It should be easy to get medical help. Any one should find no difficulty in getting a doctor to see them when they feel ill or need a medical opinion. Unfortunately it is not so. The doctor’s appointments are made for days and weeks in advance. One cannot easily leave one’s job when the time which 15 minutes not occupied by seeing the doctor is taken off in travelling to the doctor and waiting to see him. Hospitals are crammed with people who are not cases of accident or emergency, but who had not any idea as to how to get the particular treatment for which they were in need.
There are really practical difficulties to be met here. The people with trifling ailments become worse. The ailment is not serious until they are aware of the necessity for medical treatment. The knowledge of the difficulties with which one is surrounded, and of what there is to be done about them, will help one to get medical treatment when the necessity arises.
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The Booking Problems
Practically all doctors book their patients for consultations for routine visits weeks ahead. This suits those coming for preventive medicine or treatment of ordinary health complaints. When rapidly occurring symptoms develop which require urgent, but not sufficient germs to be reported to give them some reminders, the situation changes. The respiratory infection, for example, that makes it difficult for one to breathe, the spreading of a skin eruption, or the continued pain of some chronic condition affecting the daily life of the individual should be brought to the notice of a doctor, though not of sufficient seriousness to cause one’s coming to the casualty department. On the other hand, it is practically impossible in most cases to get an appointment at the family doctor for an adequate consultation and examination.
Most doctors keep a number of so-called same day appointments for patients who wish to go to see them for cases of urgent condition, but these rapidly become used up. The patient telephones when the doctor’s coal works at so many mornings, and it meets in its full cruelty with the communication which is to greet the doctor in from the telephonic month or even the telegram in the message “we are quite fully done to-day, how about a morrow?” There is no certainty each day that it be possible to see a doctor which creates uneasiness.
It is the great unoverlap which is in evidence between “this means medical treatment” and “this is an accident,” that leaves the individual case in a rigid bar lock. The orthodox method of dealing with it does not cover the distance that is required to be filled between these two extremes. The Issue of Time Commitment
When appointments are available, the time required is not limited to the time spent in consultation. The time to get to the clinic, find parking, wait in waiting rooms and return, can take two to three hours for a 10-minute appointment.
This becomes a limitation for people, particularly those with inflexible work situations. It is a large waste of time to take half a day off from work for a brief medical consultation. People are then forced to choose between taking time off work, or delaying medical treatment.
Parents with young children have additional problems to face. Arranging for care of an infant is one. Furthermore, those living in rural situations have an even larger time investment – even the nearest GP may be an hour’s distance. The renewing of a simple prescription often becomes a half-day’s commitment.
Options for Virtual Care
Recent developments in technology have created options to overcome many access barriers. Many medical consultations handled by a Telehealth GP can now be conducted virtually at any time in any place. Medical assessment, diagnosis and treatment can occur without a physical visit. The consultation may be done from home during the lunch hour, or after putting the children to bed, thereby eliminating travel time and making it possible to have the health care fit into one’s life rather than arranging life around medical appointments.
Many medical problems can readily be handled by video consultations. Respiratory infections, skin diseases, mental health problems, reviewing medication, renewing prescriptions, and general advice can often be effectively managed through virtual appointments. The physician is able to observe the symptoms, ask their questions and make their diagnoses in the same way as they would have done in office.
It is normal for prescriptions to be sent electronically to pharmacies. Referrals to specialists are handled in the same manner as for office visits. Emails are sent with medical certificates. The administrative side of things works smoothly through virtual avenues.
The technical requirements are limited to the bare bones, being a smart phone, tablet or a computer with camera and internet connection. Most people already have the relevant equipment.
What Works Virtually And What Doesn’t
Virtual consultations have limitations. Medical examination that involves direct examination and listening to heart sounds cannot take place on the video link. Certain diagnoses need direct examination.
There are certain conditions where visual examination of patients via the video link works well. Skin rashes, eye disorders and throat inflammation lend themselves well to examination via the video link.
Mental health discussions work particularly well in the virtual context. The privacy of their home often leads people to open up more readily. The lack of travel means that people can be seen more frequently, if that is indicated.
Management of chronic diseases, medication reviews, follow-up appointments for stable conditions are well suited to the virtual context. As the doctor and patients have established a relationship, the video consultations provide for good follow-up care.
Emergencies are still required for in-person examination or emergency care. Chest pain, major trauma or concerning symptoms in children require direct examination. The virtual care is but one avenue for health care provision. It supplements traditional health care but does not replace it.
The Cost and coverage Issue
Bulk billing for tele health consultations operates in similar fashion to in-person consultations, where patients with Medicare cards are often paying nothing out-of-pocket. Private billing arrangements vary from company to company.
The hidden costs associated with personal consultations, such as fuel costs, parking, lost work, etc., makes the virtual consultations financially attractive even when the consultation fees are similar. This is largely due to the cost saving involved in the time saving.
Health fund coverage for tele health has been expanded so that most insurance policies treat the telehealth consultations like person visits.
Shift in Patterns of Health Care
The acceptance of virtual health care has changed dramatically. An avenue which was regarded as a compromise is now seen as being effective for many health care requirements. Doctors have altered their consultation techniques and patients are now comfortable with the format.
It is the advantage of convenience which is behind this. Those people who formerly delayed obtaining health advice because of difficulty in scheduling consultations, now have access very readily. This quick access often leads to minor problems not becoming major ones.
For the elderly who have mobility problems, the disabled, those in rural locations, the people with young families and the shift worker, vial health care improves access to health care significantly, which previously may have accessed very hard to obtain.
Integration with Traditional Care
Virtual consultations are more effective if done as a part of a great health care bill. Personal health checks, immunisations, and procedures requiring equipment are done in person. Advice, prescription renewals and follow-up consultations can often be done via the virtual system.
This gives patients the flexibility to attend. When travelling is difficult they have access to virtual consultations. In those cases where direct examination is required, in-person consultations can take place.
Patient records integrate through both the virtual and in-person consultations, thus providing continuity of care. Pathology and medication histories are available whether seeing the doctor personally or via the video link.
Access to Health Care
The fundamental purpose for the movement in health care is that people gain a better opportunity to obtain medical help when they want it. Lessening the avenues of barriers means that health problems are addressed earlier rather than being procrastinated until they worsen.
Technology is responsible for the improved access but the fundamentals remain unchanged, and that is that the connection is made with patients and doctors for assessment, diagnosis and treatment. The method of connecting is of far less importance than the actual connection which hopefully will be made when required.