title: A survey of direct-to-consumer teledermatology services available to US patients: Explosive growth, opportunities and controversy.
abstract: Introduction Direct-to-consumer (DTC) teledermatology is radically changing the way patients obtain dermatological care. Now, with a few clicks, patients can obtain dermatological consultations and prescription medications without a prior physician-patient relationship. To analyse all DTC teledermatology services available to US patients. Methods We performed Internet searches to identify DTC teledermatology services available through Internet webpages or through smartphone applications. For each service, the scope of care provided, cost, wait times, prescription policies and other relevant information were recorded. Results Twenty-two DTC teledermatology services are available to US patients in 45 states. Six (27%) services offer care from international physicians. Sixteen (73%) services allow patients to seek care for any reason, while six (27%) limit care to acne or anti-aging. The median reported response time for DTC teledermatology services is 48 hours from the time of patient request. The median consultation fee for companies providing care from US board-certified physicians is US$59. Across all services, consultation fees range from US$1.59 to US$250. Conclusions DTC teledermatology services are readily available to patients in most states. These services may reduce the cost of patient visits, expand access to care and increase patient convenience. However, the presence of services staffed by physicians who are not US board-certified, as well as the use of incautious language regarding prescription medications, is concerning.
authors.affiliation: 1 Stanford University School of Medicine, USA.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Fogel
authors.affiliation: 2 Dermatology, Stanford University School of Medicine, USA.
authors.forename: Kavita Y
authors.initials: KY
authors.lastname: Sarin
mesh_terms: D002568:Certification / Q000592:standards; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods / Q000592:standards; D003880:Dermatology / Q000191:economics / Q000458:organization & administration*; D000067108:Direct-To-Consumer Screening and Testing / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D005249:Fees and Charges; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D012017:Referral and Consultation / Q000191:economics; D012871:Skin Diseases / Q000175:diagnosis / Q000628:therapy*; D017216:Telemedicine / Q000191:economics / Q000592:standards; D014481:United States; D014850:Waiting Lists
keywords: Cost analysis; ehealth; online health; self care; teledermatology