Al's Morning Meeting

A growing number of health insurers are starting to pay doctors for the time they spend dealing with patients' medical problems via the Internet.

... Aetna is one of the largest health insurers in the country. Blue Cross [and] Blue Shield of Florida, the state's largest health insurer, began such reimbursements in January 2005. Cigna, another big national company, will begin making payments in January.

"If you ask patients, the vast majority want to communicate with their doctors via the Internet," said Dr. Charles Cutler, Aetna's national medical director for quality. "Once physicians become enthusiastic, there will be a tipping point."

Cutler said the encrypted, Web-based messaging system should give doctors confidence that their online communications with patients will be secure. Beyond that, "given the convenience and efficiency for both patient and physician, I think it will rapidly expand."

Cutler and other insurance and health-care experts make it clear that online consultations -- which typically cost $30 to $40, with the patient picking up part of the cost through a copayment -- are for nonurgent medical problems only.

But such nonurgent problems make up a significant minority of patients' office visits to the doctor -- 20 percent to 30 percent, according to physician surveys cited by RelayHealth, a California company that provides Web-based communications services for Blue Cross [and] Blue Shield of Florida, Aetna and Cigna.

"Florida is one of the fastest-growing markets" for Web-based communication between doctors and patients, said Kenneth Tarkoff, chief operating officer for RelayHealth. Though California is several years ahead of the pack, Florida is one of just six states where RelayHealth offers the service, through 13 insurance plans.

Web-based doctor-patient communication is getting a lot of interest from employers who provide health benefits for their workers, said Tarkoff, who predicted that within two years, "this will be a standard benefit for employees."

Physicians also will benefit, said Dr. Charles Batson, who has run a thriving family practice in Longwood since 1987.

Like most primary-care doctors, Batson is more high-touch than high-tech, and he acknowledged being skeptical about communicating with patients via the Internet. But seven months after he began offering Web-based communication to his patients -- including scheduling, prescription refills and online consultations -- Batson is a believer.

"More Web visits will be a thing of reality," said Batson, who typically does seven or eight online consultations a week with patients, with the average consult taking 10 minutes. "It behooves most physicians to at least be open to the concept."

Batson said Blue Cross pays him $27 for each online consultation. Though he doesn't view the reimbursements as much of a moneymaker, he said consultations in particular, and Web messaging in general, have been a boon to his practice.

The system was relatively inexpensive, boosted office efficiency, and "every single comment we've had [from patients] has been positive and thankful," Batson said. "From a business perspective, if you have happy patients, it will have a positive spin financially in the long run."

So far, higher fuel prices do not seem to have had a significant effect on boat sales or on the amount of fuel sold at marinas. The Seattle Post-Intelligencer reported this week that fuel sales are robust.

The Lansing (Mich.) State Journal asked boaters and campers how they will react to higher gasoline prices, and the Pittsburgh Post-Gazette reported that local anglers might not be deterred by high gas prices, but might instead change their fishing habits to adapt to price changes. In Knoxville, Tenn., the News Sentinel reports that RV sales in 2005 hit a 27-year high.

MySpace: A Generational Disconnect

Gannett New Jersey did a big spread on the national parental freak-out over MySpace.

Some sociologists and many MySpace users laugh at the media coverage of MySpace, saying baby boomers' reaction is similar to the way their grandparents' generation freaked out over such moral threats as rock 'n' roll.

"Back then, meeting someone from all these other states wasn't happening; they had their communities and that was it," said Lourdes Gonzalez, 23, a MySpace user from Pine Hill who decked out her profile with romantic images.

"We like the whole meeting new people thing. And I guess it's hard for them to understand that. They did have Woodstock where they met new people, but people frowned on that, too."

Mary Gray, an assistant professor at Indiana University who researches new media, said the current "hysteria" over MySpace is similar to the moral panic that raged when the Internet, movies, telephones and TV were first introduced.

"This is this generation's way of getting together, and that always makes an older generation nervous," said Gray, 35. "We don't like when young people get together without our permission."

Experts say adults are placing more restrictions on what young people can do outside the home, so they gather, meet and express themselves online.

"They've basically grown up in Internet culture, and this is the equivalent of our malls and social settings," said Danah Boyd, a social media researcher at the University of California, Berkeley.

She compared MySpace profiles to a teenager's bedroom wall, complete with pictures of hot celebrities and best friends. The conversations found on the MySpace pages are not unusual from past generations either, she said.

"It's very much practices that would be recognizable to all of us who grew up as teenagers -- although most of us forget the mundane parts of it -- they're just doing it online," Boyd said.

Note from Al: I am sick of MySpace hype and, barring some big honking development that I cannot ignore, I promise I won't mention it again for at least a month.

Waterproofing Your iPod... and Other Poolside Stuff

My kids are enjoying the first day of their summer vacation today. Since the summer pool season is just about to begin (if it hasn't begun already), here are some cool new things, like music earplugs for swimmers and waterproof coverings for MP3 players.

Note from Al: I am also sick of the iPod hype. Again, barring some big honking development that I cannot ignore, I won't mention iPods again for at least a month on Al's Morning Meeting.