sas5814 Posted March 23, 2021 Share Posted March 23, 2021 I know telehealth takes a lot of forms but I have recently seen a new one. Our clinic has 2 telehealth rooms where the patient comes to the clinic and has a virtual visit with the provider who is somewhere else. We have the attachments for otoscopic exam and ascultation etc. and the nurse handles the attachments for the provider. I have heard of similar setups for a specialist to consult on a patient in hospital or in a rural or under served area but this is really unique. I was wondering if anyone else had seen such a setup and how it was received by the patients? Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 23, 2021 Moderator Share Posted March 23, 2021 VA clinic has done for years. including PT and OT patients don’t seem to mind. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted March 23, 2021 Author Share Posted March 23, 2021 I'm new here so I am still getting oriented but it was just different to make the patient travel and the provider not. It makes more sense if they were getting specialty consults but this is primary care/IM. I suppose it let us use physicians who are licensed and live somewhere non-local. Meh. Not really an issue just interesting to me. Quote Link to comment Share on other sites More sharing options...
surgblumm Posted March 23, 2021 Share Posted March 23, 2021 I had this when I was hospitalized for Covid-19. They only used asclutation of my lungs and a NA brought in the TV and placed the stethoscope. Frankly, I was very disappointed. I did not see an NP or PA for the five days in the hospital and I did not see a physician. They knew I had a 42 bradycardia but no living person entered my room to listen to my heart. While the physician on the other side of the TV was talking to me she was interrupted by someone to read a chart for a fifteen second portion of time. I think this is the most impersonal manner to receive healthcare and a person can no longer talk with their physician of record unless you manage to get them by phone. I think that there may be more disappointed patients than we surmise. bob 1 Quote Link to comment Share on other sites More sharing options...
MediMike Posted March 23, 2021 Share Posted March 23, 2021 2 hours ago, surgblumm said: I had this when I was hospitalized for Covid-19. They only used asclutation of my lungs and a NA brought in the TV and placed the stethoscope. Frankly, I was very disappointed. I did not see an NP or PA for the five days in the hospital and I did not see a physician. They knew I had a 42 bradycardia but no living person entered my room to listen to my heart. While the physician on the other side of the TV was talking to me she was interrupted by someone to read a chart for a fifteen second portion of time. I think this is the most impersonal manner to receive healthcare and a person can no longer talk with their physician of record unless you manage to get them by phone. I think that there may be more disappointed patients than we surmise. bob This disgusts me. I'd get called for an 0300 consult on a patient, go in, see them, talk to them, exam them etc. and the nurse would then tell me I was the first provider to enter the room in 3 or 4 days. The hospitalists, nephrologists etc would just eyeball them from the doorway. We can debate about the benefits of a physical exam with the plethora of imaging available to us these days, but go SEE your patient at least. 1 4 Quote Link to comment Share on other sites More sharing options...
charlottew Posted March 24, 2021 Share Posted March 24, 2021 19 hours ago, MediMike said: This disgusts me. I'd get called for an 0300 consult on a patient, go in, see them, talk to them, exam them etc. and the nurse would then tell me I was the first provider to enter the room in 3 or 4 days. The hospitalists, nephrologists etc would just eyeball them from the doorway. We can debate about the benefits of a physical exam with the plethora of imaging available to us these days, but go SEE your patient at least. Yeah, especially since I've been vaccinated, I've been going into the COVID rooms and talking to/examining the patients. With proper PPE of course. Pre-vaccination I was much more wary - but I have pre-conditions that make me a very high COVID risk. Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 24, 2021 Share Posted March 24, 2021 The VA uses it with HUB providers - providers who work to cover in-need situations. Your float provider lives in City X and is covering for City M - they use the remote vitals and the WOW - Workstation on Wheels - and the nurse or health tech uses the equipment as the provider requests. It helps cover situations where there would not be enough providers otherwise. Not perfect but it works as a stop gap while getting more providers at one site. I don't agree that it should be first line long term. I would think it amazing for a remote village in Alaska who needs a cardiology specialty eval from the lower 48 and the machines could help him/her "hear" and see the patient. Nothing ever really replaces the hands on approach but the world is paradigm shifting the reality of technology is here to stay - it really depends on who uses it and their ethical code of what is right for the patient. I am still NOT looking at your tonsils on a phone camera in a bathroom at your place of business while you duck out on a break feeling like crap but won't leave work sick......................... My two cents 1 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 25, 2021 Administrator Share Posted March 25, 2021 6 hours ago, Reality Check 2 said: I would think it amazing for a remote village in Alaska who needs a cardiology specialty eval from the lower 48 and the machines could help him/her "hear" and see the patient. We had this in my rural family medicine rotation in Forks, WA 9 years ago--Telemedicine suite with echo and EKG, connected to a cardiology group a couple of hours away. Needed a specially trained RN to run the patient end of things, I think. Never really saw it used at that time, but I'm sure it was. Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted March 25, 2021 Share Posted March 25, 2021 My dad made a butcher block table when I was growing up. Many nights and weekends were spent on that table, and, reluctantly, I had to discard that fine table thirty years later, and I cried, so many memories were in that table. That table lasted three decades. It had value. Mass produced tables last a few yew years. as long as medicine- the most human of professions, really- is packed and sold as a commodity; as long as we are pressed to move people through the medicine machine; as long as patients and our care are considered products- medicine has no value. the element of healing can not be measured. It’s in the relationship. The trust. The laying on of hands. we all know this. But until administration and bean counters stop running the show, people will be given the most inexpensive treatment available, courtesy of Omnicorp (tm). 1 1 Quote Link to comment Share on other sites More sharing options...
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