Adversity and necessity mandate invention.
During the COVID-19 pandemic, telemedicine has been transformed almost overnight into a necessary medical tool for remaining connected to our patients. Without warning, physicians suddenly found themselves in the position of adding communication technologies, learning regulatory requirements, and adapting to an entirely new way of interacting with patients, sometimes reinventing their standard clinic procedures. Similarly, government and private health care had to modify longstanding obstacles and prohibitions by allowing interstate practice and revising reimbursement policies.
I doubt there is a physician in our state who believes they could have managed their patients through this pandemic without the benefit of telemedicine. Having said that, telemedicine is not a panacea.
Practicing in a rural environment, we have discovered that bandwidth challenges are a huge issue. Older patients also have vision and hearing challenges that make telemedicine less effective than face-to-face visits. There is still an enormous amount of paperwork involved in conducting a telemedicine visit, it is not simply a matter of “picking up the phone and chatting.” That is one reason why it is so important to have parity for video and telephone encounters.
Despite these challenges, most clinicians would like to maintain the availability of this tool as we continue our social and medical confrontation with coronavirus. At the same time, we also recognize inherent limitations that telemedicine imposes (I just cannot do a good knee exam over the telephone). The challenge we now face is to define and refine best practices for employing telemedicine. Part of this effort will require continued advocacy and encouragement of health delivery systems to support telemedicine. Some of this will also necessitate new legal safe guards for practitioners employing this tool.
As you reflect on how this pandemic has changed your practice, please consider how you can support and contribute to the future of medicine in our state by advocating for your patients and your practice. It is up to us as clinicians to help mold the future of healthcare delivery.