What I Learned In My First Year As a Telemedicine Provider

What I Learned In My First Year As a Telemedicine Provider

By the spring of 2020, a realization struck me.

For the first time since I had started in medicine, there was a chance that we wouldn't have enough money coming into clinic to keep the lights on. We had recommended our patients stay home and isolate during the beginning of the pandemic, and thankfully, most of them were listening (we're blessed with great patients).

However, you can't keep a medical office open without patients. We had to pay our utilities, EMR fees, rent, billers, malpractice, staff, etc. Our staff had been with us for years and we weren't willing to let anyone go.

A lot of us in medicine are not natural entrepreneurs. Well, perhaps that's not correct. Medicine attracts intelligent, inquisitive, compassionate, and hard-working individuals. We can be problem solvers of the highest caliber. However, for years upon years of training we are myopically focused on training our brains to treat our patients.

So when a once in a century pandemic hits and you're in danger of closing up shop, it takes a bit of a frameshift to go from having a brick and mortar clinic to running a virtual clinic.

We took a crash course in learning telemedicine CPT codes so we could collect revenue. We also took a little bit of inspiration from people that used the opportunity telemedicine presented to live life on the road.

It was such a wondrous reimaging of the way the average healthcare provider could provide quality care.

So I'd like to take the opportunity to share 3 important lessons I've learned while working a remote telemedicine job for the past year:

I love telemedicine.

Telemedicine is great. Patient's can stay in the comfort of their own home and can visit with their provider in their jammies (theoretically we can too!). 

There's something that makes the day a little better when you're not rushing out of the door trying to brave traffic and parking to make sure you can rush into a packed and hectic doctor's office. You can feel how much more relaxed and comfortable patient's are when they're talking to you from their own home.

White coat hypertension, a phenomenon by which people become so stressed in a doctors office that their blood pressure increases is a very real thing. A relaxed patient not only makes for a better patient-provider interaction, but also has real physiological implications.

Not only do our patients get to spend more time at home, but healthcare providers can as well. If there's something that's been missing in the field of healthcare, it's work-life balance.

I've spent more time at home over the last year than I have in the proceeding 5.

And you know what? It's been an absolute blessing.

That said...

Telemedicine Can Be Lonely

There is something to be said about the camaraderie of medicine. Working together as a team to take care of your patients. There is something a little bit isolating about reducing the whole enterprise of healthcare to your screen.

Sometimes I could go an entire day without interacting with another member of my team. Our medical assistants would efficiently line up our medication refills, schedule our patients, field their calls, and help our patients set up their remote visits all without needing our input. In a way, it's a model of efficiency, on the other hand it can be pretty jarring change.

Medical trainees are used to spending so long together in training at the hospitals they used to literally be "residents" of the hospital where they both lived and worked (hence the term). 

If I had to choose between the two, I would pick telemedicine hands down every time. However, we can still acknowledge that which we lost as well.

I do think professional telemedicine societies will play a larger role in networking and creating even virtual co-working spaces. Perhaps a way of just virtually popping your head into a colleagues office to discuss a difficult case if you will.

Telemedicine Jobs are the Future 

 Healthcare providers are burned out. There's just no getting around it. It's not new either.

The 2021 Medscape Physician Burnout report detailed that 79% of burned out physicians stated that their burnout predated the pandemic and the top two factors contributing to burnout was "too many bureaucratic tasks" and "spending too many hours at work."

Telemedicine addresses both in one fell swoop. It's not just doctors either. There has been an explosion in telemedicine jobs for NPs, PAs, nurses, and other providers. It's easy to see why.

It's important to know that this demand for more telemedicine is not just driven by healthcare professionals. The COVID 19 healthcare coalition survey revealed that over 80% of patients who had telemedicine visits during the course of the pandemic were very satisfied with the level of care provided and hoped telemedicine care would continue after the pandemic.

Offices will need to adapt to this new reality. I learned in the last year that healthcare providers can leverage their innate creativity, intelligence, and compassion to replicate the high quality of care they provide in person in a virtual setting.

Healthcare is changing.

I, for one, am happy to have changed with it.