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Joanne Pizzino, MD, MPH, is board-certified in both Preventive Medicine and Integrative Medicine.  To learn more about Functional Medicine healing, visit our YouTube videos by typing: Whole Health Solutions Cary into the YouTube search engine. To sign up for updates on Dr. Pizzino’s telemedicine practice, visit her website at www.whole-health-solutions.com and scroll to the bottom of the page to sign up.

House Calls: How Telemedicine Can Increase Your Access to Better Health

By Joanne Pizzino, MD, MPH
Medical Editor of Health&Healing

Dr. Pizzino

As we continue our love affair with tech-nology, you can now reach your doctor in more ways with more convenience than ever before. However, despite spending more than double on health care than any other country, 20 percent of Americans still live in areas where shortages of physicians and health care specialists exist. The U.S. still ranks the lowest overall among eleven industrialized countries on measures of healthy lives, health system efficiency, and access to care. Telehealth is “the use of technology to deliver health care, health information or health education at a distance.” This can include store-and-forward technology, such as a remote radiologist reading your X-rays, as well as remote patient monitoring, such as a pacemaker monitor at a clinic that reads your EKG while you are at home. Today, I will focus on a more intimate and “natural” form of telemedicine, that of a virtual visit with your personal physician through the blessings of video conferencing.

Telemedicine: Pro and Con

First, let’s look at some of the reasons you might want to be able to access your doctor from your home, workplace, or even while you are on vacation. Obviously, there is convenience, and even time saving if you do not have to drive to and wait in the doctor’s office. You also would avoid potential exposure to other folks there with communicable diseases. If you live in a medically underserved area, you can now have access to primary care and specialists in distant locations.

Next, what are some reasons telemedicine visits might not work for you? A strong doctor-patient relationship is the foundation for high-quality health care. Telemedicine should support, not replace, traditional care delivery, so you will still want to have a local health care provider for certain issues. For instance, although often desired for “urgent care visits,” many such visits cannot be accurately diagnosed even with the best video technology now available. It is impossible for the doctor to determine if your chest pain is a heart attack, pneumonia, or bronchitis through telemedicine alone; or if your sore throat is strep or just a virus that will not respond to antibiotics. Even if you show the doctor a swollen and bruised ankle, a video conference cannot combine careful bedside examination with an x-ray to determine if you have a sprain or a fracture. Fully half of my patients complaining of burning or painful urination did not have an infection on in-house urinalysis, so real-time labs are often necessary in urgent situations. Also, at least for now in North Carolina, telemedicine is not reimbursed by all insurers, and may not be reimbursed the same as an office visit, making your doctor less likely to be available through this medium. (Please urge your legislators to pass “telemedicine parity” legislation to remedy this inequity.)

From the standpoint of an Integrative and Functional Medicine specialist such as myself, the real value of telemedicine is increased access to this science-based field of whole-person care. Because of the reduced cost of care delivery, visits may be less expensive, and more available to those who live in the vast areas of the country without such highly-trained physicians. The ability to dedicate a full hour to listening to the patient’s entire story, intimately knowing who you are, and what is important to you and your health is key. Then, I can provide detailed education on lifestyle, nutrition, botanical medicine, and other holistic means to empower you to take charge of turning on the natural healing power innately built into your body. This is rare in the conventional health care world of six-minute visits based upon cookie-cutter guidelines. Telemedicine gives everyone access to precise, personalized and proactive health care from a physician trained in how to heal root causes rather than just handing you a prescription to cover up symptoms. If you have an Internet connection and a computer-integrated camera, you owe it to yourself to experience a “live” Integrative Medicine telemedicine consultation to learn how you can achieve optimal wellness and vitality.