In today's New York Times U.S. section there is a profile of a psychiatrist named Dr. Sara Gibson. Like many psychiatrists around the country, Dr. Gibson sees many patients over the days and weeks. What makes her different though, is that often her patients are hundreds of miles away.
Gibson is one of a growing number of telepsychiatrists, doctors practicing over high speed connections, with clients spread over large, often rural, swaths of the country. As many as 18 states now include telemedicine in Medicaid coverage, and 8 specifically include telepsychiatry. This represents a large jump that can be tied in no small part to the increasing spread of high speed internet connectivity nationwide. The article also points out that often, as is the case for Dr. Gibson, the areas serviced by telemedicine rate especially highly in substance abuse and other risk factors for mental health problems.
The American Psychiatric Association says on its Web site that it supports telemedicine, "to the extent that its use is in the best interest of the patient," and practitioners meet the rules about ethics and confidentiality. But in places like Apache County, where the alternative is no treatment at all, most mental health workers say that every new wire and screen is to be deeply cheered.
According to Dr. Gibson and even some of the patients who agreed to be interviewed, the video conferencing can be a little more comfortable than traditional office therapy because for some the distance between therapist and client is a cushion, especially when dealing with clients who have suffered trauma. "It's less intimidating at a distance." Dr. Gibson said.
Telemedicine is a step in the right direction, and should help to ease some of the financial burdens on the healthcare system. Using telemedicine, a doctor could better practice preventative care, checking in on patients before they develop serious conditions, and monitoring things like drug dosages quickly and efficiently. The real barrier here will continue to be technology, as most folks do not have a webcam or other means of setting up a two-way video connection. But, as is the case in Dr. Gibson's area, small offices can be set up and run on the cheap and can save doctors and patients (not to mention taxpayers) all kinds of expenses. This is something to keep an eye on, especially as newer technologies make price less of a burden. Telemedicine is not, and will not, be a sea change, but instead it's a natural extension of what most doctors already do. In many ways, it appears as if we might be seeing the beginning of the 21st century house call.
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