Unfortunately, there is no major oncology center where cancer patients can go in the Eastern Province. The woman and her family faced many difficult decisions and they needed guidance. Until recently, such a situation would have resulted in this very ill women being forced to travel to a physician located in another city in order to gain insight about how to proceed.
However, last week Arab News was privileged to witness the woman's family using a service that allowed them to confer with Oliver Dorigo, Ph.D. and MD, a specialist in Gynecologic Oncology at the University of California, Los Angeles. They selected Dr. Dorigo from a list of cancer specialists available through the website of www.2nd.md. Using 2nd.MD, the family sent Dr. Dorigo a simple question asking if he could provide information and possible assistance in regards to their relative's health issue. After he replied yes, they requested an appointment and paid the fee of $280 for a 20-minute consultation. Once the appointment was confirmed, they uploaded the results of all the woman's medical tests and the images of the CT scan to a special area on the 2nd.MD website. The next afternoon, the woman's husband and brother seated themselves in front of a laptop's webcam and Dr. Dorigo conferred with them live from Los Angeles.
He had already reviewed the woman's test results and his advice to them was clear. They needed to do a new CT scan as the one done previously was incomplete. He also insisted that they request specific blood tests and immediately find a very experienced surgeon to carry out extensive surgery after chemotherapy was begun. He encouraged them by sharing his experience that there was an excellent possibility that the woman would respond well to the chemotherapy. It was incredible to watch the air of hopelessness fall away from the husband and brother. Dr. Dorigo provided them with a straightforward plan of how to proceed, what to consider in selecting physicians to carry out the plan and he promised to send them all his recommendations in writing.
In 20 minutes, the family went from hopeless and confused to energized and determined. The husband rushed to discuss with his wife the information provided by Dr. Dorigo. The doctor's detailed notes arrived later that night and in three days the family traveled to Jeddah to carry out the recommended plan. They were able to specify to physicians what was required and in fact the doctors in Jeddah concurred with the strategy. Chemotherapy was started on Sunday and the woman has already returned to her home in Alkhobar to rest between chemotherapy sessions.
Was the 2nd.MD service perfect? It wasn't — but it was amazing. Due to the poor Internet connectivity in Saudi Arabia, the live stream video wasn't ideal. Both parties had to be patient when asking and answering questions due to latency issues and sometimes the audio wasn't perfectly clear. The site has the option for a telephonic conversation instead of a video conference and in the Kingdom this should be recommended as interaction would be smoother. The family members involved spoke excellent English so communication wasn't a problem. Uploading some huge files, such as the CT scan, required assistance from the 2nd.MD team, but they were happy to oblige.
The physician was incredible. Dr. Dorigo made the decision to hold the conference at five in the morning in Los Angeles to accommodate the time difference. He stayed with the family for ten extra minutes to ensure that all his advice was clear. He followed up within hours with four pages of written notes. The family, which had been struggling to gain useful information from local physicians and Internet resources were empowered by the video conference. They had already investigated many possible treatment centers and were able to immediately choose the best one based on Dr. Dorigo's advice. The patient went into the consultation in Jeddah with a clear direction, prepared to undertake the necessary treatment without delay. She remains confident, her morale high, ready for the fight ahead.
"2nd.MD is a service that offers direct access to doctors in the top 12 out of the top 17 medical institutions in the United States," said Melissa Sawa, director of operations, 2nd .MD. All doctors have a profile that lists where they went to school, their specialty, their ideal patient, etc. Any individual can log onto the site, search for a specialist, book an appointment, and speak to the doctor over the phone or through a video portal — similar to Skype. The doctors listed on our site are not only good, but the best in the US and it is a great option for the people of Saudi Arabia and Middle East to speak to the best doctors without the need to travel."
The 2nd.MD service can be used by anyone who has questions about a surgery or procedure. Individuals with chronic illnesses can explore whether their current treatment plan is as up-to-date as possible or whether there are treatment options their local physician may not have considered. For conditions where treatment is not available in Saudi Arabia, 2nd.MD provides a chance to establish a relationship with a doctor before traveling.
"Due to the caliber of physicians we are signing up, money isn't a huge factor for them," explained Sawa. "They already work for prestigious institutions, have been awarded 'doctor of the year,' and some have invented new medical procedures. Most of our physicians are truly excited to reach out to individuals that they would have never been able to help prior to this service. If clients want to include translators, family members or their personal doctors in their appointment, they can do so."
The doctor's fees are set by the doctors themselves. They usually take experience, awards and their career history into account. Sawa remarked that by having the doctor set the fee, it allows for a true marketplace to take place on the 2nd.MD site. Doctors receive 80 percent of the total rate of the session. If a potential patient cannot determine which doctor would be most suitable, a client support team available through the 2nd.MD website can help to narrow down the choices. The client support team will also run a test of the video conference service before the appointment time to ensure that the equipment and connectivity are adequate for a successful consultation.
It was impressive to see that Dr. Dorigo never pushed to have the cancer stricken woman travel to UCLA for treatment. In fact, he discussed with the family how to choose a competent local oncology center to carry out the initial care and gave them a recommendation of how quickly treatment must begin. He offered to confer with the medical team in Saudi Arabia or elsewhere at any time. Dr. Dorigo recommended that after the initial chemotherapy and surgery were complete, that the family contact him again so that he could help them to develop a treatment plan in order to manage the cancer over the longer term. Viewing Dr. Dorigo as their champion, that is exactly what they plan to do.