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No offense, telemedicine = YUCK. 

Hands on cannot be beat and telemedicine is producing some interesting litigation - provider licensed only in state X but patient in state Y. 

I think it is horrible for acute care - simply cannot look in ears, throats, hear lungs, squeeze calves, percuss flanks, feel bellies - cannot do a UA or culture by phone - not even vitals.

I am old and have a personal goal to never do telehealth. 

Be careful - never do half baked medicine.

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I am old too.    I am getting ready to return to full-time work after taking the last couple of years off to recharge.   The thought of seeing patients with Google medical school degrees, dealing with doctors who cut out of town at 5 pm on Thursday and turn their phone off so they are unreachable, being expected to do everything the doc does and know everything he knows for a fraction of his income, driving an hour each way to work.........    I'm just not feeling it.    I'm too old to go in a completely different direction, so I'm hoping to find something I can do with the education and certification I already have, while not having a job that makes me want to gouge my eyes out with the Taco Bell spork on the way to work.

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good luck. I think it is a little easier if you are in a position where you don't have to make x dollars. Right now I'm ramping up my last 8-9 years of work to get ready to retire so I'm trying to make bank. Therefore my misery level gets high some days. I do, however, find joy in being an old fart who won't take crap from doctors. We have an ortho doc who is a particular ass (funny since his wife is a PA) who wanted me to grade an elbow dislocation on some scale I had never heard of and call him back. He can look at the xray himself in about 30 seconds. I said "Nope. I'm either going to document you refused to consult and see the patient or whatever you tell me to do with her. You pick." 

He isn't coming to the house for drinks any time soon......

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It sounds really low-rent to some PAs who do internal medicine or some such, but the best job I ever had was at a retail clinic.    I had nearly complete autonomy over the day-to-day functioning of the clinic, didn't have to worry about reattaching a limb or doing brain surgery, and the pay was much better than FP.   The hours stink, though, and employment is always by staffing services rather than the hospital who owns the clinic.        

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We do a fair proportion of phone visits- but those are to check in with our established patients.

If the entire purpose of a visit is to have a conversation about "so how is the losartan/ citalopram/ metoprolol working out?" then making the patient take half a day off from work and deal with our parking ramp is not only not indicated, it's bordering on mean. 

If they have anything whatsoever that we might feel should be looked at, listened to, or palpated, then we have no hesitation about asking patients to come in for an office visit. But 15 minutes on the phone is often actually a better way to learn about how it's going, when the patient is relaxed and receptive. 

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At the VA I have a phone clinic for designated, existing patients on stuff that doesn't have to be touched. It bills and we do bill outside of VA bennies. There is a telehealth division that I hope to never experience. Not to say it is awesome - lack of hearing aids can be cumbersome and spelling drug names can be tedious. 

Distance stuff with a provider on each end can save an ICU patient or cardiac but the Skype in the closet at work for bacterial vaginitis or otitis media is asinine. 

Psych, meh, hard to get vibes and see full body language but it has its moments. 

I am 25 yes in and likely 15+ to go. Not ready for telehealth - would work at Home Depot first.

Just my crusty old 2 cents.....

 

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  • 1 year later...
On 9/30/2017 at 5:23 PM, lyn1985 said:

Is anyone practicing telemedicine?    I have found a couple of opportunities, but nothing has panned out yet.   If anyone has advice on this, please let me know.

I am in the same boat due to health reasons. I just dont have the clinic stamina. Did you ever find anything? 

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I'm also interested in doing telepsych down the road once I have more psych experience under my belt. I think it's one of the few specialties that lends itself to virtual healthcare, but it seems the main telehealth corporations are strictly NP and MD/DO. I went so far as applying to a position only to receive an email stating they need NPs due to licensing and supervision requirements. Made my case to the recruiter for our training, scope of practice, yada, yada, yada...

 

Sigh.

 

Maybe one day. The clinical rat race is wearing me thin already. I'd love to see if telemed can provide some relief.

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23 hours ago, pa-wannabe said:

I went so far as applying to a position only to receive an email stating they need NPs due to licensing and supervision requirements. Made my case to the recruiter for our training, scope of practice, yada, yada, yada...

 

Sigh.

 

Maybe one day. The clinical rat race is wearing me thin already. I'd love to see if telemed can provide some relief.

Killing us.

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  • 10 months later...

Spam aside, it’s interesting to see this old thread come up. How is everyone feeling NOW about telemedicine?
 

Me, I’ve had a few recently where it’s clearly not the best option, but for example this morning my patient either has biceps tendinitis or maybe some shoulder arthropathy. In the clinic, I could do some passive ROM maneuvers and feel for the crepitus or any clunking, sure. But video is good enough for checking some key active ROM and ruling out quite a few possibilities. And the plan is the plan regardless, at least for now. 
 

I rather doubt that we will ever get back to seeing 100% of these issues in the clinic, and there will be at least a few patients asking “can we just do this by video?” at least to start with. And I do believe I’m okay with that. 

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It was increasing in the medicine field but the pandemic has obviously pushed it to the forefront which is a positive I think.  Needed refill on my medications.  Had not seen by PCP in a while video chat briefly gave him my vital signs reviewed my labs & all done.  10-12 minutes easy.  

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