How Texting With Doctors Can Keep Patients Out of the ER | with Dirk Perritt
Dr. Dirk Perritt is an emergency physician and founder of Text A Physician, a text-first care model built around a problem he saw repeatedly in the ER: many patients did not need an emergency department. They needed fast access to a qualified medical professional who could answer questions, provide reassurance, prescribe when appropriate, or direct them to the right level of care.
In this episode, Wade and Dr. Perritt discuss how that idea grew from giving patients his personal phone number into a model designed to give entire communities the experience of having “a doctor in the family.”
They cover why traditional telehealth often creates too much friction, how municipalities can help fund direct access to care, where text-based medicine has limits, how patients are referred and followed after a visit, and how TAP uses technology and AI to support physicians rather than replace the physician-patient relationship.
Dr. Perritt also explains why he believes everyday healthcare access could eventually become part of community infrastructure in much the same way cities think about 911 and EMS.
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Episode Outline
00:00 A doctor for less than $10?
00:28 What ER television never shows you
02:48 Creating the “doctor in the family” experience
04:14 The patient who started the idea
06:08 Why cities are already paying for healthcare
08:33 How COVID exposed gaps in healthcare infrastructure
09:51 What if everyone in the city had access to a doctor?
10:46 Why traditional telehealth loses patients
11:44 Launching Text A Physician
12:29 When the original funding ran out
14:14 How the model got below $10 per family
15:08 Can you really provide medical care by text?
17:28 Why follow-up matters
18:11 What happens when a patient needs more care?
20:36 Where text-based care has limits
22:13 Staffing care across an entire community
23:21 How often patients actually use the service
26:09 The technology behind Text A Physician
27:16 Medical records, privacy, and patient data
30:50 Labs, imaging, and care beyond the text
32:45 From city employees to citywide access
35:03 Could healthcare become infrastructure like 911?
36:27 How the model expands into new cities
37:45 Why people initially do not believe it
38:24 How AI supports the physician
40:23 Final thoughts