Telemedicine Isn’t New, But COVID-19 Made It Popular

We’ve been hearing a lot more about telemedicine lately, and with good reason. With COVID-19, it has emerged as one of the best (and safest) ways for doctors to deliver care during the pandemic—without the worries and risks of face-to-face visits.

But if you haven’t had a telemedicine visit yet, you may be wondering what it is and how it works. Plus, can it actually replace seeing your doctor?

As someone with more than a dozen years of experience using telemedicine with patients, I’ve seen its upsides and downsides. Here are the most important things I believe you should know.

What is telemedicine?

While telemedicine has surged in popularity during COVID-19, it’s not a new concept. Virtual visits by phone (hence the name telemedicine) originated back in the 1950s as a way for doctors to conduct telephone visits for patients in remote areas of the country.

Now, as technology has changed, it has expanded to not only include doctor visits by phone—but by video conferencing and even text.

One of the biggest upsides of telemedicine is that it’s a real timesaver. Patients like the fact that it saves them the time of driving to the office and sitting in the waiting room. Plus, they don’t have to take time off of work or worry about childcare. As a doctor, I also like the fact that it allows me to monitor a patient’s progress more readily.

How does a telemedicine appointment work?

In many ways, a virtual office visit feels a lot like an in-person visit. Usually, the patient calls or video conferences in and waits in the virtual waiting room until I join the line at the appointment time. For video appointments, I use a secure HIPPA compliant platform that protects patient privacy.

I’ll begin the visit the same way I would if we were meeting in my office. I typically ask patients about their day and how they’re feeling. Then, I’ll ask specific questions based on their health concerns—such as their mood, bowel habits, pain level, and the like. If the patient has a blood pressure cuff, thermometer or glucose meter to record objective measurements at home, those markers can be helpful as well.

In my practice, a typical telemedicine visit lasts about 30 minutes. Then, I come up with a treatment plan which the patient receives through the patient portal. Depending upon your healthcare provider and your health needs, the visit could be shorter or longer.

One important note. Before scheduling a telemedicine visit, you want to check with your insurance provider to make sure telemedicine visits are covered. Many insurances will treat it the same as an in-person visit, charging the same co-pay or other out-of-pocket fees. So, it’s important to verify your coverage.

What can be treated with telemedicine?

Telemedicine typically lends itself well to treating chronic, not acute, conditions. For example, I often use it for patients who have been experiencing symptoms for at least a month, since I can run through a list of questions, asking patients what they’re taking, what has changed in their life and for a detailed description of their symptoms.

There are also times telemedicine can be a savior. For example, for someone with chronic low back pain that makes it difficult to drive or climb stairs, a virtual visit can be a blessing. I can ask questions to assess pain and severity, understand what makes the pain better or worse and try to hone in on the source. Then, I can suggest treatment options—such as more rest, stretching exercises, and hot or cold applications. Plus, if a medication or nutraceutical needs to be prescribed, I can do that as well.

There are also times telemedicine can work in tandem with in-person care. For example, I can send a patient for bloodwork or urinalysis, then use a remote visit to review the labs and discuss the treatment options. Even something as complex as fatigue can often be treated and monitored by telemedicine if a patient has already had their bloodwork.

What conditions require an in-person doctor visit?

While telemedicine can work well for monitoring chronic conditions, if you’re experiencing something acute—such as a sore throat or chest pain—you need to see a doctor in-person. It’s important in these situations to get a physical exam and appropriate lab testing (e.g. EKG or strep test) which can’t be replicated with a virtual visit.

Healthy Directions

There have also been times that I’m seeing a patient in a virtual visit and realize I need to see them in person–or that the patient needs immediate care and needs to go to an urgent care center or emergency room.

Are there downsides to telemedicine?

One of the biggest downsides of telemedicine is that you don’t get one-on-one contact with your doctor, so you miss out on the healing element that comes from being in the same room as another person. Also, during virtual appointments, I’m limited in sensory cues, such as smell, which can give me a more complete picture of the patient’s condition.

It’s also important to remember that telemedicine can’t completely replace in-person appointments. I need to see my patients in the office at least once a year to make sure I don’t miss something that can’t be identified during a remote visit.

The bottom line…

In many ways, telemedicine lets a patient have the best of both worlds. You can get regular medical care without leaving the comfort of your home. Since a virtual visit can happen anywhere, you can even check in with your doctor while on vacation.

Telemedicine is also a good way to seek a second opinion on a health issue—perhaps when it’s not practical to see a practitioner in-person. It also gives you the flexibility to seek the care of a provider who may not be right in your community.

I’m thrilled to see that many healthcare providers have recently expanded their practices to include telemedicine. I’m hoping that one of the “silver linings” of COVID-19 is that we’ll all be more comfortable in combining the best of in-person and virtual medicine—keeping providers and patients connected in the quest for better health.

Biography: Dr. Drew Sinatra is a board-certified and California-licensed practicing naturopathic doctor who holds a Doctorate in Naturopathic Medicine from Bastyr University, America’s top naturopathic and complementary medical school. As a self-described “health detective,” he works with patients on “health care” rather than “disease care” at his practice, the CLEAR Center of Health, in Northern California. As one of the country’s leading naturopathic physicians, Sinatra’s areas of expertise include digestive disorders, autoimmune disease, hormonal balance, fatigue, mold and mycotoxin illness, and complex chronic disease. Sinatra is a member of the California Naturopathic Doctors Association (CNDA), American College of Nutrition (ACN) and American Association of Naturopathic Physicians (AANP). He is an author, speaker and adviser for the research and development of clean and plant-based nutritional supplements with Healthy Directions.

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