We’ve written frequently about the growing acceptance of telemedicine by hospital clinical staff, patients and their families. Still, we do encounter naysayers along the way.
Many of those who voice concerns about telemedicine are physicians who have had little contact with it in medical school or in their years in the profession. I understand their reluctance to embrace telemedicine in the hospital setting. I was in their shoes myself at one point in my career.
I know we usually can’t turn these professionals into telemedicine champions in one meeting, but when we listen to them, acknowledge the value of their perspective and share our experiences with successful programs, the result is often positive for all concerned.
The need for touch
“You can’t touch the patient.” It’s one of the most common objections to telemedicine that I hear from physicians. I understand it because the human bond has been part of the art of medicine for centuries. Showing empathy and holding a patient’s hand during a time of medical crisis are not only expected of us from the people we serve, but they are also things that any physician worth his or her salt wants to do.
How do I respond to this concern? I talk about how we maximize other ways of communicating. We look for physicians who have good “webside” manner; who can convey empathy through the camera and the words that they use. I emphasize that we mentor our providers to ensure they can be effective no matter how many miles between them and their patients.
I also make the point that the telemedicine physician isn’t the only person interacting with the patient. It is always a team effort with other clinicians onsite who can provide, literally, the necessary hand-holding.
Not a lone ship
In addition to comforting the patient, the sense of touch is often critical for a doctor to develop a thorough diagnosis of a patient’s condition. Doctors also need their hands to perform procedures like inserting a feeding tube or arterial line. When physicians ask, “How can you practice medicine without using your hands?” we remind them that the telemedicine physician is not a solo ship, but the leader of a coordinated team.
I tell questioning physicians that we build systems of care in collaboration with physicians on site, and other members of the clinical team—nurse practitioners (NPs), physician assistants (PAs) and nurses. They become the hands of the physician. With our 10 years of experience leading telemedicine programs in hospitals, we can address virtually all circumstances where a hands-on approach is necessary to inform decision-making about the patient’s care. For example, nurses can palpate for skin temperature changes or swollen glands under the direction of the telemedicine physician. In doing so, they are an extension of the off-site physician into the patient’s room and, for a while at least, their hands are his/hers.
Different specialties require different telemedicine protocols
When it comes to certain specialties like cardiology, there are procedures that telemedicine physicians can’t do—inserting a stent, for example. But there are many other aspects of care that TeleCardiologists can perform, like evaluating heart disease, congestive heart failure, arrhythmias and other conditions. In so doing, they can help cardiac patients who don’t require invasive procedures to stay in their hometown hospital to get the attention they need.
My point to the naysayers is that telemedicine can be a partner to hospitals across a wide range of specialties—not only in non-touch fields like behavioral health, but also in cardiology, pulmonology, ICU care, and more. Yes, sometimes we do have to recommend the transfer of patients to other hospitals or treatment centers when specific procedures are warranted, but overall we are helping hospitals avoid transfer of a significant percentage of patients who need the care of a specialist. That just wouldn’t have been possible before telemedicine came on the scene.
The numbers are instructive, too
Another way to help naysayers understand the benefits telemedicine provides is simply to show them our numbers at Eagle Telemedicine. With 150 programs in 100 hospitals nationwide, we demonstrate our value to physicians, patients and families every day. And that’s not only in standard areas of practice like Eagle TeleHospitalist and TeleNocturnist care, but also across a range of 10 specialties: TeleCardiology, Tele-GI, Tele-ICU, Tele-ID, TeleNephrology, TeleNeurology, TeleOncology, TelePsychiatry, TelePulmonology, and TeleStroke.
Not all these programs began with unanimous approval from leadership at the hospitals that brought us onboard. But in most cases, we were able to turn around the naysayers sufficiently. Even if they hadn’t become vocal advocates of telemedicine by the time our meeting was over, they had learned enough to decide it best not to stand in the way of progress.