, not in the room with us but on the other end of a webcam connection, 100 miles away. So we’ll need to awkwardly straddle our desk to give her a glimpse of our gullet.

It might sound funny to people used to wearing paper gowns and feeling a cold stethoscope on their chest, but to an unprecedented degree, a host of doctors are stepping into the brave new world of “virtual medicine.” Some are using secure Web site services or setting up virtual offices where patients can input health data like blood pressure readings or request prescription refills—without leaving their desk or sofa. Others are emulating middle school students, using Web chat programs to gather information on patients’ symptoms and firing back diagnoses from their keyboard. And then there’s the webcam: Already the enabler of Skype conversations with far-flung family members, it’s now playing a starring role in virtual office visits that have an eerie likeness to the real thing.

Once limited mostly to rural areas where large-animal veterinarians outnumber family doctors, digital medicine is breaking into the mainstream. Manhattan Research, a tech-focused firm, recently reported that in 2009 about 40 percent of physicians were communicating with patients online, up from about 15 percent five years before. Meredith Abreu Ressi, a VP of research with Manhattan, says most of the doctors are deploying the computer “to discuss clinical symptoms” and often to make real diagnoses. Insurers have taken note too. Aetna and Cigna now routinely cover virtual visits, and UnitedHealthcare will be rolling out its own nationwide site offering chat and webcam features later this year.

It’s another weird ingredient in the strange cauldron of the health care system. Medical costs already average more than $7,500 annually per American, and with most people’s out-of-pocket costs continuing to rise, any way to save money is looking good to patients right now. And of course, in a still shaky job market, many employees would rather avoid skipping work for a trip to the clinic. “To not have to schlep out in the snow to see the doctor, that’s the dream, isn’t it?” asks Thomas Weida, a family-practice doctor in Hershey, Pa. But Weida and other physicians worry that online medicine could compromise patient privacy or worse, lead to diagnoses that are flat-out incorrect or harmful—the kind of thing that could turn the digital dream into one of those going-to-school-naked nightmares.

Cheaper. Faster. Better?

Without a doubt, virtual medicine looks enticing to penny-pinchers. Studies have found that Web visits cost $25 to $50 for patients who aren’t going through their insurance network, compared with the $100 to $125 they’d pay for the same service in a bricks-and-mortar office. To sweeten the deal for people who do have coverage, insurers like Hawaii’s Blue Cross Blue Shield offer the sort of copays not seen since the 1980s—$10 for online visits for straightforward conditions like ear infections or sinus pressure. And a quick e-mail to the doctor for a prescription refill is usually gratis.

Just as important in the era of the impatient patient, many online services offer appointments within the hour. That’s a far cry from the 20-day wait that’s now the average for a routine physical in many large U.S. cities. In specialties where waits can stretch even longer, Web medicine is catching on even faster. Instead of queuing up for the dermatologist, for instance, some patients get their skin conditions diagnosed by flashing their rash at a webcam. Skittish pregnant women can get quick-hit answers to their concerns directly from gynecologists—instead of bozos on a message board—via live chat. And doctors can easily monitor patients with chronic conditions like diabetes by having them input data like daily weight and blood-glucose count via a Web site designed to spot aberrations. Some doctors say they benefit from the convenience as much as their patients do. Lisa Rankin, a primary-care doctor in Port St. Lucie, Fla., says she’s often able to do Web visits while sweating away on the stationary bike in her basement, saving her office hours for more serious cases. Compared to playing phone tag with patients, she says, “the computer is easy as pie.”

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