Doctortutes. I made that word up, in case you haven't guessed. It is not an amalgamation of the words "doctor" and "substitutes". It is a combination of "Doctor" and "prostitutes". Doctortutes: Doctors who pimp themselves out for money.
Now it may be argued that pretty much all doctors; -except maybe the ones without borders, charge money for their services, so therefore all doctors could be termed doctortutes. Not so. Charging a fair or market price for a recognized service, and operating out of a regulated environmentt, such as a hospital or private practice, as most doctors do, is accepted, legitimate business practice, not doctortution. But trawling the streets, classifieds or the Internet soliciting clients IS Doctortution, in my opinion. And quite a few doctors are engaging in the practice (pun intended): Some are lone operators with flash, smooth-talking websites; -the Internet equivalent of acrylic platforms.
But most don't bother with these costly "cheap" tactics. Most use pimps.
Yes. I said it: Internet doctor pimps. Who needs science fiction when the real world is right here?
Here is the story:
Just the other day, I was noodling around the Internet, researching something (probably a scam), minding my own business (sorta), when a pop-up window appeared on my screen (note to self: upgrade pop-up blocker). The window advised me that there were twenty doctors standing by waiting to answer my medical question, and invited me to type it into the box. So for laughs, thinking this will stump all 20 of them I typed in "why do I have a seizure after I eat a meal?"
And then another box popped up, asking me how much I was willing to pay for this answer? And the term "doctortute" hit me. I started to save screen shots and write this piece...
..and then my feckin computer crashed! I lost all the screenshots and everything else. Bummer.
My computer mysteriously came back from the dead a day and a half later after I decided not to finish my cliffhanger story about the beginning of 2010. Apologies to my regular readers, but I took that crash as a sign, even though I know some people may suggest that maybe it was the internet doctor pimps and the doctortutes who might have actually have been sending the "sign", as that is what I was working on at the time of the crash. I don't believe it. Conspiracy theories don't impress me any. (while superstition apparently does... I'm Irish. What can I say?)
So last night I went back on the hunt for the doctortutes. I found some at justanswer.com, which seems to be one of the biggest pimp sites; supporting not only doctortutes, but also plumbertutes, mechanictutes, lawyertutes (OK that's nothing new) and various other "tutes" who will answer questions in exchange for your cold, hard credit card number.
It's actually not a bad gig for a "tute", who I imagine is playing Solitaire or Farm Town in-between answering questions.
I didn't manage to find the popup that had found me the last time (I have no idea what I had been doing to deserve that!), but on the main site there was a space to input my question, with 24 doctors online, apparently waiting eagerly to answer it.
I couldn't resist. I knew it meant committing funds that I don't have (can you claim blogging expenses on your tax returns? Honestly, legitimate journalists have it so much easier than Sick Mothers), but I really had to see where this would lead. I figured that even if I didn't get a viable medical answer out of this (and I didn't expect one), I might at least get a good story for this blog, albeit at rather a high price. And I kind of liked the idea of exploiting a dotortute in order to write about him here -which is probably something I should address in therapy (I'll put it on the list).
So I went for it.
I typed in my question: "Why do I have a seizure after I eat a meal?" There was a followup question of what I had done about it, and I wrote "tried multiple AEDs, most of which made the problem worse". And I hit "Enter"
Then we get to the nitty gritty:
I was told "Dr. P "wants to answer my question" and I was asked how much I wanted to pay for this answer? I was given a few price options and prompted to the middle one, which is $38. Would I pay $40 to have that question answered? Hell yes! I would pay a lot more than that. Of course, I figured their definition of a satisfactory answer might differ from mine. However, the curiousity was killing me, so I continued on.
The site had said that I wasn't going to pay unless I was
satisfied with the answer. It then advised me that it was going to take a
"deposit" against this answer.
OK fair enough. Except the 'deposit' was the entire amount, placed into
"my account" Hmmm....
