goShadow partner Dr. Timothy Wong is a Primary Care Physician located in the bustling East Liberty neighborhood of Pittsburgh, PA. His clinic, iHealth, operates on a revolutionary “flat fee” model and accepts no insurance. Recognizing the barriers to care inherent in the US health insurance model, Dr. Wong bucked the traditional mold and instead of billing insurance and charging a co-pay, charges all patients a flat $35 upfront fee for service.

With no expenses incurred for insurance billing and coding and eliminating the need for a large staff, Dr. Wong takes payment via ipad and is the sole employee of iHealth. This keeps the costs low for patients who lack insurance, need a same-day appointment or have questions that can be addressed via phone/video. He sees the majority of his patients on a walk-in basis, and due to his approach and lack of insurance requirements, they come from all over the tri-state area. 

In the midst of this unprecedented health crisis, Dr. Wong has some insights into how to remain patient-centered in an era when many aren’t receiving care face to face. With a newly released telehealth platform, he is hoping to reach more patients than ever before. He also has practical insights and important information for staying healthy, when to seek care and taking proper precautions to protect yourself and your family. 

What are the benefits of telemedicine? Do you find it is a struggle to properly communicate/diagnose patients over the phone/virtually?

The benefits of telemedicine include increased access to care due to low cost of providing care and increased convenience. Our platform actually gathers a great deal of information before the patient even schedules an appointment, so it is more efficient and yields better diagnoses than other platforms. I suspect the biggest problem with telemedicine is the limited physical exam that can be done. Even something as simple as a cold requires a thorough physical exam; though there are many conditions that do not require a thorough exam (headache or birth control management for example). 
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Are you seeing an increase in patients (in person or via telemedicine) since the start of the COVID-19 pandemic? What is your plan going forward to continue to provide care, especially as lockdowns and quarantines extend?

I have seen a great deal of interest in telemedicine... as patient volumes have decreased significantly in my clinic (the same for other urgent care clinics and primary care clinics). Our clinic will continue to be open as people still require primary care services for their acute and chronic issues. We will hopefully be able to pivot to doing more telemedicine as well. Governor Wolf has pointed out that health care facilities should remain open during the lockdown. 

What is your recommendation for patients who need non-COVID related medical care? Or who are experiencing other health symptoms but don’t want to use valuable resources?

I would agree with the current recommendations of avoiding elective procedures (knee replacement, cosmetic surgery, cancer surveillance procedures, etc). Primary care is still available and clinics are still safe places (as we have precautions that help ensure patients with possible COVID symptoms should remain at home and not be seen in the clinic). If there are possible COVID patients in a clinic, the clinic should shut down or sanitize heavily before allowing other patients in the clinic. I would also recommend using the emergency departments only if you believe it is a true emergency. It is estimated that 1/3 of ER visits are not appropriate. We should try our best to let the Emergency Rooms focus on life-threatening issues. 

Patients with other health symptoms should continue to utilize the healthcare system. There are no county or State guidelines that prohibit patients from seeking care if they require it. For example, if your uncontrolled diabetes at home, getting help is far safer than potentially getting exposed to COVID. If you think you might have a heart attack or stroke, these are medical emergencies and are more life-threatening than possibly being exposed to COVID. Again, I would try to avoid going to the emergency department if you have minor issues so that the staff there can focus on the major cases.

What is your advice for anyone/everyone going forward? 

I would follow the county and State guidelines. These can change daily, so being aware is important. If you start to develop any COVID symptoms (fever, cough, shortness of breath), I would call the County Health Department to see if you require testing. Testing, unfortunately, is still difficult to get. If you do not have any COVID symptoms, you currently do not need testing but should quarantine as usual. 

For those patients who live in rural areas, what do you recommend they do during the current crisis if they need medical care?

Rural areas are safer in terms of potential exposure to COVID when compared to urban areas. I would follow the local county guidelines and still seek medical care if needed. Patients still need their hypertension, anxiety, diabetes, and cholesterol managed. Rural areas have much lower cases of COVID currently and the potential risk of exposure currently in most rural areas is quite low. Again, I would avoid any unnecessary activities but seeing a medical professional would be fine. 

Healthy people can continue to be healthy by following the recommendations. Minimizing unnecessary exposure, cleaning hard surfaces, keeping informed, staying at home and continuing to be patient. This might also be a good time to develop some good habits if possible (set new cleaning routines, learn and practice healthier recipes, start exercising at home, etc.). Also, think about others during this scary time and practicing empathy for those affected more greatly than us is important. 

Any additional thoughts:

I think putting the pandemic in perspective should help. The CDC estimates that 35 million Americans had symptomatic seasonal influenza last year (2018-2019) that resulted in an estimated 34,000 deaths. While deaths from COVID will unfortunately increase, this also puts something like influenza in perspective as well. Getting a flu shot every year is extremely important and I hope the current pandemic instills some valuable lessons to our community despite being a difficult and tragic way to learn. 

For more information on iHealth and Dr. Wong’s new approach to insurance free healthcare, visit https://ihealth.clinic/. 

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