I work in rural Maine, which means that none of my patients get stuck in traffic jams when trying to make their appointments. It all means that some of them have to travel very long distances and times just to make a doctor’s office visit.
When I see one of these patient in follow up, for example, and realize that the visit only will need to last a few minutes, I can’t but to to feel ashamed of the current system we have.
A patient that maybe only needs advice and reassurance, sutures removed, review of test results, or just a look at a wound, who has to spend time- and money- probably wasting a day’s worth of salary, a tank of gas or paying a baby-sitter, to come and see me unnecessarily… That’s the reflection of a system that has no respect for the patient.
It is known that 80% of office visits don’t require physical contact. With the communication technology available today, even in rural areas, most of these interactions could take place by using remote presence tools (Telemedicine). Using a Wifi network, a cellular connection (3G, 4G, LTE) and a PC, laptop, tablet or even a smartphone, patient and provider could connect with live audio and video, synchronously , to have a “virtual presence” chat, that involves all the elements of a “real”, physical visit, minus the “touch”! There are many applications that allow this to happen keeping the exchange of information completely private and secure ( Skype, ClearSea, Vydeo, etc.)
Even for acute consultations between providers, in cases f Steve trauma, this is actually being done. Since 2011, we have been using “iPodTeletrauma” to connect with a network of Emergency Departments (TEDx “iPodteletrauma, the $229 130 million sq. ft. Trauma Room” )
I really believe that patients should refuse to come to their appointments, in cases like these. The more these available modalities are made known to the patients, the better; because change and adoption will only happen if and when the public starts demanding this change in the paradigm of their care.