Recently I've had some less-than-stellar experiences with doctors. When I went to a podiatrist for help with a foot issue, he seemed stumped and offered a smattering of wild-guess suggestions. (None of them worked.)
When I went to a vision clinic for an eye exam and updated prescription, I waited 45 minutes to actually get into the exam room and another 25 minutes before I threw my hands up and left. (Note to doctors everywhere: Work on your customer service. If there's a delay, acknowledge it and apologize for it. In 47 years I've never experienced that simple courtesy.)
So when I realized I needed to see a dermatologist, I really didn't want to see a dermatologist. I wanted to explain my symptoms and see if maybe there was an ointment that could fix me up. Like, if I passed a dermatologist in the street, it would probably take 60 seconds.
But that's not how it works. The typical process for such a thing:
- Look up dermatologists in my healthcare provider's directory and hope to find one reasonably close to where I live.
- Call to schedule an appointment.
- Wait probably 2-3 weeks to get that appointment.
- Drive to the dermatologist's office.
- Fill out countless forms while waiting goodness-knows-how-long to get seen.
- Spend 5 minutes with a doctor who says something like, "Yeah, that's Eczema, here's a prescription."
- Drive to drugstore, get prescription filled.
- Get ridiculous bill from healthcare provider, which maybe covers part of it, but definitely not the co-pay.
Sounds great, right? So much time and energy down the drain. And yet my problem -- red, itchy, flaky skin in a few areas of my face -- was getting worse.
Apps to the rescue!
I'd heard of online consultations with doctors, but I always thought those were general practitioners focused on things like coughs and allergies.
As it turns out, there are numerous apps that can pair you with a dermatologist for a virtual consultation -- usually powered by the camera in your phone. I looked at four such apps and tried one. Here's the rundown, with my initial impressions of each and the reason I chose the one I chose.
DermatologistOnCall (iOS): Promising to diagnose "more than 3,000 skin, hair and nail conditions," DermatologistOnCall charges $59 per online visit -- but I was quickly scared off by the push to purchase a multi-visit package (starting at $165 for three).
First Derm (Android|iOS): To use First Derm, you snap two pictures of your skin, then get an evaluation and recommendation from one of about a dozen dermatologists. However, the only issues covered are rashes and moles. You can get a response within 48 hours for $24.99; within 24 hours for $39.99; or within 8 hours for $99.99.
SkyMD (Android|iOS): Before letting you do anything else (or revealing its pricing), SkyMD requires you to create an account. Nope, sorry, not until I know what I'm getting (and paying). Even the SkyMD FAQ page says only that it's "usually comparable to a typical office visit copay."
Spruce (Android|iOS): With some of the best ratings on both the App Store and Google Play and a reasonable-seeming visit fee of $40, Spruce seemed like a good pick. However, it's currently available in only about 15 states. Luckily, mine was among them, but the app starts by asking you to identify your issue: acne, Rosacea, etc. I didn't know exactly what my issue was -- that's what I needed help with! Unfortunately, there was no "I don't know" or "I'm not sure" option.
First, Derm no harm
I was really tempted to go with Spruce, but the reality is I'm cheap. I felt like if I was going to have another unsatisfying (and unhelpful) medical experience, I was going to pay as little as possible. (Yeah, my bad attitude wasn't helping anything. Maybe next I'll look for online therapists.)
So I chose First Derm. I figured the redness and itchiness qualified as "rash," so I tapped through and began the evaluation process. It was simple: snap two photos of the area (in this case my face), then describe the symptoms.
As for the pricing tiers, I had no problem waiting 48 hours for my diagnosis. So I used PayPal (there's no in-app purchase option for payment), checked out and that was it. I think the entire "visit" took about 5 minutes.
"Cleanup on aisle 12!"
Then I waited. I'd expected some kind of confirmation and/or status email, but I never received one. And as I got toward the end of the 48-hour window, I started to get a little aggravated.
Then I realized I hadn't actually checked the app since submitting my case. When I opened it again, there was still no indication anything had been done. But when I tapped the Menu button and selected View Case, I discovered that an answer had been received -- less than 90 minutes after the submission.
So, my bad for not checking back sooner, and First Derm's bad for not notifying me of a response. (In its defense, notifications for the app were "off" in the settings, so it seems possible I'd refused the request to enable them. That's my default choice.)
The "diagnosis" (which was provided "as general information only" and "not a diagnosis or treatment plan") suggested Seborrheic Eczema and proceeded to list the various symptoms -- all of which matched mine to a tee. The recommendation: "a mild steroid cream such as hydrocortisone 1% with antifungal effect (e.g. miconazole)."
Although the response didn't expressly indicate this was available OTC, the key clue was in the conclusion: "See a dermatologist in person for prescription medication if the condition doesn't improve."
So I zipped up to my local drugstore and headed to the ointment aisle. Turns out there are zillions of skin creams, many of them with hydrocortisone. But I looked and looked and couldn't find a single one with "antifungal effect" or "miconazole."
I did, however, find a product specifically designed to treat eczema -- which, according to my virtual doc, is what I have! So although I was aggravated I couldn't find exactly what had been recommended, I did find something.
Long story shortened: Bought the tube, used it for a couple days...problem solved. Literally, it was better the next morning, and hasn't recurred except for a short period when I forgot to apply the cream.
Could I have received the same advice from, say, my friendly neighborhood pharmacist? Almost certainly. Am I glad I didn't go through all the hassles of seeing a real-world doc? No -- I'm overjoyed. To me, this was $25 extremely well spent, because I saved both time and aggravation (even if there was still a bit of the latter).
Your mileage will almost certainly vary, depending on your skin issue and the app you choose. In hindsight, I think I would have gone with Spruce, because it promises a proper diagnosis and treatment plan (with a prescription, if necessary), not just "general information."
That said, my outcome with First Derm was ultimately very positive, so you can bet that the next time I have a skin issue, one of these apps will be my first stop.
Your move, eye doctors.
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