Traditionalists proclaim “Patients need to be seen in person!”

Certainly this is sometimes true, but definitely not in all cases. When you really think about it, which patients truly do need seen in person?

For the sake of this article, let’s restrict the discussion to patients who are asymptomatic. No concerns. They just want their prescription renewals and to be back on with their lives.

For examples:

• Patient on levothyroxine. Stable for years. No concerns.
• Patient with history of depression on an SSRI. No concerns.
• Patient on hypertension meds. No concerns.

Think of all the tests and bloodwork and vital signs that can be updated without needing to see a doctor in person:

• Blood pressures, Heights, and Weights can all be updated and documented in the EMR by a nurse or even well-trained medical office assistant.
• Bloodwork can be ordered and completed without seeing the doctor.
• Routine follow-up investigations like echocardiograms and other imaging can be ordered without seeing the doctor in person.

Today’s technology adjuncts like OceanMD can be used to collect updated histories from patients via email.

For examples:

• The patient on levothyroxine can be sent a hypothyroidism questionnaire to complete.
• The patient with depression can sent questionnaires for depression follow-up and updated metric like a PHQ9s and a GAD7.
• The patient with hypertension can be sent a hypertension questionnaire.

Again, all of this can be done asynchronously without the need for an in person visit.

So, you’ve got a patient with:

• A stable chronic condition,
• No concerns by the patient,
• Updated vitals and tests done without needing to see the doctor,
• An updated history collected electronically without any concerns.

Does this patient need to see the doctor in person?

With today’s EMR capabilities and adjunct technologies, preventative care can be kept up to date without the need for face-to-face in person doctor visits.

1. EMR capabilities allow for searches and mass email notifications (or even traditional paper letter mail) for patients who due for tests.

2. When the patient calls in for the Rx Renewal in the first place, that prompts the doctor and staff to review the chart for preventative care that is due.

Again, bloodwork, immunizations, mammograms, colon screening, BMDs, etc, can all be ordered without the need to see the doctor in person.

Remember, we aren’t talking about a patient who is calling in with new chest pain. Or new light-headedness. Or palpitations. Etc.

We are talking about the cases of stable, asymptomatic patients needing routine prescription renewals.

Which patients truly need seen in person by the doctor? I’m not saying the answer is none. But I suspect the answer is less than you may have initially thought?

by Dr. Adam Stewart

April 7th, 2023