BLOOMBERG BUSINESSWEEK:: DOCTORS ON DEMAND.

In his various professional incarnations, Phillip “Dr. Phil” McGraw has been a practicing psychologist, bestselling author, television personality, and spokesman for weight-loss products of dubious efficacy. Now he’s got a part-time gig as an adviser to a startup called Doctor On Demand, which is announcing itself to the public today. The service will try to increase online access to doctors, which could have far-reaching effects on health care. McGraw helped conceive the San Francisco-based startup with his son Jay McGraw, a reality TV producer. The company has raised $3 million from investors including Google Ventures (GOOG), Andreessen Horowitz, Venrock, and Shasta Ventures. (Bloomberg LP, the parent of Bloomberg Businessweek, is an investor in Andreessen.) The startup seeks to help people bypass costly in-person visits to crowded medical offices and emergency rooms by letting them use mobile devices to set up video chats with doctors. “There are 1.2 billion ambulatory care visits every year, and the vast majority of people are walking in for something like colds or urinary tract infections that are very amenable to an initial consult over video,” says Adam Jackson, the company’s co-founder and chief executive officer. Each online consultation costs $40. Doctors who enlist in the company’s network will collect $30 per session. They can diagnose illnesses, prescribe medicine, or refer a case to a caregiver if it seems like an emergency or requires lab work or an in-person examination. “It’s the bane of my existence, but everyone has a smartphone, which means everyone has a video camera. Everyone is paparazzi,” says McGraw, a shareholder and adviser to Doctor on Demand. “There are also many good things to come from this change in technology and telemedicine is one of them. It’s a giant step forward and a great opportunity to help people live healthier lives.” The service goes live today in 15 states, including California, Florida, New Jersey, New York, Ohio, and Texas. (Many states have laws preventing Doctor on Demand from setting up shop.) The company says it has enlisted more than 1,000 doctors to offer video consults a day or two per week. The company trains physicians to use its service, and it handles all the extras, including patient questionnaires, pharmacy networks, and malpractice insurance.

USA CDC: HISTOPLASMOSIS-infected house in St.-Eustache, PQ.

Morbidity and Mortality Weekly Report (MMWR) Histoplasmosis Outbreak Associated with the Renovation of an Old House — Quebec, Canada, 2013 Weekly January 3, 2014 / 62(51);1041-1044 On May 19, 2013, a consulting physician contacted the Laurentian Regional Department of Public Health (Direction de santé publique des Laurentides [DSP]) in Quebec, Canada, to report that two masons employed by the same company to do demolition work were experiencing cough and dyspnea accompanied by fever. Other workers also were said to be ill. DSP initiated a joint infectious disease, environmental health, and occupational health investigation to determine the extent and cause of the outbreak. The investigation identified 14 persons with respiratory symptoms among 30 potentially exposed persons. A strong correlation was found between exposure to demolition dust containing bat or bird droppings and a diagnosis of histoplasmosis. Temporary suspension of construction work at the demolition site in Saint-Eustache, Quebec, northwest from Montreal, and transport of the old masonry elements to a secure site for burial were ordered, and information about the disease was provided to workers and residents. To prevent future outbreaks, recommendations included disinfection of any contaminated material, disposal of waste material with proper control of aerosolized dust, and mandatory use of personal protective equipment such as gloves, protective clothing, and adequate respirators.