My daughter is a senior in high school. She is busy completing her college applications and the most common question is “Why (insert school name here)? It is a classic question that puts the prospective student on the spot. Do you know enough about your prospective school to say what specifically appeals to you? Do you know enough about yourself, to know what is important about a prospective school? I think that question is a basic question that must be answered for any important decision. Why?? It certainly applies to a paradigm change like telemedicine.
Why would you use telemedicine as a patient? That question is pretty easy for most patients to answer. Do you like the experience at your doctor’s office? Is the parking easy? Is the wait reasonable? Do you get a valuable exchange for the time, energy, money and general hassle that going to a doctor entails? Was it worth it? Would you prefer to meet with your doctor from the comfort of your home or your office? If you have chronic medical conditions, how much time have you spent waiting on a short provider visit, how much money have you spent, how much time off work or away from your friends and family have you lost waiting for a few minutes from your healthcare provider? Telemedicine provides a solution for many patients. You can send your data about your health from your app, smartwatch or mobile device. You can connect to your provider from the comfort of your home or office. You can forget about the hassle of parking and finding your way around a hospital or medical office. You can skip the hours spent waiting. You can connect on your terms as a patient. It can’t replace an in-person visit but it can certainly supplement that visit for many patients. Telemedicine makes a lot of sense for patients.
For a provider, the question of “Why Telemedicine?” is harder. Doctors and nurses are creatures of habit. They don’t easily change habits that have served them well for years. Changing a paradigm of care is certainly a big thing to ask of a healthcare provider. Most are as busy as they can stand. They don’t have enough hours in the day to do the work they are asked to do now. Why would they want to learn to work in a different way? The answer is found in almost every survey of healthcare providers today: Doctors and nurses are not happy with the way healthcare is delivered today. Their job satisfaction is at an all-time low. They are asked to see more patients, spend less time with each patient, and get paid less for each visit each year. The paperwork and EMR time is increased and the time “being a doctor” is less and less. The answer for most is to work harder. That just leads to longer hours and less job satisfaction. I would propose that the real answer is to work smarter and more effectively. One of the most valuable (and least valued in my opinion) aspects of today’s healthcare system is the concept of physician time. The goal should be to maximize the most expert care by a physician for the treatment of the sickest patients and to allow routine preventive care that moved outside the hospital years ago, to move outside the doctor’s office today. Telemedicine makes sense for chronic and preventative care. It can be performed by nurses, nurse practitioners, and physician assistants as well as physicians. It can time shift appointments to a time that works for both the patient and the provider. The sickest patients still need to come in for an in-person appointment but the chronic, preventative care that is reviewing data from lab work, and tests, counseling about lifestyle modification, and asking questions searching for the early symptoms of disease, can all be done over a high definition mobile connection. Telemedicine frees up the provider’s schedule to see those patients that require an examination while allowing quality care to be performed remotely by several members of the care team. Much of that remote care is currently provided over the phone, is unreimbursed, and still carries a malpractice risk. Telemedicine allows a higher level of care for those visits and a much more personal connection and a higher level of satisfaction for both patient and provider.
Why Telemedicine? It is moving healthcare into the 21st century using advanced mobile technology to supplement the patient-provider connection, not replace it. We will look back one day and wonder how we worked in healthcare the way we currently work.