It’s time for a new medical specialty in asynchronous care

Anne Thompson

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Doctor sits at computer answering messages. -- first opinion coverage from STAT — Adobe

By Muthu Alagappan, Rishi Khakhkhar, and Ben Kornitzer

Oct. 4, 2024

Alagappan is an internal medicine physician and the founder and CEO of Counsel Health, a virtual medical practice specializing in messaging-based care. Khakhkhar is a practicing emergency medicine physician and the founding medical director of Counsel Health. Kornitzer is an internal medicine physician and a strategic adviser to Counsel Health.

As primary care physicians, we see a scene play out almost daily. A patient is sitting in front of us, explaining her symptoms: She could have difficulty breathing, stress at home, fatigue. We know there is nothing more important than being fully present.

However, our minds and eyes keep darting to the computer screen and the growing inbox of messages from other patients: “I forgot my Lipitor for a week, should I double up tomorrow?” “I’ve had a cough since starting that new medication,” “I’m traveling to Vietnam next week, do I need any vaccines?”

Today, the fastest-growing care setting isn’t the hospital or home — it’s the mobile phone. Google now receives more than 1 billion health-related searches every day, and patient messages for medical advice have increased sixfold in the past decade. The explosion in patient messaging is a clear sign that patients want more access to information about their health, despite the long wait times and often unclear responses.

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