Dr. Finkelstein and Dr. Watts describe their experience with telemedicine

Video

“To convince the doctors pre pandemic of telemedicine was pretty difficult, but now we know that telemedicine works and the physicians are embracing it,” says Lisa J. Finkelstein, DO, FACOS.

At the 2023 American Urological Association Summit, Lisa J. Finkelstein, DO, FACOS, and Kara L. Watts, MD, presented 5 key points for urologists to discuss with legislators regarding telemedicine. In this video, Finkelstein and Watts discuss their own use and experience with telemedicine. Finkelstein is medical director of telehealth at St. John’s Health, Jackson, Wyoming, and Watts is an associate professor of urology at Montefiore Medical Center and Albert Einstein College of Medicine in Bronx, New York.

Transcription:

Finkelstein: I started out doing teleurology as a urologist in about 2018 because I traveled to very rural areas to see patients. Once the pandemic hit and I started to back away from actively seeing patients and heading into a semi retirement role, I became the medical director of telehealth, but also have been very involved with telehealth in Wyoming for over 10 years trying to get it off the ground. I would say that my role is to try to get telehealth in every single specialty. I often say telemedicine is medicine, teleurology is urology, and let's not make it any more difficult than that. To convince the doctors pre pandemic of telemedicine was pretty difficult, but now we know that telemedicine works and the physicians are embracing it. So when I talk to an oncologist or a dermatologist or a gynecologist, whatever ologist it is, it's listening to what works for them. So when Dr. Watts talks about teleurology, it's what she feels comfortable doing as a urologist utilizing telehealth. Not every physician has the same comfort level using technology to see a patient. So when I would talk to physicians, I say to them, make it your own, and we build their program around what they want to do. Most physicians feel very comfortable utilizing telehealth for established patients, for follow-up with patients, whether it's reviewing labs or reviewing images, more simple visits, as opposed to doing a full-fledged physical examination. But a great example of the conversion of something like that was talking to the neurologists. The neurologists were very, very hesitant about embracing telehealth prior to the pandemic because they felt that they needed to be with the patient to do an adequate neurologic exam. And we now know that neurologists have embraced, very thoroughly, doing a full neurologic exam virtually. So a virtual visit, even in urology for physical examination, is very possible. We can utilize the patient's hands to examine themselves, to look at their abdomen; you can look at genitalia virtually on camera. There are so many variations of how we can utilize telemedicine—orthopedics didn't think that they could do a great physical examination—physical therapy, rehab, all those things have embraced telemedicine in their own way, and do their own types of physical examinations, and even get to know patients as a new patient starting off with them. It's been wonderful. It's been eye opening for me; I'm learning every day about what is possible with this new innovation.

Watts: I don't think I can add much to that. I think that was such a great summary. And I just learned quite a bit about neurology from you, Dr. Finkelstein, so thanks for educating me too. I think it's been evolving in my practice and also within our department. We were one of the original institutions publishing on audio-only during the pandemic, and so a lot of our telehealth that happens is still audio only and then a proportion is also video visits as well. Similar to what Dr. Finkelstein said, I find that the follow-ups for lab results, postops that don't require a tube or drain removal or suture removal, all of those lend themselves very well to a televisit. Patients who are seeking a second or third opinion about a treatment option but that you don't necessarily need to see in the office, we can review their records online on a video visit easily and review nomograms together and treatment options is a great [use of] telemedicine, and that's mostly how I'm using it at present today.

This transcription was edited for clarity.

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