How One Dermatologist Learned to Launch - and Like - Telehealth

Small and solo medical practices looking to adopt telehealth should be thinking more about the convenience it offers patients than financial reimbursement.

That’s the advice of Amy Witt, a dermatologist who launched an asynchronous telehealth service through her electronic health record platform in 2017 and has more recently adopted video-based virtual visits. The Maitland, FL-based doctor, who runs her practice with two PAs, sees telehealth as a way of connecting with patients – both regular and new – in a way that she might not get in an office visit.

With telehealth, “you’re only focused on them, which, when they’re in the office that’s true, but you know there’s a waiting room full of people (and) there are noises outside the room,” she said during an episode of Xtelligent Healthcare Media’s Healthcare Strategies podcast series. “It’s very different. You’re just completely caught up with them.”

It’s “one more way to feel connected to each other,” she adds. “It’s a win-win, even with less reimbursement.”

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Witt, who does “a little bit of everything” at her practice, including surgeries once a week, launched an asynchronous platform with a goal of helping her younger patients with acne issues, giving them a platform to seek treatment from home or while away at school. At that time it was easy to teach her patients to take a picture of their skin and send it to her for review.

The coronavirus pandemic changed all that. Her office was closed to in-person visits from March 18 to May 4, prompting her to rely on video visits.

“We were kind of spoiled with photos because nobody saw us,” she recalls. But with video, the session became a house call, allowing her to see the patient at home and meet their family and pets.

“It was much more personal and you could feel much more connected with patients,” she says. “It was not as scary or disconnected as you would think.”

Witt started by charging $50 a telehealth visit, but has since reduced that to better match up with patients’ health plans. In a small practice, she says, the work that goes into a telehealth visit can be more time-consuming than an office visit, as it’s often just her handling and documenting the visit.

“It’s a huge blow to the profit margin for physicians because they’re still putting in a lot of effort and time,” she says.

To that end, as her practice eases back into a mix of in-person and online sessions, Witt and her two PAs are scheduling certain banks of time for telehealth visits, usually during the early morning or late in the afternoon. That option is a life-saver at a time when she’s trying to get caught up, and could easily be scheduling in-person appointments nine months out.

“I think telehealth is really just invaluable - It’s just incredibly efficient and easy,” she says, noting it’s ideal for families with child-care concerns, elderly patients, those trying to fit appointments around work or school and those at risk of developing COVID-19. “It’s a nice option.”