Guest Author
I wonder how my mother’s past year may have gone differently had telemedicine been an option for her care.
Following the resection of the lower lobe of her lung due to cancer, she developed an inability to swallow properly. She was diagnosed with aspiration pneumonia, and after multiple hospitalizations, she was fitted with a feeding tube.
Some of the coughing subsided but not fully, and a host of other problems remained. For example, any pills, no matter how small, would cause her to choke, and the slightest exertion would leave her out of breath.
Her pulmonologist had no answers. Her gastroenterologist told her the coughing and choking were due to anxiety. She cried during that visit. That only confirmed his assumption.
Over the past year, my mom went for six barium swallow tests. They all came back unremarkable.
Finally, she was referred to a specialized swallowing clinic at the University of South Florida in Tampa. Of all the tests the physician administered there, we would never have guessed that it would be her seventh barium swallow that gave an answer.
Her esophagus was constricted at points to 25 percent of the size it should be.
The USF physician was distressed: how could this have been missed? On the imaging he performed, the stricture was blatantly apparent. Less than one week later, my mom went in for her first in a series of procedures that will stretch open the stricture. We are optimistic.
Sadly, my mother’s experience is far from unique. The story is just one among millions in which patients struggle for answers or treatments that might be just a few phone calls away.
Tallahassee is a phenomenal place to live and has extraordinary physicians. But Florida’s capital city does not have a swallowing disorders clinic.
Nor does Florida law require insurers to compensate physicians for consults on cases from afar.
Had a swallowing specialist been called to consult on my mother’s case after the first or second test with no answer, think of the costs that could have been saved to everyone.
Duplicative tests, excessive medications, and the placement of a feeding tube could have been avoided, along with a year of unnecessary suffering.
This is the way that insurers should think about telemedicine: not as an additional benefit that they are required to cover, but instead as a practice that can avoid exponentially greater costs down the road.
Efforts are underway in Florida to achieve greater access to telemedicine, including safeguards to ensure that telecommunting physicians are held to the same standards as those who practice face-to-face.
As telemedicine becomes a hot issue of 2014, I urge policymakers to acknowledge what the practice will mean in reducing cost and suffering.
