Why I started Modern Migraine MD

Modern Migraine MD is a start up company that brings doctors and headache sufferers together using telemedicine and virtual visits to treat people. Migraines and many headache conditions are well suited for this type of doctor patient interaction and this specialized niche in medicine is a great fit for using this technology. For a nominal concierge fee, people can choose a single consultation or a membership package. They can schedule virtual visit appointments easily online from the comfort of their homes where I can see them, speak with them and make a continued plan of care. I can see patients from distant geographic areas that don’t have access to headache doctors, prescribe medications online, and get testing done when necessary including ordering imaging such as MRI scans. Virtual appointments have been performed in the field of Neurology for a long time as there is shortage of Neurologists and an even bigger shortage of headache specialists.

By the time people end up on the other end of the screen to “see me” so to speak, they have come on a long journey to find pain relief. Some people are unable to get an appointment with a Neurologist or Headache specialist for months. Others have been in and out of urgent care facilities, seen primary care doctors multiple times or had to go to the ER unfortunately because the symptoms got so severe. Most people talk to friends or family and google symptoms of their headaches and think they have an aneurysm or brain tumor. This is normal in the modern world but the information makes the anxiety worse. By the time they are in front of me, symptoms are severe and the fear, anxiety and the stress surrounding the possibilities of brain disease run rampant and out of control.

Most patients have been given little time to be heard and even less time for counseling and discussion. In some busy emergency rooms and primary care practices my patients get 5-7 minutes with busy distracted doctors. Reassurance, counseling, discussion, answering questions and explaining what we know in medicine takes more than 7 minutes. Often, we have to repeat, teach, discuss and convince patients over more than one brief visit to understand their condition. This is very human, and it takes us all time to learn new information.

I see a gap in the way health care is delivered and how doctors can give care. I see fragmented specialists sitting in separate offices, each of us taking care of seemingly disparate body parts but not taking care of the whole person or thinking about the whole person in the context of health and healing. I see doctors rushed for time, buried in paperwork and bureaucracy worried not just about patients health but worried about the time they can spend with patients, the collections and money they can bring into their practice or hospital or group they work for, and the lengthy documentation required to provide information to insurance companies for payment. The weight of this burden is a lot to carry while also trying to be present for a patient. It scatters us as doctors as even at our best we are mere humans.

I often would wonder about this scatter. How does the patient suffer when some of my attention is with them and some of it is occupied with finishing a note for an insurance company? How is 10 minutes is enough time to hear someone out? I know the effect of this scatter. The patient does not have my full attention and I feel anxious, on edge, and rushed while seeing a patient.

I believe this is a major element of the healing process that often gets lost in our modern health system. There is simply not enough time for doctors to listen and truly hear someone.

Statistics, numbers and the bottom line are great for business, but I don’t think it is the best thing for humans. When I see patients, they need time to be able to talk about their symptoms, to be able to have the freedom to tell me about the other pains they might be having and also maybe to talk about certain lifestyles and habits. This doesn’t require an hour typically, but usually requires more than the 10 minutes allotted to them on a schedule. I have grown tired of following what others’ have deemed enough time to see a patient and have experienced first hand the burden of extensive note taking and the checking of boxes that do almost nothing for the patient, have become rote for doctors and are primarily done to have insurance companies, not doctors, stipulate what is important to know about patient history.

I still see patients in a traditional brick and mortar practice called Downtown Neurology in New York City. I love seeing patients and am grateful for my job and how I can try to help people. I will continue to see patients, but I can’t help but imagine a truly modern system of healthcare where we use all the tools available to give both the patient and me as doctor what we need to heal. That means eliminating some of the overhead, the middlemen, and connecting as humans.

I started this company to allow the space and time for a patient to be able to tell me what is going on without clock ticking. The technology allows patients to sit comfortably in their homes without the annoyance, pain and burden of travel. I created the space and time for doctors to be able to comfortably sit and listen, without the constraints of rushed appointments, overhead and cutting out the glut of paperwork and overhead involved in using insurance. We can spend all of our time being doctors.

The membership offering is way I feel I can give people true concierge service at an affordable price with access to me on email and time to have follow ups to carefully reiterate and change the plan of care as necessary. There are almost always questions after a visit, and research has shown patients often retain about 20% of what a doctor says to them during a first visit. This happens often and part of the process of learning how to take medicine and understand a condition. Most doctors don’t have the luxury of spending more time with phone calls and emails after a visit. The result is patients don’t take their medicines correctly or even at all.

For me, virtual visits have been liberating, and I am constantly amazed by how much patients like the experience of seeing me online. We both feel more relaxed and have time to talk and to listen. Bridging the gap between high end concierge medicine, technology and reducing and helping doctors do what they need to do, ie being a doctor, is why I started this platform. I believe true modern medicine utilizes technology and information but doesn’t forget that we are human. I believe healing is at the intersection of harnessing and using technology to enhance our communication and human connection. It has allowed me to help patients who are far away and given me the space and time to do my job.

I myself suffer from migraine headaches. It has been a long journey to slowly figure out how to get treatment and to recognize the many other symptoms that accompany migraine headaches. I have learned a lot, been able to help many patients, and will use this endeavor to make the experience even better.