Medical Treatment Right There at Home
Disclaimer: Views expressed in Bob’s Blog belong solely to the author and do not purport to reflect the opinions or views of the CAC Office in Aging or its staff.
The changes in our lifetimes have been amazing. Things are coming back now that disappeared years ago. They may not have come back in the same format, but the concept is the same.
When I was a child . . .
Doctors Made House Calls
When I had a high fever, the flu, measles or chicken pox, our doctor came to our home and treated me. Of course, there were certain things I had to go to his office for–injuries, school physical exams and vaccinations.
I also recall doctors seeing older people with serious conditions at their homes – those who had a problem getting to their offices.
During major outbreaks of the flu, parents could call their family doctors, explain the symptoms, and the doctors would call in a prescription to their pharmacy. That was done primarily to keep sick people out of their offices so they wouldn’t spread their illnesses to other patients.
Doctors also did that for those people taking medications for extended periods of time.
As time passed, house calls disappeared. Patient loads increased dramatically and doctors no longer had the time. Today there are a few doctors still making house calls. However, they charge a premium for them.
Doctors still have their nurses call in prescriptions for their patients. However, that is normally to extend a prescription medicine the person is already taking. Most of the time now, a person needs to see a doctor before they will prescribe a new medicine.
A Big Change in Treatment is Coming – It Will Happen in Increments
It may take years before it is complete. However, there will be a significant shift in the way people are treated.
You may have heard of Telemedicine. Here, your appointment with your doctor is over your computer or cell phone rather than at their office.
There have been Telemedicine appointments for some time. During the Covid-19 pandemic, they have become more frequent.
Remember Dick Tracy and His Ability to Have Video Calls through His Wristwatch
When we saw that as kids, we wanted to be able to do that. There was much talk about video calls. However, by the 1980’s, the phone company was saying video calls were not feasible. The technology was too expensive. Computers and the internet changed all of that.
In 2003, Skype was introduced. People could use Skype for video phone calls with their family and friends. The audio and video quality was not always great, but most times the calls were free.
More recently, Apple developed FaceTime. People can make video calls on their iPhones. Not to be outdone, Goggle developed Google Duo for use on Android phones.
People were slow to move to Skype. They found it difficult to use and they stayed away from it. Facetime was easy to use. Many people with Apple phones started to use it.
At the same time, several software companies developed audio and video applications for companies. People could take part in conferences and meetings over the Internet.
The Two Most Popular Were Zoom and Cisco’s Webex
Then Covid-19 hit. Suddenly, businesses shut their offices and had their employees work from home using desktop or laptop computers.
Supervisors and managers had to meet with employees and employees working on the same projects had to meet with one another. Sales and Service people had to meet with customers. Since in-person meetings were out, most frequently these were online. Zoom was most frequently used.
Zoom has been easy to use. It also added a free plan. Many people started using it to keep in touch with their family and friends since they couldn’t meet with them in-person.
Covid-19’s Impact on the Medical Profession
When Covid-19 hit, there was fear of it spreading in doctors’ office. Many offices shut down temporarily. Many people afraid of getting the virus also avoided going to their doctors’ offices.
That led to doctors to question . . .
. . . How Can We Best Treat Our Patients?
An answer was telemedicine. They could start to use video options similar to Zoom and Webex. Those enabled them to see and interact with their patients.
Doctors could have routine office visits with patients online. However, there were some things online visits did not permit such as, treating an injury, measuring blood pressure and listening to a person’s heart with a stethoscope.
Prior to the Covid-19 outbreak, insurance companies, Medicare, Medicaid or TennCare only wanted to pay for online visits for those people in rural areas whose doctors were miles away.
The outbreak of Covid-19 changed that. They now pay for many of these appointments.
Here are some of the medical professionals currently utilizing telemedicine
- Family Doctors
- Physical and Occupational Therapists
- Mental Health Professionals
- Nurse Practitioners
- Internists including gastroenterologists
In August of 2020, Tennessee lawmakers passed a law requiring Telemedicine appointments be treated the same as in-person services. There is a time limit and the law remains in effect until April of 2022.
At this time, the benefits of telemedicine are great. That law probably will be extended.
The Advantages and Disadvantages of Telemedicine
There are many benefits of telemedicine appointments for people like you and me. Here are some:
- People living in rural areas or in areas of a city without a wide range of doctors have easier access to the doctors they need.
- People treated at home are not exposed to viruses and germs as they might be at a doctor’s office.
- Access to a doctor is available at all times of the day and not only during normal patient hours.
- The response to people with chronic conditions is quicker, resulting in faster, lifesaving treatment.
- People who dislike going to doctors’ offices are less anxious.
- Typically, they are cheaper than in-person visits.
- More people without insurance can afford to get treatment.
There are also disadvantages. Here are some:
- Currently the doctor can’t listen to your heartbeat, take your blood pressure or assess your other vitals.
- They can’t do blood or urine tests.
- Nor can they do pap smears or eye pressure exams for glaucoma
When a doctor needs a blood test, a urinalysis, or any other lab work or an x-ray, the patient can stop by the office or the clinic for these. They can do this at times convenient for them and be in and out more quickly. They would no longer have to wait for their appointment.
The Impact Telemedicine Will Have in the Future
As time passes, there will be more advances in medicine and with telemedicine appointments and what can be done. Here are some:
- Right now, watches are being developed to record heat rate and take blood pressure.
- Monitors will be developed to do EKGs., EEGs and other electronic tests.
- There will be small cameras in pills to check a person’s gastro-intestinal track for digestive problems.
- Tests will be developed to check for kidney and urinary problems.
Seeing a doctor in their office will become less frequent
There is One Place Where This Will Be a Real Blessing
Right now, people with a serious medical condition can be referred to specialists and clinics far from where they live when there are none locally to treat them. Places like this are
- Vanderbilt Medical Center in Nashville,
- Johns Hopkins in Maryland,
- the Mayo Clinic in Minnesota, and
- M D Anderson in Texas.
People go to one of these for their initial evaluation and any necessary follow-up treatment.
Each of these trips can be expensive. Sometimes, people who don’t have the money cannot return for follow-up care as frequently as the specialist would like to see them.
Most probably in the future, the patient may only have to go for the initial evaluation. Follow-up appointments may be done online. If any testing is necessary, it can be done locally and sent to the specialist for evaluation.
The only time a patient may have to go back to see the specialist is when the doctor may want to try something new or if surgery is necessary. The patient would save money by not having to make all the other trips.
Currently, a doctor can only prescribe medicine in the state or states where they are licensed. A change will probably be made here to allow specialists to prescribe medicine in states where their patients live.
Changes from Telemedicine Will Not Occur Overnight
They are going to take time. You and I may not see all of the improvements that do occur. We will be able to take advantage of those that do.
Just imagine how different it will be for our children, grandchildren, and great- grandchildren when they need medical treatment. They will really benefit.
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