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Before President Trump took office, Dr. Steven Corwin, chief executive of NewYork-Presbyterian, was already convinced telehealth would transform American health care.

But now — with Trump proposing to slash Medicaid and the National Institutes of Health budget — Corwin says it might also help save it.

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  • TeleOutreach could help to provide specialist services where few or none exist. Having a Project Echo only design is unfortunately not possible. The dollars that will be invested will crowd care into a different model that banks on much higher utilization.

    TeleProfiteering involves expansion of services to three types of people as seen using the Ecology of Medical Care
    1. Those who have symptoms and would not go see a physician (perhaps 30 a month out of 473)
    2. Those who have symptoms and think about seeing a physician but do not (30 a month out of 110)
    3. Those who have symptoms and would see a primary care physician (30 a month out of 110)

    As with retail clinics, there will be no outcomes changes. There will be greater costs. Dollars scarce in places in need of health care will be sucked away from local investment and local workforce support. Teleprofiteering will see as many as primary care – both at about 80 – 90 per month out of 1000 Americans, 800 who have symptoms, 327 who think about seeking care, 217 who do seek care, and 110 who visit primary care.

    The primary care offices will be undermined by the new technology that will take the least complex patients as well as sending them the most complex. Lowest overhead will overcome highest and getting worse. Primary care where needed has little option with regard to who they see, the contracts they are forced to sign from payers, the rapidly increasing cost of delivery, or the complexity of their patients increasing fastest.

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