30 Comments
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Nancy's avatar

Seriously dude, sign up for Doximity, any minimal spam is worth you being more clinically effectiveness. It's a much kinder tool for both pts and clinicians. Tech challenged patients (cognitively impaired. under-resourced) deserve so much more than our hospital's EMR (and our own unrestrained emotional frustration with that billing machine).

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Mary S. LaMoreaux's avatar

So true. I did telehealth once for a sinus infection. The doctor asked what my blood pressure was. I didn't have it. She asked what my temperature was. I don't have a thermometer. She asked if my sinuses hurt. I said yes. So she gave me the antibiotic I wanted for a sinus infection. It helped in that I wouldn't have gone to the doctor without the telehealth, but it wasn't real doctoring.

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Branden Tarlow's avatar

Great piece capturing every doc's frustration with the telehealth experience.

I have discouraged virtual visits for the past year (still do a handful per month). The experience of seeing someone in the office and doing an exam is such a more satisfying experience. Sometimes if technology moves us backwards.

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DocH's avatar

Interesting piece! I've done virtual visits with people well into their 80s and enjoyed them quite a bit. I think Virtual Visits are a good tool, used best by a PCP who already knows the patient with it being just one type of visit amongst in person visits.

Long before the pandemic, I was advocating for coverage of Virtual Visits. They have many benefits: time and effort saved on the part of the patient; some time saved on the part of the physician. Larger view benefit: less people vying for parking spots at the doctor's office, less people on the roads, etc. Many office visits are a review of data/information - labs, test results. If a patient prefers doing that via televisit, that seems reasonable.

Now a more important point: Medicare only planning to cover these visits through March 31, 2025. They may become a thing of the past - for the time being anyway. I really think they make too much sense as an option to be done away with. Again, as something the patient and doctor can decide they want to do or not, they serve a purpose.

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Michael Buratovich, Ph.D's avatar

Bad kitty!!

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Jim Ryser's avatar

This reminded me of walking in line at Space Mountain, at all the things in 2000 that were going to make our lives easier! Yes I’m old and was one of the first to ogle all the time saving necessities in that long, slow line. So excited that maybe when I’m 30, all the work will be done for me so I can play cops and robbers ALL the time and never go to school again. Boy was I flattened when I realized that the more simple things are supposed to be, the worse that they get. I miss a hand written hospital note. Now we have Cerner, or EPIC! REAL TIME SAVERS! Bravo on your article, sir!

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Ernest N. Curtis's avatar

Good example of how low medical care has descended with "telehealth". To paraphrase George S. Patton, "God how I hate the 21st century."

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toolate's avatar

Yes all true and not at all exaggerated in my experience. But...seeing her home,her pet, her granddaughter etc etc etc is a window into her world that we used to get via house calls but sadly mostly no longer do.

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Marc Keen's avatar

Why don,t you just get rid of video visits and have her come to your office?

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MBP's avatar

And there is such a concept of having a separate phone for patients to contact you.

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MBP's avatar

Instead of wasting all that time getting the video connection working and consequently frustrating the patient, you could have just talked to her on the phone.

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Edward GRAY's avatar

Yes, well the doc is probably restricted by policy to use this substandard tool.

Why does telehealth have to be harder than Zoom or FaceTime?

Those services are ubiquitous, especially post pandemic.

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shoehornhands's avatar

I, too, have a super helpful video meeting cat.

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Melissa Fountain's avatar

Used to have 2 of those. Now I have a golden and he lays his nose across the keyboard when he wants to watch "doggie movies" which are dog rescue videos.

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JDM's avatar

Telehealth is generally frustrating for the clinician and often equally frustrating for the patient. But, as house calls no longer exist (except for the supremely wealthy), they can be life savers for the homebound.

That patient was likely frustrated at the quality of the interaction, but likely appreciated being able to meet with her doctor at all, without the prohibitively exhausting all-day trip to the hospital that a 30-minute in-person visit would entail. And perhaps the daughter was able to ask questions and learn more about her mother’s conditions and her doctor’s approach to them.

This does not mean that the current state of the telehealth visit is in any way acceptable. Better and timely IT support would immediately improve what we currently have. But current tech has a long way to go to reproduce the most important aspects of an in person visit.

We must push our hospital administration not to accept the status quo of telehealth visits and advocate for our IT folks to look constantly for better technical approaches to virtual visits.

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Melissa Fountain's avatar

I have done teleconferences as a patient but only when I have had to. As officially a senior citizen and labelled as disabled I have experienced both and you are correct, nothing replaces an in-person visit (however brief) to a teleconference.

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Nicenurse66's avatar

One concerning issue I’m seeing is that some providers with poor social skills actually prefer telehealth to in-person visits as they feel more comfortable without eye contact. That’s a problem on a whole different level…

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M Makous's avatar

Good anecdote on the truth of how 'tech makes life easier'. Though Dr Stern was pretty thorough in his recounting of the steps involved in this failed encounter, I'd bet he omitted some of the finer points. Perhaps things like a mandatory password re-set, or verification step first requiring a page to be unlocked.

God forbid if you enter an incorrect passcode more than twice. You'll be locked out until a system administrator unlocks your account after a 45 minute phone call with several times being put on hold.

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Brenda from Flatbush's avatar

Over my 40 years as a medical writer and editor working with "thought leader" clinicians, as well as years spent caregiving the frail elderly, I learned many clinical "pearls." The one that always comes to mind when I read about the pathetic innovation called telehealth is this: A brilliant and compassionate gerontologist begged his primary-care colleagues, "At every visit, make sure your elderly patients, especially those with diabetes, take off their shoes and socks. Look at their feet!" Try doing that on a webcam!

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KTonCapeCod's avatar

I had a patient who was a gynecologist and was doing telehealth. I scratched my head at that! And then he said he didn't think he would ever go back into the office. I scratched my head again. How will I palpate my own ovaries? I guess we have the self breast exam supposedly mastered. I can palpate my own thyroid. How about listen to my lungs and heart? And I am working on taking my own paperwork smear. Or maybe we could ask a friend!

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