Well; in for a penny, in for 38 dollars: I continued on. I had been promised that someone called "Dr P" had been standing by to answer my question. Then Dr P was suddenly gone..
...and Doctor Ozz was looking at it. I guess he passed it up too. Finally someone called "Mysticdoc" decided to take my question. That was worrying. I wanted a real doctor, not a mystic! Then I looked at his profile, and realized that "Mystic" was probably meant in terms of Mystic, Connecticut, as opposed to "Mystic Meg"
Thank Christ for that! Because if it was anyone connected to her, that would be downright scary...
Mysticdoc actually came back with some intelligent questions.
Do you have any other medical condition?
What medication you are taking currently?
How do you know these are seizures?
Association with any particular food?
Any family history of seizures?
What tests have been done so far?
These questions I answered equally intelligently, with the honest facts as best I could remember and summarize them (what tests have been done? OMG that's a tall order to remember on the fly!)
There was some back-and-forth. The way the system works is this: the "tute" doesn't get paid until the client accepts the answer and the client can ask follow-up questions related to the answer (but any questions on a "new" matter would be another chunk of change) . Therefore, the doctortute is incented to give a satisfactory answer. It would be highly unlikely that I would receive the two most popular answers I get from regular doctors, which are
a. "I can't help you"
b. "have you seen a psychiatrist?" (ie. it's all on your head)
Now, although I have argued against this in the past (here and here if you are curious), these are both considered perfectly legitimate responses in traditional medical practice, where doctors are not actually required to help you and they still get paid for the visit and their time. However in doctortution, the compensation is directly tied to a satisfactory answer. The "patient" (I have to use this term loosely here. Hey, Let's keep in theme and use the term "john" ) can refuse to pay if an unsatisfactory answer is given. Yes, the pimp still has your money, but the john can either go to another doctortute, or can start the process to have the money returned (and I am not sure how easy this process is, but it is there). It is an interesting change to the dynamic, don't you think? Much more customer oriented.
"Mysticdoc" gave me two good pieces of information I think I can use:
1. Sodium and calcium (both minerals with which I have had issues in the past) play a huge role in seizure pathogenesis.
2. A functional MRI
(fMRI) would probably be a good test for me to see what is going on in my
brain. I asked him if the MRSpect, the scan that #30 is planning to do as part
of his study is the same thing, and he said no. The fMRI would be better.
Funny thing is this: #25 had mentioned performing a fMRI a few years ago, them he changed his mind because "nobody would read the paper". Fuck papers! This is about getting my life back, not about papers.
So I figured Mysticdoc had earned his $40 and I paid him (love that they leave space for a tip!) and allowed him to move on. I declined to leave a deposit against any future questions I might want answered. No free money from me!
Then I thought some more: You know, with the discounts many HMOs and other insurance companies negotiate, a regular visit doctor visit probably pays about the same as one of these internet consultations, but with much higher overhead (offices, staff, insurance). So for the doctors, doctortution is quite a good gig. They can hang out at home in their jammies, with one eye on the telly, picking and choosing which questions to take, getting paid directly for their time. It's not a bad deal for them. And it answered the question I had when I first saw the site: Expecting people fresh out of med school, I had been surprised to see some of the doctors lurking sported lots of qualifications and years of experience. I guess if you are a doctor, this is a handy way to use your qualifications part-time to top up the old income: You know, pay the country club fees, alimony and your daughter's speeding tickets.
Is doctortution a good thing?
I don't know. I think it is an interesting development in the healthcare system, and it satisfies our need for instant gratification. Of course, an Internet doctortute is no substitute for an actual physical examination or for someone's regular doctor and -needless to say- doctortutes can only advise, not diagnose or prescribe. But I think, as a fresh and unbiased set of eyes on a case, doctortutes might have their (limited) use. I know my experience has spurred me to go find a new neurologist, a seizure expert this time.
I'm losing count, but I think this will be #31. Maybe that will be the charm?