Telemedicine: What Doctors Want You to Know

  • senior Caucasian couple sitting on living room couch holding up tablet with telehealth doctor's appointment
    Telemedicine is likely here to stay.
    Telemedicine had already been on the rise before the COVID-19 pandemic, which brought telehealth to the forefront for both patients and doctors. A wide range of symptoms and conditions can now be addressed through a virtual visit. Practicing physicians at three of the largest telemedicine companies (interviewed prior to the COVID-19 outbreak) share what they want you to know about telehealth and why it's likely to become the new normal.
  • Mother with her baby on telehealth appointment with pediatrician
    1. “Telemedicine is not as different as you might think.”
    “Lots of patients think this is just an advice system or something less than a real evaluation. In fact, it is a real healthcare evaluation that is regulated by healthcare boards and by state as well as the federal government. It’s treated as a real healthcare encounter,“ says Nicholas Lorenzo, MD, chief medical officer of MeMD, a telemedicine company based in Scottsdale, Ariz. Still, if you’re considering telemedicine, take into account privacy concerns, the ability to use the technology, and possible electronic glitches. And remember there is no substitute for many hands-on medical procedures.
  • young woman with laptop on sofa with feet up
    2. “Convenience is a big feature of telemedicine.”
    Telemedicine companies tout the ease of care. In traditional healthcare, “You make an appointment that is probably not convenient and travel to the office; you wait in the waiting room; you fill out a clipboard–all that stuff,” says Dr. Henry DePhillips, chief medical officer of Teladoc, which began in 2002. “With a telemedicine visit, it’s more like, ‘I don’t feel well, let me jump on my smartphone.’ And the experience is 30 minutes front to back most times, and it’s wherever you are located. For consumers with busy lives, there is a subset of medical problems that are totally appropriate to be treated remotely,” he adds.
  • Family walking away from camera on red-sided rural farm in winter
    3. “In some areas, telemedicine can provide better access to healthcare.”
    “One of the holy grails of virtual care telemedicine is providing services in underserved areas, whether they be low population or rural areas,” says Dr. Lorenzo. Some people have to travel hours to get to a provider and, if they need specialized care, it can get complicated. “In rural communities, if your loved one gets put into an ICU and the expertise they need is not available, they may need to be transferred an hour or two away,” says Dr. Ashok Palagiri, a critical care specialist with Mercy Virtual Care Center in St. Louis. “So now you have put a very large distance between families and their loved ones while they are getting critically ill care. Using virtual medicine can keep patients in their communities.” Palagiri consults with doctors remotely, and monitors extremely sick patients when staff is shorthanded.
  • senior Asian female cancer patient waving at tablet and sitting on couch during telehealth appointment
    4. “Telemedicine providers say virtual care can mean lower-cost healthcare.”
    Telemedicine is cost effective for the patient as well as the provider. “The overhead cost of providing telemedicine care is a little bit less than having an infrastructure like a building. So the cost of care is less, and that’s nice for the consumers,” says Dr. DePhillips. “It can give you the same type of treatment and satisfaction [as on-site care], and in most cases is less expensive,” says Dr. Lorenzo. 
  • Eye doctor and patient in exam room
    5. “Most online doctors also have traditional practices.”
    “We have doctors who are licensed across the United States. All of them have a private, brick-and-mortar practice. All of them do telemedicine part-time on an ’as able to’ basis,” says Dr. DePhillips. Many doctors welcome the variety. “Most virtual providers will have an in-person practice, so they mix and match. They spend a good chunk of their time on live care, but also a nice chunk is spent on virtual care. They seem to enjoy it. It is a different experience and you reach a different audience,” says Dr. Lorenzo.
  • Doctor examining woman's neck and throat in office
    6. "Be aware of the limitations of telemedicine."
    “We end up referring about 5 to 6% of the patients who come to us to live care. You can’t treat everything in this fashion,” says Dr. Lorenzo. “Although, with the advent of more and more wearable sensors and such these days, more conditions can be treated virtually.” For instance, you can upload a picture of your rash to an online dermatologist or send your vital signs from your fitness device to your virtual doctor. There are other constraints on virtual care, though, including a lack of visual cues for the doctor and the inability to feel lumps and bumps. “Palpating” can be a big part of a live exam.
  • Corporate connection
    7. “Be sure to check out your virtual care company.”
    Not all telemedicine companies are created equal, so do your homework. “Probably the best way to do that is to take a look at the history and the credentials of the company itself. Make sure you are getting a board-certified physician to deliver your care,” says Dr. DePhillips. “The provider you are using must be able to provide care in a quality fashion. It is not ‘healthcare-lite.’ We are talking about an evaluation and treatment that is equivalent to what you would get in the live setting,” adds Dr. Lorenzo. Credentialing, training and quality oversight should be part of your telemedicine company’s practices.
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    8. “Telemedicine can be more than just basic care.”
    Patients with serious medical conditions may be helped through specialized telemedicine. In hospital settings, “We can assess the patient with high-definition cameras. If they are on a ventilator or medication drips, we can see how the patient appears and if they are in distress,” says Dr. Palagiri. Doctors can provide care in ways that were not possible before telemedicine. Palagiri remembers one of many critical cases. “We had a young man who was exposed to a toxic substance. Every night, when I would go home from the hospital, I needed to have confidence that someone was going to be able to manage him through the night. So every night I would call my virtual partner, and they would continue to manage this man. The patient not only was on a breathing machine, he developed kidney failure. He pretty much had every system failing and without 24-hour critical care, it would not have looked good. But, working together, we did get him stabilized.”
  • Hispanic doctor and nurse practitioner reviewing chart
    9. “Telemedicine can help address physician shortages in the U.S.”
    In areas where doctors can be hard to come by, patients can get more attention and quicker responses with the help of telemedicine providers. Local doctors can share the demands on their time with virtual partners. “We provide a continuum of care” says Dr. Palagiri. “During the daytime, most hospitals have critical care physicians or assistants at the bedside, but we are available to provide a consult or an opinion to help onsite physicians. During the nighttime, our role is to keep an eye on patients who are deteriorating, trying to identify potential patients that could use help sooner than later."
  • Senior Caucasian woman talking to doctor on computer with blood pressure cuff on at home
    10. “Telemedicine is expanding into other areas of healthcare needs.”
    If you have a medical condition that could develop into an emergency, virtual care can provide a safety net for you. “The monitoring of chronic conditions like heart disease, heart failure, diabetes, or lung disease like COPD is one of the hottest areas of virtual care right now,” says Dr. Lorenzo. Sensors and video cameras can connect you to providers who know how to respond quickly and effectively to get you in-person care in urgent situations.
Telemedicine | What Doctors Want You to Know | Telehealth
Contributors

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
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Last Review Date: 2021 Apr 9
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