Telehealth: The pandemic’s silver lining
In 1986 I moved to Sacramento to join a highly motivated physical therapists’ team at Kaiser Permanente. I left private practice in Tempe, Arizona, to surround myself with top notch physical therapists in the profession. I was a couple of years out of PT school, and I was now far away from my family and friends. That didn’t deter any of them from calling me regularly to ask what they should do about a sore back or injured shoulder, sprained ankle or swollen knee. I would pace my apartment on the phone (landline – remember those?) obtain a history, ask what made their back worse and better, what they had done to help it, and then try and give them something to stretch, strengthen, rest or protect the injured area. I found these phone PT visits to be a challenge as I couldn’t see their swollen knee or examine it with my hands. Over the years, I had developed a skill in helping people over the phone with musculoskeletal problems. As a matter of fact, after a day of mentoring in Chico last Thursday afternoon, I spent the last 30 minutes of my drive evaluating and treating a friend of mine over the speakerphone in my car. Together we figured out that he strained his medial collateral ligament (MCL) in his right knee. I gave him instructions on what to do and to call me over the weekend. He called me Sunday morning just three days later with the great news that his knee is much better, and he stated he could manage it from here. I didn’t realize that those skills I was developing in the late 80s would pay dividends now. And it’s a whole lot easier now with the added visuals.
Telehealth has been around long before my attempt at providing quality care over the phone. Physicians have been doing it with patients for several decades. Dr. Peter Van Houten and his colleagues at the Sierra Family Medical Clinic on Tyler Foote Road have had the opportunity to integrate this craft due to their patients’ nature coming from so far away and the difficulties of administering healthcare. In 2009 Dr. Peter was awarded the Rural Champion award for the State of California. This prestigious award, given to one physician annually, was largely for his pioneering work bringing behavioral health into the medical care setting.
The magazine Radio News published “The Radio Doctor – Maybe!” in 1924, portraying the future of patient-doctor visits using radio and video.
The 1962 cartoon, “The Jetsons,” portrayed George and Jane Jetsons talking on the TV. The year was supposed to be 2012. I’d say that was close, but my flying car isn’t quite ready.
There are many video chat options today. There is FaceTime, Zoom, Ring Central, Google Duo, and Facebook’s WhatsApp, to name a few. In medicine and rehab services, a secure and confidential video chat must be used. At Body Logic Physical Therapy, Uber Conference is the current confidential platform used.
Research on the efficacy of Telehealth
A survey of 1,300 physicians in April 2020 found 90% were using some form of Telehealth, and 63% planned to continue after the pandemic, a significantly higher adoption rate than the 20% seen before COVID.
Researchers administered online surveys to 211 people who used Telehealth for a lower limb injury or sports-related injury during the COVID-19 public health emergency that opened real-time Telehealth to PTs. Overall, more than 90% of participants gave an “excellent” or “good” rating in having their concerns addressed, therapist communication, treatment plan and overall satisfaction. About 87% of respondents gave an “excellent” or “good” response to a future telehealth visit’s perceived value.
Not all people have the equipment, internet connectivity, ability and comfort to use the technology for the patient. There can be language and cultural barriers. For us in healthcare not all insurance providers reimburse telehealth services.
Two months ago, my patient Gigi (not her real name) had a work-related injury to her shoulder. She did not want to come into the clinic due to the pandemic, and she was very skeptical of a telehealth visit. After our initial evaluation and our ability to work together to figure out what rotator cuff muscle was injured and how she would treat it, she was so happy that she gave it a try. I had her tying the TheraBand around doorknobs and turning her body in various positions to get exactly what she needed to strengthen her shoulder. She was able to move her laptop into different places so that I could see everything happen.
Currently, every medical office and PT practice can use Telehealth to deliver quality healthcare. The pandemic is not going away anytime soon, and we need to help everyone stay safe. Get outside to exercise and stay healthy during these cold winter months, and if you get injured and need some PT, give them a call, they will be more than happy to treat you over a telehealth visit.
John Seivert is a doctor of physical therapy and he has been practicing for 34 years. He opened Body Logic Physical Therapy in Grass Valley in 2001. He has been educating physical therapists since 1986. Contact him at bodylogic2011@ yahoo.com.
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