Is Videoconferencing Appropriate for Psychiatry?

Videoconferencing is one of several telemedicine tools slowly gaining acceptance in American medicine. Doctors are relying on it to treat patients in rural settings. Locum tenens physicians are relying on it to treat more patients without having to visit multiple locations. Indeed, videoconferencing is starting to pop up everywhere. But is it appropriate for psychiatry?

Psychiatric care has traditionally taken place in a face-to-face environment. Doctors sit and speak with their clients in a private setting designed to be personal and comforting. On the other hand, telemedicine appears to be anything but. It appears to be cold and impersonal on the surface. Thus, it is understandable that psychiatrists would be reluctant to embrace videoconferencing.

Clinician resistance aside, things may be reaching a point at which videoconferencing is no longer avoidable. Take the prison system, for example. There is as much need for psychiatric care inside prisons as there is outside. Yet there are not enough clinicians to provide that care in-house. Telemedicine and videoconferencing offer some relief.

Prison Videoconferencing in Minnesota

Minnesota prison officials are having the same problem prison systems around the country are facing: they don’t have enough medical personnel to provide adequate care to patients. In some of the state’s prison facilities, psychiatric care is provided via telemedicine and videoconferencing. Moreover, it seems to be working.

One particular clinician profiled by the Waseca County News treats patients remotely from her office in Tennessee. She works with patients at a Rush City, MN prison via videoconferencing. Prisoners see her sitting at her desk with bookshelves and knickknacks behind her. She sees them in the prison’s medical facilities.

Dr. Tanuja Reddy is fine with the arrangement. She told the Waseca County News that she sees the same types of patients and address of the same types of concerns. The only difference is that she and her patients are communicating via live video instead of face-to-face.

A Solution to the Recruiting Problem

The men’s prison in Rush City has turned to psychiatric telemedicine out of necessity. The town, about an hour or so north of the Twin Cities, already has trouble recruiting medical professionals because of its rural nature. The problem is exacerbated within the prison system because it is an environment clinicians don’t necessarily want to work in.

Rather than continuing to try to recruit for psychiatry jobs to come to Rush City, officials decided to give telemedicine a try. It appears to be working for them.

A Different Way to Practice

An added benefit of the telemedicine model is that it opens up recruiting to a much wider audience. Psychiatrists willing to treat patients via videoconferencing can do so across state lines as long as they are licensed in the states where their patients reside. A psychiatrist like Dr. Reddy could theoretically hook up with a telemedicine provider to offer psychiatric services around the country, never actually seeing patients in her office.

Although this might seem like a strange way to practice psychiatry, it is a valid way, nonetheless. The biggest downside of the telemedicine model is that it doesn’t allow for the same kinds of social interactions experienced in the office. But Reddy doesn’t see that as a problem. She feels she is still able to relate to patients by paying attention to their demeanor, actions, movements, and words.

Videoconferencing certainly makes it easier to find psychiatrists willing to offer care in certain settings. If that’s what it takes to guarantee quality psychiatric care in environments where it is not otherwise available, so be it. Offering care through videoconferencing is better than offering nothing at all.

 

Kherk Roldan

Kherk Roldan

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