In his article in the New York Times, Kirk Johnson reports about the new trend of Psychiatry sessions through telemedicine. Here is an excerpt from the report:
Dr. Sara Gibson looked into the television screen and got right down to it.
“What’s keeping you alive at this point?” she asked her patient, a middle-aged woman who asked to be identified only as D. D grimaced, looked down, then to the side and finally into Dr. Gibson’s face, which filled the screen before her in a tiny clinic three hours east of here in the Arizona desert.
“Nothing,” said D, who Dr. Gibson says suffers from bipolar disorder and post-traumatic stress from the sexual abuse she suffered as a child.
It is Wednesday in the hinterlands of rural Arizona, and the psychiatrist is in. Sort of.
Actually, Dr. Gibson was here in Flagstaff in a closet-size office of a nonprofit medical group, with a pale blue sheet behind her as a backdrop and a cup of tea at her side. She is one of a growing number of psychiatrists practicing through the airwaves and wires of telemedicine, as remote doctoring is known.
Psychiatry, especially in rural swaths of the nation that also often have deep social problems like poverty and drug abuse, is emerging as one of the most promising expressions of telemedicine. At least 18 states, up from only a handful a few years ago, now pay for some telemedicine care under their Medicaid programs, and at least eight specifically include psychiatry, according to the National Association of State Medicaid Directors. Six states, including California, require private insurers to reimburse patients for telepsychiatry, according to the National Conference of State Legislatures.
Growing prison populations have a lot to do with the trend. Since reimbursement for prison care is easy and safety issues for doctors are significant, many telemedicine programs, notably an ambitious one in Texas, started there. Now, the falling price of technology is making care available to far-flung rural residents like D.
Dr. Gibson rides a disembodied circuit through this terrain. On Wednesdays, she sees patients in the tiny community of Springerville near the New Mexico border through a firewalled T1 data line, and on Thursdays in St. Johns. Each side of the exchange has its own television-mounted camera, angled so that doctor and patient can maintain the illusion of looking into each other’s eyes in real time…
The American Psychiatric Association says on its Web site that it supports telemedicine, “to the extent that its use is in the best interest of the patient,” and practitioners meet the rules about ethics and confidentiality. But in places like Apache County, where the alternative is no treatment at all, most mental health workers say that every new wire and screen is to be deeply cheered…