APPs offering telehealth – are you part of the trend?

Before the COVID-19 pandemic, I wanted to offer teledermatology services as part of my practice. At the time, my organization allowed limited telemedicine services and only allowed it for physicians.  

And in March 2020, that all changed.  I was suddenly allowed to practice teledermatology overnight.

Granted, I was never able to schedule the same volume of telehealth visits as I had in-person visits, I liked that I was able to provide some level of care to my patients while social-distancing in my home.  I vividly recall taking appointments in my home office, collecting detailed HPIs (ones that my medical assistants would ordinarily be helping with), updating my own patient medication and allergy lists, sending encrypted emails with PDF copies of lab orders for patients to print at home, and issuing my own electronic prescriptions.

More importantly, I remember most of the visits just talking to patients about how they were doing.  I would inquire about the health of their family.  I would find out if they could work from home and how they were adjusting.  I would check to see how they handled their personal anxieties from the pandemic.  It was good to direct my own anxieties about the pandemic into trying to help some of my patients constructively.

Looking back, those spring 2020 telehealth visits probably helped me more than them.  I felt like I was offering concierge-level dermatology care during those one-on-one visits, and it was a good distraction from obsessively following COVID-19 infection and death statistics on the news.

I have wondered if other APPs had similar experiences, but it probably depended on what specialty one was practicing then.

As an NP or PA in clinical practice, did you offer telemedicine services at the onset of the COVID pandemic?  

At the height of the COVID-19 pandemic, the medical specialties most frequently offering telehealth services were: 

1. Endocrinology
2. Gastroenterology
3. Neurology
4. Pain Management
5. Psychiatry 
6. Cardiology [1].

Are you still offering telehealth services for your patients now?  

In the post-COVID era, some expect that the following specialties will be the most likely to continue offering telehealth services:

1. Primary care (incorporating both internal medicine and family medicine)
2. Radiology
3. Psychiatry
4. Neurology
5. Dermatology [2].

Should APPs continue to offer telehealth visits for their patients?

JAMA reports that while >50% of patients prefer in-person visits, most patients wish for telemedicine visits to be available if needed [3].  

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I still offer telehealth appointments, but most of my patients elect to be seen in the office.  In particular, telehealth visits have been a game-changer in managing acne for patients on Isotretinoin while they are off at college.  I still joke that telemedicine is the best thing that came out of the pandemic.  

Are you still using telemedicine in your daily practice?  Is your area of practice one of the specialities listed above?

Nikki Rataj Casady, DMSc, PA-C

email@appcolleague.org