Dr. Ankur Desai of AmeriHealth Caritas: Maintain the same level of professionalism that you would normally have if you were meeting your patient in person

Maintain the same level of professionalism that you would normally have if you were meeting your patient in person. As an example, as a psychiatrist, how you present yourself is important, as it provides an example to your patients. Even though I am working from home, patients still notice what clothes I am wearing and […]

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Maintain the same level of professionalism that you would normally have if you were meeting your patient in person. As an example, as a psychiatrist, how you present yourself is important, as it provides an example to your patients. Even though I am working from home, patients still notice what clothes I am wearing and the surroundings of my room. One patient of mine commented on the paint color of the walls in the room where I work from home. Try to maintain as professional an atmosphere as possible when working from home.


One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Dr. Ankur Desai.

Dr. Ankur Desai is a behavioral health Medical Director for AmeriHealth Caritas. He also maintains a private practice in Freehold, NJ, known as Premium Psychiatry Services of Central New Jersey LLC.


Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

I am originally from New Jersey and attended college and medical school in Boston. As a medical student I became interested in child psychiatry. After medical school, I moved to Baltimore and completed my adult psychiatry and child and adolescent psychiatry residency training. After my residency, I moved back to New Jersey where I started my private practice and began working as a psychiatrist at a community mental health center. After working in community-based mental health and residential treatment centers for a couple of years, I started work as a medical director for AmeriHealth Caritas in 2009.

Can you share the most interesting story that happened to you since you began your career?

That’s a difficult question to answer, as my career has taken many turns. No one story comes to mind. Instead, I look back and am grateful for the opportunities that I have had. Over the years, I have had the opportunity to work in such a variety of different settings, from office-based patient care, to school-based work, to residential treatment services, and to administrative services. I have been extremely lucky and fortunate to have so many opportunities in my 15 year career, and through all of them I have still managed to successfully maintain my own private practice.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

I don’t keep certain “life lesson quotes” in my mind to help guide me through life. What I can say is that there are certain philosophies and constructs which I live by. If there was one I would emphasize it is that I try to live my life with a sense of duty, diligence, and discipline, having full faith in the Lord above. I try not worry about results or have any expectations from any of the work I do. I want to do the best I can at whatever I do and then let the “let the chips fall where they may.”

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I am grateful for having such wonderful parents. My mother and father ensured I had a great childhood and provided everything I needed. I had a storybook childhood, with a nice home, a nice backyard to play in, set up in a great neighborhood with other good families and children to play with. My mom and dad were responsible for making those wonderful childhood memories, and it’s those memories that played big roles in my interest in becoming a child psychiatrist. I was just fascinated with the whole concept of how people grow up from children into adults and the different experiences that shape that process.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

The biggest benefit to meeting with a patient in person is that it provides an opportunity to read non-verbal cues and body language to get a better idea of a person’s overall physical and mental health. Video conferencing helps a provider to see the patient’s face, but you don’t get as good a picture of whether they are fully receptive to what you are talking about.

It is also difficult to get an idea of their entire body frame, so it’s difficult to determine whether they have gained or lost weight, or whether they have sustained a physical injury or had another physical issue, for example.

Meeting a patient in person also enables the doctor to get a fuller picture of their physical and emotional health. Meeting in person also provides an opportunity to check aspects of physical functioning like gait and mobility and regularly monitor vital signs like heart rate and blood pressure.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

Telehealth is largely dependent on technological factors like Internet signal and the software of the telehealth program you are using. Sometimes, shortcomings or glitches in the technology can negatively impact the quality of the interaction and conversation doctors are having with patients. Certain important statements could be lost in translation if there is a poor Internet signal or there are issues with the audio/visual features of the telehealth program.

The inability to meet with a patient in person sometimes makes it difficult to read nonverbal cues and body language to get a fuller picture of their emotional state and physical status.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)

  1. Maintain the same level of professionalism that you would normally have if you were meeting your patient in person. As an example, as a psychiatrist, how you present yourself is important, as it provides an example to your patients. Even though I am working from home, patients still notice what clothes I am wearing and the surroundings of my room. One patient of mine commented on the paint color of the walls in the room where I work from home. Try to maintain as professional an atmosphere as possible when working from home.
  2. Be punctual. Working from home does not change the rules regarding maintaining appointment times and staying on schedule. I find that most of my patients are generally punctual about their appointment times, so to provide them with the same level of respect, I also try to stay on schedule or as close to it as possible.
  3. Additional follow-up between visits may be needed. When there are technical issues affecting the sound and picture during telehealth visits there is always a chance that some important clinical information could be missed. When I have a telehealth visit with technical difficulties, and there are some outstanding questions I have regarding the treatment, following up with a phone call may help clarify answers that could impact the treatment plan. I had an adult patient who had issues with their audio function during the telehealth visit. I ended up calling the patient to get information on his updated symptoms and response to a recent medication change.
  4. Reminders for appointments are just as helpful as they would be for in-person visits. When follow-up reminder calls are done for your patients it also helpful to email them the video link with the follow-up reminder call. This way the patient is getting reminders through two separate mechanisms.
  5. Setting appropriate boundaries. Telehealth can sometimes make it more challenging to set boundaries I would normally establish for in-person treatment. Most patients understand these boundaries, but occasionally you may need to re-establish them.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

I believe the largest positive effect of telehealth is that it provides treatment providers with an opportunity to remain engaged with their patients, even if they are not able to make it to the office in-person. In my practice, telehealth has essentially eliminated the “no-show.” Most of the times, you can work out a way to connect with the patient either through an audio or video telehealth visit.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

I believe the video function is critical in replicating the “in-person” experience. A video program which allows multiple people to be conferenced in closely replicates an in-person visit.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

A video program which allows multiple people to be conferenced in would be an ideal telehealth system.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

Patients should treat these visits just like in-person visits. Ideally, they should feel comfortable sharing information with their provider that they would have normally shared during an in-person visit. It also means that these visits need to be conducted in a confidential, quiet setting both on the patient and provider side.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I see two aspects of life, health maintenance and education, as the foundation to a healthy society. Along these same lines, I would work hard to allocate resources to healthcare technology which focuses on delivering treatment in a cost-effective manner.

How can our readers further follow your work online?

www.amerihealthcaritas.com

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

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