“This is a fabulous supplement to a practice,” says neurologist Elaine C. Jones, MD, FAAN, about telemedicine. “It’s fun, and I do enjoy it.” Jones started doing telemedicine about four years ago, evenings and weekends at first while running a busy solo neurology practice. After a couple of years, she says, “It was going well, so I cut back on my day job.”
Jones’ introduction to teleneurology came at her community hospital. “I originally brought it in to provide coverage, so that I wasn’t the only neurologist 24/7.” The company she brought in, and the one she still works for today, Specialists On Call (SOC Telemed), soon asked her to join their team. And like many neurologists in private practice, Jones says she was always looking for ways to bring in more revenue. SOC’s TeleNeurology component fit the bill.
Meanwhile, running a small private neurology practice was only getting harder. “It was just getting so complicated and so stressful, constantly having to see more patients and worry about all the regulations.” The telemedicine allowed her to cut back on her practice hours without losing money.
Jones does this work as a salaried employee with a set schedule and says, “When I’m on—I’m on; and when I’m off—I’m off.” SOC is a private company that hires physicians and contracts their services to hospitals for a flat fee. “They cover most—if not all—50 states.”
But there are other telemedicine models, include spoke-and-wheel systems. These are usually hosted at a larger academic center and used to support outlying hospitals. Telemedicine is also being set up to provide services at central locations like nursing homes and primary care offices. New services are popping up all the time. “It’s exploding across the country,” says Jones.
More physicians are getting involved, and more patients are receiving care than ever, but telemedicine is still in its early stages, and it’s not for everyone. Technology, the primary driver of this new frontier is also its weakest link. You can’t perform certain tests and the technology isn’t always reliable.
But it’s not just that calls sometimes drop and people struggle with their devices. “We talk about how people are more connected than ever but still disconnected. There is that interpersonal relationship that you lose being on computers,” says Jones. “The way most of [telemedicine] is set up now is kind of ‘one and done.’ We’re doing mostly emergency care. The patient interaction is different. I love working with patients, talking to them, getting to know them, and following them over time. You don’t do that with teleneurology.”
One remedy Jones has found is to make quarterly visits to Haiti, where she provides neurological care in an extremely low-technology environment. She also has developed kinship with her SOC TeleNeurology colleagues. “There may be five or six doctors on shift covering different states and hospitals. We have a messaging system, and we have this running joke about being in our yoga pants, because of course people only see you from the waist up.”
After doing telemedicine for a couple of years, Jones closed her private practice altogether and took the opportunity to travel. Today she does telemedicine full-time from a home office in Rhode Island and ports of call in places like Thailand, Japan, and Haiti.
But you don’t have to quit your day job like Jones did. “Telemedicine fits a lot of people in all sorts of ways,” she says. So, whether it’s the yoga pants, the flexibility, or the extra income that appeals to you, telemedicine is certainly worth looking into.