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“It was a no brainer,” says Marcos Nunez.

As a restaurant owner and two time cancer survivor, Nunez took a tip from one of his regular customers: telehealth.

“I do it on my computer at home. For the simple fact that it's a light nicer to relax and see him on the big screen. I could do it here at the restaurant if I needed to. It is very very convenient.”

Between the pace of the restaurant industry and the current healthcare market, he says prioritizing health is challenging.

Nunez does not have health insurance.

He says most of his employees would rather pay out of pocket instead of paying high premiums and high deductibles. While he does not want a hand out, he says the prices need to be reasonable, “these days where health insurance is mandatory it's cheaper to pay the penalties.”

In 2016 emergency department (ED) physician David Circle started a telehealth practice with other local ER doctors to improve access to care for patients outside of the Emergency Room.

Dr. Circle says it is a common thread for ED physicians to see patients in the ED that do not need to be there. But for his telehealth patients, they are most thankful for the transparency in costs, which they are able to provide by not accepting insurance.

“It adds complexity and costs and doesn't really add any value. It's really put up a barrier between myself as a physician and my patients because utilizing insurance patients don't have the ability of right anymore to come see a doctor in the way they see fit,” says Dr. Circle, “we are trying to reach people directly.”

As BIDMC's Chief of Surgical Oncology, Jennifer Tseng's clinical love is to take out pancreatic cancer. She is wholeheartedly and passionately committed both in her practice and in her research to improving cancer outcomes. Tseng's current research is examining the impact of insurance status on cancer survival, not only to guide care at BIDMC, but to inform state and national institutions as the country moves forward under the Affordable Care Act.