The COVID-19 pandemic has disrupted life for physicians in many ways, and how your patients prefer to receive care is one of them. While it’s not ideal for every health problem, telehealth has proven to an effective way for those who want to avoid unnecessary physical contact to still consult with a physician. However, for a physician who hasn’t done it before, practicing medicine through a screen can seem like a daunting prospect. Here’s how one physician first started practicing telemedicine along with some tips to help you get started too.
Getting started in telehealth
While many physicians are new to practicing telemedicine, Dr. Patrick Marsh, a locum tenens psychiatrist, has been seeing patients this way for several months before the pandemic hit.
Dr. Marsh initially started working locums when his wife’s job in the U.S. Air Force began taking her around the country. Locums was a way for him to be closer to her while continuing to practice medicine. When they decided to settle down, one of his regular locums employers at a rural hospital in Oklahoma gave him the chance to try out their new telehealth system.
“It’s a solo shop down there,” says Dr. Marsh, describing the one full-time psychiatrist on staff. “When he leaves town, they need someone to cover their hospital unit. I cover four to eight days a month so that the provider can have a little bit of time off. It’s working out pretty well.”
Dr. Marsh has been grateful for the chance to practice medicine remotely, especially because it allows him to spend more time with his wife. “If it weren’t for telehealth, we would be apart a lot more than we are.”
Practicing telemedicine during the COVID-19 crisis
Telehealth made it possible for Dr. Marsh to keep working during to the COVID-19 crisis, even though he came down with a virus himself. He’s still not sure it was the coronavirus; “Who knows what I had,” he says. But despite his illness, he was able to continue offering patient care through telemedicine because there was no risk of transmission.
When he reflects on the risk traveling to his assignment could have posed to himself and others, he says, “It seems foolish. I would have gotten on an airplane, rented a car, driven to a 3rd city, rented a hotel room, gone to multiple restaurants during the week of the time I was there seeing patients.”
Dr. Marsh also regularly provides on-site care as a locums at a hospital in Florida. Recently, he learned that two of their physicians were out for a 14-day quarantine, because they had been exposed to the virus. “These doctors were at home, not sick, but not able to come to hospital.” For him, it reinforced the urgency for healthcare facilities to get set up to support telemedicine visits. “If they had telehealth, those two doctors could be working right now,” Dr. Marsh says.
Tips for getting started doing telemedicine
If you’re new to telemedicine, it does pose new challenges to the way you’ve always practiced. However, despite the literal barrier between yourself and the patient, there are ways to make the process easier and more effective for both parties. Here are five tips for physicians who want to start practicing telemedicine.
1. Find out what telehealth system is being used
Not all telehealth companies are the same, so it’s important to make sure you are getting the support you need both technically and clinically. Ask these questions before accepting an assignment:
- What kind of tech support does the company offer?
- Is there adequate support from nurses to help with patient follow up and calling in prescriptions?
- Does the malpractice insurance specifically cover telehealth?
- How many calls can you expect to receive per shift?
2. Prepare in advance for the appointment
Spend as much time preparing for a telemedicine visit as you would for an in-person appointment. Review the patient’s medical history (if available) and why they want to speak with a physician. Test your technology to ensure the platform is functional and that your audio and microphone work.
3. Pay attention to appearance
This includes not only how you look, but how your space looks as well. Many physicians opt to wear a white coat. They find this can inject confidence into a situation that can seem strange to a first-time telehealth patient. Whether you wear a white coat or not, ensure that your appearance is neat and professional. Notice what’s behind you too, and clear away any clutter or distracting items. You want your patient to focus on you, not what’s going on in the background.
4. Document everything
When practicing telemedicine, your primary source of information is what the patient is telling you. While you may be able to make some observations through the screen, it’s important to accurately report everything the patient says. For physicians who usually work with scribes, this is especially important to remember. Some argue that the documentation for a telemedicine visit is even more important than for an office visit.
5. Be understanding and express empathy
Just like you may feel a little strange treating a patient through a screen for the first time, keep in mind that the patient may feel the same way. Introduce yourself and explain clearly how the appointment will work (for example, if you’ll be taking notes). It’s also helpful to look into the camera when you’re speaking with the patient and not at the screen, as this better approximates making eye contact. Finally, remember to show empathy and patience.
The future of telehealth
The COVID-19 pandemic has only accelerated the public’s adoption of telemedicine, and it doesn’t seem to be going away any time soon. For many patients, the convenience of speaking with a provider from their own home is something they’ll want to continue doing, and many providers find it convenient as well.
“Federal insurers have relaxed a lot of their requirements because of COVID-19; they’re allowing people to do basically whatever it takes to get through this,” says Dr. Marsh. “But I don’t anticipate that once it’s over that those rules are going to be gone.”
Dr. Marsh hopes that future regulations will allow hospitals to continue using telemedicine, especially in rural areas where provider coverage can be difficult to come by.
Now that telehealth is becoming more widely accepted, Dr. Marsh plans to continue the new way of practicing medicine as a locums. “With things opening, I will continue to do telehealth,” he says. “I’ll still do some in-person work, but it is hard for me to travel. If somebody is sick in either Florida or Oklahoma, they could call me the night before and say, ‘Hey, can you cover something tomorrow?’ and that’s perfectly reasonably because it is telehealth. If I had to fly down there, there is no way I could cover a shift on a moment`s notice.”
From limiting travel to providing much-needed care in underserved areas, telehealth can be a great way for physicians to care for patients from wherever you’re located right now.