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Have you tried to find a new primary care doctor lately? Roughly a hundred million Americans don't have one. In Massachusetts, a woman called 10 physicians. None were taking new patients. A few could see her in two years. Then the woman learned about an AI-based option. Reporter Martha Bebinger from member station WBUR takes it from there.
MARTHA BEBINGER, BYLINE: The woman, Tammy MacDonald, has high blood pressure and had a recent breast cancer scare. So she was in close touch with her primary care physician until her doctor's sudden death this summer. MacDonald shifted from sadness to shock fast.
TAMMY MACDONALD: We live in Boston, and we're supposed to have this great medical care, and I couldn't get my mind around the fact that we just didn't have any doctors.
BEBINGER: MacDonald grew anxious about refilling her prescriptions. She reviewed a letter from her health care network Mass General Brigham and noticed the link to an AI-enhanced telehealth alternative called Care Connect. MacDonald downloaded an app, spent about 10 minutes chatting with the AI agent about what she needed and scheduled a virtual visit with an actual doctor.
MACDONALD: I think I got an appointment the next day or two days later. It was just such a difference from being told I had to wait two years.
BEBINGER: MacDonald has used Care Connect four times since it launched in September. Sometimes MacDonald only interacts with the chatbot, or AI agent. Her virtual visits have all been with the same doctor, one of 12 on staff for Mass General Brigham Care Connect. MacDonald still wants a primary care provider she can see in person. For now, she's relieved and likes that Care Connect has a doctor on call 24/7.
MACDONALD: This is a logical solution in the short term, but at the end of the day, it's the patient who's feeling the aftermath of all the bigger things going on in health care.
BEBINGER: Primary care doctors like Michael Barnett are dealing with those bigger-picture things going on in health care. He describes rushed, complex patient visits, then evening spent updating medical records and responding to patient messages. Primary care doctors earn 30- to 40% less, on average, than specialists, like cardiologists or anesthesiologists. Barnett, who is also a Mass General Brigham doctor, says spending money to create a cheaper, virtual, AI-enhanced system will erode morale and push more physicians out.
MICHAEL BARNETT: It's actually undermining our capacity to have a primary care system that can serve more patients, which is what we need. But instead, we're using it to basically fill a gap. That sounds like a Band-Aid for a broken system to me.
BEBINGER: Care Connect is not just a Band-Aid, says Dr. Helen Ireland. She's a primary care physician who manages the program at Mass General Brigham. Hospitals have to find new ways, she says, to offer patients primary care.
HELEN IRELAND: This is part of the puzzle of how to help with the current crisis and really serve those patients who want virtual care.
BEBINGER: Care Connect is also available through five other hospital networks around the country. Dr. Steven Lin, who started the Stanford Healthcare AI Applied Research Team, argues it has a limited role.
STEVEN LIN: In its current state, the safest use of this tool is for more urgent care issues - your upper respiratory tract infections, your urinary tract infections, your musculoskeletal injuries, your rashes.
BEBINGER: Lin, who is also chief of primary care at Stanford University School of Medicine, says patients with multiple chronic conditions, like high blood pressure and diabetes, are better off with a regular doctor they see in person. K Health, the company that helped create Care Connect, counters that it is not just for urgent needs, that patients with more complex conditions are receiving safe, effective care. And Lin agrees, to a point.
LIN: I would rather these patients get care, if that care can be safe, than not get care at all.
BEBINGER: More patients will soon have a choice about whether to try Care Connect. Mass General Brigham is expanding it to all residents of Massachusetts and New Hampshire in February.
For NPR News, I'm Martha Bebinger in Boston. Transcript provided by NPR, Copyright NPR.
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