Many times an expensive doctor visit could be avoided if you could just talk to the doctor to discuss the situation over the phone. If you could do a quick email exchange and have a prescription waiting for you at the pharmacy, you could save time and money, and let the funds in your Health Savings Account continue to grow for your retirement. There are now online physician consultation services that allow you to do just that.

While an ER visit may indeed treat medical needs, the reality is that most visits end up being more about peace of mind. If your child's skin is turning red in the middle of the night, you might not know if it's harmless flushing, or a serious allergic reaction. So you rush off to the emergency room, fill out some forms, and sit in a room full of contagious people. You wait and wait, finally get to speak to a nurse, then wait some more, and explain your problem again to the resident. Then you may have a battery of tests done, wait some more, and finally leave with a prescription and a bill for $650.

All this for a problem that could have been far less expensive, and handled more simply and expediently by discussing the situation with your doctor. According to the American Medical Association, about 70% of doctor and emergency room visits are actually just informational.

However, asking your doctor a health question is rarely as easy as picking up the phone. Because insurance companies do not normally reimburse doctors for phone care, most traditional practices avoid offering such service. Instead, their objective is to get you into the office so that you can be billed for the service you receive.

Paying for that office and the surrounding bureaucracy is not cheap. A doctor's costs may include the office itself, a receptionists, a triage nurse, someone handling insurance billing, office managers, and expensive medical equipment. All this is very expensive to maintain, so generating as many office visits as possible is critical for most doctors to even stay in business.

So you get stuck in a system that is inconvenient, expensive, and does not value your time.

Telephone Consultation Services

As health savings accounts become more popular and more people are paying for their own doctor visits, several companies have begun offering inexpensive telephone and email consultations with board-certified physicians. These companies can offer dramatically lower prices because they have cut out most of the costs that burden traditional medical facilities.

Though telephone consultations are obviously not appropriate for all medical conditions, it is an accepted standard of care for many health-care problems. In fact, telephone medicine has been around as long as the telephone, and is practiced throughout the country by most doctors at nights and on weekends.

Here are a few companies that are now offering telephone consultations with licensed physicians:

Doctor on Call (www.unadoctoroncall.com). This company currently has over 240 board-certified physicians on call, with 24-hour access. The physicians with this service will not diagnose or prescribe, but they will provide information based on your questions. The price is a bargain - only $5.95/month for the family for an unlimited number of calls.

TelaDoc Medical Services (www.teladoc.com). This company also provides 24-hour access to members and dependents age 12+. Telephone medical consultations are with primary care doctors who can also diagnose medical problems and prescribe appropriate medications. There is an initial $18 registration fee, and a monthly fee of $4.25 for an individual or $7 for a family. Consultations are a flat $35.

Doctokr (www.doctokr.com) is a practice run by Virginia physician Alan Dappen. Though this service is only available to people who can come in to his office for an initial visit, it is a model likely to be copied by other providers as consumers become more price conscious when shopping for medical care. 24-hour access is available by telephone and email. Consultations are billed in 5-minute increments ranging in price from $15 to $22.50. A simple consultation to request medication refills costs from $10 to $15 for up to 5 medications. There is a monthly fee of $5.95.

Saving You Time and Money

Not only will these services save you money when compared to a typical doctor visit, but they will also save you time. You may be able to quickly resolve routine medical issues in a fraction of the time you would spend accessing care from urgent care facilities, emergency rooms or physician offices. If you use a service that will prescribe medications, you could have your consultation finished and the medicine in hand in less than the time it would otherwise take just to visit the doctor.

As telephone technology evolves, these services will add picture taking and even recording vital signs, and the scope of these physician consultations will become broader. With doctor visits approaching $100 each and ER visits in excess of $800, it doesn't take much to justify the small monthly fee for most of these services.

Though there are certainly times when visiting your doctor's office or the emergency room is the most appropriate thing to do, as a smart consumer you owe it to yourself to be aware of all your options. Using a physician telephone consultation service can help you avoid the expense, time, and hassles of urgent care facilities, emergency rooms, and visits to the doctor.