sas5814 Posted April 1 Share Posted April 1 (edited) I think we all know virtual visits are just a fact of life these days for many reasons. There are opportunities for expansion of services where it is totally appropriate and can really improve access to care. There are also manifest abuses to make a buck and/or create a shiny looking metric. I am interested in some solid, well constructed data about the effectiveness of VV in terms of quality of car in addition to access to care. I can find hundreds of opinion pieces but not much in the "real" data category. Quick read of NIH and Mayo on the subject suggests specialty consults virtually seem to have equal outcomes as live visits with some variation by specialty. However the data on primary care is murky and the more complicated the patient the murkier it gets. Edited April 1 by sas5814 Quote Link to comment Share on other sites More sharing options...
SedRate Posted April 2 Share Posted April 2 9 hours ago, sas5814 said: I think we all know virtual visits are just a fact of life these days for many reasons I have yet to have a virtual visit. And honestly, I'm really hoping I don't ever have one. There is just more you can assess in person. The lighting is better for physical exams, palpation, auscultation, crepitus, demonstrate hands-on stuff like wound care, assess odor and warmth, etc. Anyways, this is just another opinion for you but thought I'd participate. Quote Link to comment Share on other sites More sharing options...
TWR Posted April 2 Share Posted April 2 (edited) I discourage them in my practice for a multitude of reasons, many of which were mentioned by Sed Rate above. Also, how many telemed patients check some or any of their vitals before the visit? "I know my body" is not a good answer. I think patients like telemed/video (which insurance companies insist on now), because of the convenience to them. I am surprised how many households don't have a thermometer!!! MAYBE medicine refill but not medicine changes and maybe referral questions but that is all. Just my personal and real-life experiences in my practice. Edited April 2 by TWR addendum and correction 1 Quote Link to comment Share on other sites More sharing options...
SedRate Posted April 2 Share Posted April 2 2 hours ago, TWR said: I am surprised how many households don't have a thermometer!!! Same! Patient: "I had a fever." Me: "What was your temperature." Patient: "I don't know, I just felt warm." 1 Quote Link to comment Share on other sites More sharing options...
entpac Posted April 4 Share Posted April 4 I get referrals for ear pain with diagnosis of otitis media or eustachian tube dysfunction. After reviewing the chart, some were Telemedicine and no one examined the ear. Many of these patients were treated with antibiotics and a fair number of them have TMJ referred pain for which antibiotics were never indicated. I use telemedicine on a limited basis for selective follow up only. 1 1 Quote Link to comment Share on other sites More sharing options...
TWR Posted April 6 Share Posted April 6 On 4/2/2024 at 9:52 AM, SedRate said: Same! Patient: "I had a fever." Me: "What was your temperature." Patient: "I don't know, I just felt warm." My favorite "I know my body"!!!!!!!!!!!!!!!!! 1 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 6 Moderator Share Posted April 6 I have seen some reasonable televisits for specialists - esp derm where they can look at lesions (but can't do anything) I do not like them for PCP medicine unless there is a very specific reason - i.e. f/u on shoulder pain As a patient I am also not overly fond of them medicine delivered, but the one thing going for them is they are crazy easy.... Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted April 6 Administrator Share Posted April 6 Long-term occ med follow-up, where I'm actually not doing medicine so much as case management, virtual visits work fine. The relevant specialists all see the patients in person, and they're each supposed to have a PCP to take care of the family medicine complaints. This allows me to take patients who live literally more than 100 miles away from my clinic. Either patient or clinician gets to veto telemedicine ("No, I need to see you in person...") which is a good safety valve. 1 Quote Link to comment Share on other sites More sharing options...
SedRate Posted April 6 Share Posted April 6 7 hours ago, ventana said: I do not like them for PCP medicine unless there is a very specific reason - i.e. f/u on shoulder pain I'm interested to hear more about virtual visits for something such as f/u shoulder pain. I would imagine a hands-on exam is pertinent, especially if the pt still has pain... Or do you just evaluate them visually and refer to specialist? Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 7 Moderator Share Posted April 7 It would be for injection f/u or say PT follow up. I would want to have seen them already but checking in on a treatment course is okay on tele. Just not new complaints. If not working then go onto next course of txt. (Possibly referral). Quote Link to comment Share on other sites More sharing options...
thinkertdm Posted April 7 Share Posted April 7 Ummm…won’t someone please think of the administration and shareholders? Virtual visits are solid income. No one gives a hoot about good medical care. You are about 50 years too late if you are thinking we have anything to do with medicine. We are income generating machines. Period, end of sentence. 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 8 Moderator Share Posted April 8 ^^^^^^^. I have now changed from say we have a broken health care system to saying we have a revenue generating profit system. Quote Link to comment Share on other sites More sharing options...
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