Chris Pagnani, MD, medical director and founder of Rittenhouse Psychiatric Associates in Philadelphia, emphasized the benefits of telemedicine and its role in increasing accessibility, especially in the field of mental health care.
By implementing telemedicine, Pagnani's practice has expanded its services to approximately 10,000 patients in Pennsylvania, New Jersey, New York, Delaware, and Maryland.In a previous interview American Managed Care Journal®Mr. Pagnani discussed how to approach telemedicine without compromising quality of care.
transcript
With the increasing use of telemedicine, how do you decide which cases require in-person counseling versus those that can be effectively conducted through a virtual appointment?
Certainly, I believe that for certain patients and certain types of illnesses, in-person consultation can be really beneficial. Examples include many people who suffer from substance use disorders such as alcoholism, benzodiazepine use, and opioid use, who may have a history of mental illness, or who are worried that they will develop schizophrenia. Examples include people who are present. or schizophrenia. and individuals who are in crisis or concerned about their safety.
Eating disorders are also a problem because when you see someone face-to-face, it's easier to say, “Wow, has there been a big change in their appearance over the past month or the last few months,'' but sometimes it's a little bit like that. It's difficult to assess that. You may need to rely on self-reporting. Also, some people may not always be as honest as you would like and may be hiding something, especially if they are actually struggling with weight gain. That's a good example.
That being said, telemedicine has given us access to so many people that we'll have people call our office and say, “Hey, we're here. I am suffering from these specific symptoms and understand that ideally I would probably be meeting someone face-to-face in an office. “Well, I don't have a local provider, so I can't really afford to come.” They might drive three hours to work to see you. “Can I see you via remote medical treatment?”
Sometimes the health care provider has to be a little flexible and understand that this person is receiving this type of care. They're telling me that, but I believe, they can't do it, or it'll be very difficult to do a doctor's office visit – well, they got treatment from me. It would be better. What we need to do is try to be very careful about their care, talking to their families, working with other health care providers, and taking other steps to make sure they're healthy. If I need to spend more time for quality care, I have no choice but to do so.
