PANDEMIC CREATED SHIFT FROM IN-PERSON MEDICINE TO TELEMEDICINE
Telemedicine is no substitute for in-person medicine
As the COVID – 19 pandemic moved across America, unabated and infecting 6 million Americans and so far killing 200,000 of them; almost all patients stopped going doctors’ offices, clinics and hospitals ERs, and cancelled all their elective surgical procedures to avoid any chance of getting infected by the virus.
Consequences of patients’ action have been financially devastating for doctors and hospitals. Yet, every health insurance company’s profits have skyrocketed to unbelievable level of billions of dollars. Because no health-care bills were submitted to them for payments. An important question has to be asked here: whose money is this? Since insurance companies didn’t do anything different to earn that money, it is obviously isn’t their money. It is the patients’ money. They paid their hard-earned money, in monthly instalments to protect their health. It should be paid back to them or their health insurance premiums should be lowered.
Some doctors on the other hand besides their financial loss, felt abandoned by their patients. Doctors are highly trained professionals to be with the sick, to help them, to take care of them. Without their patients, they felt lost, anxious and lonely. They decided to get in touch with all their patients via phone, to see how they are doing and try to help them. That is how the idea of telemedicine became a reality. Later on, they used modern telecommunication gadgets (e-mail, computers, skype, smart phones, zoom) to see their patients face, while talking to them and trying to help them from a distance. Eventually they managed to get paid for their telemedicine services.
Initially private health insurance companies refused to pay them until government sponsored health insurance Medicare and Medicate decided to pay the doctors. In the USA, private health insurance establishments usually follow the government’s lead. However not everybody is qualified for government insurance - Medicare is for people over age 65, and Medicaid for the poor. Private health insurance is much more expensive. There are about 26 million uninsured people in America.
Medicare budget’s is $750 billion a year. Studies have shown that so far, about 9 million people under Medicare have used telemedicine services of doctors and $4 billion has been paid by Medicare nationwide. Medicare coverage is slated to end when the pandemic no longer poses a public health emergency. No doubt, private health insurances will follow the same course. Yet, telemedicine services established itself to remain as a permanent part of medical care, virus or not.
However we don’t know much about telemedicine (also called telehealth, e – visits, remote medicine or virtual visits). There are many questions that need to be answered. Among them: which services are covered? How much should be paid? How should the virtual visit be documented and quality of care be checked? Should it be recorded? How will fraud be prevented? What would be working hours?
Nobody knows the answers to all of these questions. It is a work in progress and on the job training for all the involved.
Not all patients could benefit from telemedicine. For example, a patient with broken arm, a heart attack patient, a patient with acute appendicitis and many more patients have to be seen in–person. But telemedicine could be a very good screening tool and could prevent many unnecessary office and hospital ER visits, and also could be effective for those patients who need talk therapy, counseling or psychotherapy.
Studies among patients about telemedicine have shown that they much prefer in–person medicine than telemedicine. For them, the personal touch of hands on–medicine, seeing doctor’s facial expression, hearing nuances of his/her voice, showing empathy, compassion and caring could only be achieved not by virtual care but only with in–person care.
