Paging Dr. Frischer: Telemedicine
Would you have imagined that it would become common to make routine visits to your doctor…without leaving your home? World events have the ability to change human behavior quickly, and often dramatically.
Every day in my office I now routinely see patients who are comfortable “visiting” with me, sometimes in their PJ’s, from home. Many prefer it. Even as early as last summer, roughly 25% of us had used a computer, tablet, or smartphone for a telemedicine appointment. It is estimated that there were nearly a billion telemedicine visits during 2020.
Early on in the pandemic, the Centers for Medicare and Medicaid Services (CMS) granted emergency approval reimbursement to doctors for such visits. The CMS recognized that the combination of “stay at home” orders and the risks of catching or spreading COVID-19 led to the necessity of easy home access to medical care. Other non-government insurances then quickly got on board with this.
The advantages are obvious. Telemedicine eliminates the need to dress, commute, and pay for gas and parking. It keeps sick and possibly contagious people off of public transit. It is time efficient, and can be squeezed into a busy work and childcare schedule without much planning. Note that the field of mental health has long been ready for such a change, since those visits have predominantly been about talking, and not about physical examination.
The disadvantages are equally obvious. I can’t perform a physical exam on a screen, other than observing something visual that a patient chooses to show me. There are subtleties that any good physician picks up on if they are physically in a room with a patient. In person human interaction is always the most informative. The doctor-patient relationship, one built on warmth and trust, is far easier to maintain in person.
However, the bottom line is that we are still in a pandemic. Telehealth can promote public health goals by increasing social distancing and limiting contact. It maintains continuity of care, helps to manage chronic conditions, allows for preventive services, and picks up new problems early. In my own practice, this has allowed suspected or proven COVID patients the opportunity to get medical care without exposing other patients or staff in my office.
Will the use of telemedicine continue beyond this pandemic? Given the changes technology is constantly bringing to our lives, it certainly seems likely. For now, private insurance payers and the CMS have supported this transition by allowing reimbursement. Whether insurance payers will continue to offer this once we return to some form of normalcy, or whether patients will want to continue utilizing such services, is unknown. Personally, I hope to see you all in person, but for now, I urge you to continue to use any method you can to maintain your health during these unusual and tough times.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.