I think the example is contrived, not every average joe is going to connect to 'remotesurgery.stelegius.com' and perform a surgery. So if a hospital wants a stable , high bandwidth , high QoS connection for 'remotesurgery.stelegius.com' they can do that today with any ISP (think MPLS back hauls). Now the doctors that want to connect to 'remotesurgery.stelegius.com' and perform surgery can also do that by getting the same high QoS service that sometimes can even directly connect these two set of end points.