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Telemedicine in a Time of COVID-19

Telemedicine Covid

Amid the unprecedented COVID-19 pandemic, we’ve all had to make accommodations to our daily lives—including getting creative with how we socialize, shop for food, and even receive healthcare.

Telemedicine has actually been around for a while, with select physicians offering non-emergency services, diagnostics, and prescriptions via telephone or video chat—but only a small percentage of people have tried it. Now that many of us are facing stay-at-home mandates and self-isolation, millions will need to meet remotely with their healthcare providers.

While virtual access to your primary care provider and mental health professionals may be what first comes to mind, medical specialists also have options. Though most states have recommended cosmetic practices temporarily close to alleviate PPE shortages, many plastic surgeons are offering virtual consultations to allow patients to plan for future procedures and to maintain some continuity of care.

As a plastic surgeon who works with patients from all over the country, I have been engaging in virtual consultations for procedures including body lift after massive weight loss, tummy tucks, facelifts, breast augmentation, and more. I find that with preparation and proper communication, patients are comfortable with the format and have a very informative and educational experience. Here are my top tips for getting the most out of your virtual appointment:

Part 1: Getting Ready for Your Telemedicine Appointment

Before your consultation, I suggest taking a few steps on your end to ensure you have a productive, safe appointment.

  • Find a calm, private space. If possible, try to prepare a comfortable, quiet space for your video call. Ask your significant other, kids, or housemates to spend some time outside or in another space with a quiet activity. This will help you focus on your consultation and avoid distractions.
  • Remember that you control the situation and should feel completely safe. You should be allowed to “take the lead” in terms of what you want to discuss or share. Furthermore, just as in an in-person surgical consultation, your doctor should not be “alone” with you—a nurse or other staff member should also be on the call. In my virtual consults, the patient care coordinator with whom you initially spoke is on our teleconference call to provide better continuity. Lastly, you should not be asked to do anything that makes you uncomfortable. An in-person exam to discuss details of sensitive areas can be scheduled at a later date.
  • You should expect HIPAA Compliance. Many patients wonder about the safety and privacy of online consultations, but reputable physicians will use HIPAA-compliant virtual meeting applications, including, Zoom for Healthcare, and GoToMeeting. (Note that if you initiate conversation via standard email or website forms before or after the consult, those communications would not be protected in the same way; your provider can offer more secure transmission options.)
  • Do your homework. ​Before you schedule a consultation, be sure you have thoroughly researched the doctor’s qualifications. Be careful as what looks shiny and impressive online may not be what it seems. Only seek care from a physician with board certification in the specialty your doctor advertises. The board certification must be recognized by the American Board of Medical Specialties. Don’t fall for fancy-named “mail-order” certifications. If you are seeking any cosmetic procedures, I would suggest you only seek care from a physician who is certified by the American Board of Plastic Surgery. Accept no imitations! Your plastic surgeon should also have hospital privileges at nearby institutions and only perform procedures in a fully accredited or state licensed ambulatory surgery center.

2. Getting Connected and Getting Comfortable

It may take a few minutes to get connected. Get ready about 5 minutes or more in advance. That said, the doctor will understand if you are having any technical issues or need a bit of time to get used to the software. If you don’t already know the doctor, part of your appointment time should also be spent on simply getting acquainted.

“Whitecoat anxiety” is fairly common, and you may initially feel this with a doctor over video chat. That said, there is a chance you will actually feel more comfortable in your home than in a clinical setting. In states with stay-at-home orders, your doctor and their assistant are also likely to be in their own homes (without their white coats), which may help you feel more comfortable speaking with them as peers.

Whatever your initial virtual appointment challenges may be, look to the doctor to help ease any anxiety you are experiencing. (If they do not, you should consult with other providers.) Once you have established a rapport, you can dive into your concerns and clinical solutions.

3. Discussing Your Areas of Concern

One of the main differences between a virtual consultation and a typical, in-person consultation is the medium for communication. While you, your physician, and their assistant will be in different locations and utilizing smartphones or computers to meet, the content, goals, and outcome of the consult can be similar.

That said, if your area of concern relates to parts of your body that you feel uncomfortable showing in a video consultation or sending photos securely before your appointment, you can still have a productive conversation discussing all of the following items and plan an in-person follow up at a later allowable date.

The clinical section of a virtual consult is likely to cover these questions:

  • What is the nature of your concern? How long has this been a concern for you? Opening up about your personal concerns and the history of them can help your doctor get a better understanding of your situation and needs. If it is relevant to the medical care you seek, it can help to reference online before and after photos of results for patients that were similar to you in the “before” image.
  • What is your timeline for achieving a solution? Some patients have researched for months or years and are eager to move forward while others are first learning about their options. It can help your provider to understand where you are in this process.
  • What is your budget? Medical financing can be used so you may also think in terms of monthly budget. This will likely be reviewed by the physician’s staff on the virtual consultation with you.
  • Be prepared to provide your full health history via a secure method. Your provider needs to understand any conditions you may have in order to recommend the right treatment plan and determine if you are even a safe candidate for any procedure(s).

After hearing about your concerns and goals, your doctor should present some possible solutions that they know will be safe for you. If the solution is fairly clear, you may even be invited to take the next steps towards booking a procedure; however, you should never feel pressured.

Some patients have more complicated health histories or situations; in this case, your doctor may not recommend a procedure and will explain their reasoning. You may also be advised to make certain changes (for example, quitting smoking) to make a procedure possible in future.

After your appointment, expect some follow-up from the doctor or staff members you met with. You can also ask more questions; you should be completely confident and have all your questions answered before scheduling a procedure.

I hope this information helps you have a productive telemedicine appointment! You may even find that the convenience it offers makes it your first choice for certain kinds of doctor’s visits in the future.

Telemedicine in a Time of COVID-19
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Telemedicine in a Time of COVID-19
Amid the unprecedented COVID-19 pandemic, we’ve all had to make accommodations to our daily lives—including getting creative with how we socialize, shop for food, and even receive healthcare.
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April 14, 2020
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