Realize that the Telehealth appointment is just like being in office, we are still in front of each other, it’s just on camera. We may be in different locations, but we are still together. After a few minutes that distance disappears and our communication is more relaxed as we focus and address current issues, next steps, and lifestyle habits to improve health and well-being.
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 Gayle P. Myers, MD Health Conscious.
Dr. Gayle Myers, is a Board-Certified Integrative Medicine Physician with over 30 years of experience in private practice. She helps patients with complex medical conditions progress from illness and pain, to health and well-being. Foreseeing the importance of medical care continuity during the pandemic and to help patients safely navigate their health and immunity, she transitioned to Doxy.me telehealth before Vermont went into lockdown. Dr. Myers is a writer, speaker, and all-around wellness and resilience expert.
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?
My passion for medicine started in childhood when I would read my father’s medical texts. I took a circuitous route, studying botany and wetland ecology for my master’s degree. Understanding the interrelationship of plant, animal, insect, environmental, weather, and human impact was my inspiration for then going on to complete my residency in Internal Medicine. Appreciation for the natural world ecosystems and human organ systems interactions gave me the foundation for Integrative Medicine, with a focus to rebalance, restore, and maintain optimum health.
My own health issues led me to create my Health Conscious Inc. practice. I needed to find solutions that were not available within the conventional medical model. I have patients of all ages and varied medical problems, who are motivated to live a healthy lifestyle, have optimum health, and a high quality of life. Vermont is a good state to live in and practice medicine. The beautiful environment gives us the opportunity to have an active lifestyle walking, hiking, biking, skiing, water activities on Lake Champlain, gardening, and bird and animal watching. It was a gift during the pandemic to keep us active and give us a break during quarantine.
Can you share the most interesting story that happened to you since you began your career?
The ability of the human spirit and body to heal has been an inspiring lesson throughout my career. Midway through my career a patient with cancer in remission and debilitating arthritis returned to see me for more medical care. During the 5-year interim since our last visit, I had the opportunity to work with an Infectious Disease specialist in tropical medicine. I was able to speak to this very intelligent patient about the inflammatory cause of his digestive issues and the importance of rebalancing and restoring gut ecology, as 70% of the lymphatic immune tissue is in the gastrointestinal tract. It is our first line of immunity. He followed through with the treatment. After being bedridden with incapacitating arthritic pain, a few months later, he drove himself two hours to my office, walked in to thank me, and told me he was now walking and working out with a trainer, who was helping him restore his physical strength. He was transformed and so was I in that moment of gratitude.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Steve Jobs: “Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others drown out your own inner voice. And most important, have the courage to follow your heart and intuition.”
This quote rings true to my heart and career. While working in the Emergency Department early in my career, I saw the need for a broader type of medical practice that would offer a bridge between conventional medicine, and holistic and complementary medicine, now called Integrative Medicine. I had no role models for this type of practice in Vermont. Using Internal Medicine as my foundation, I then incorporated Biodynamics of Osteopathy in the Cranial Field, Nutritional and Functional Medicine, Stress Management, and Meditation tools into my practice. I saw the importance of a comprehensive approach to medical care that was preventive and health enhancing. I have had the privilege of treating patients for over thirty years, some who are still very active in their 80’s.
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?
Kevin Cahill, MD, is one of the top five people who influenced my life. Dr. Cahill, now in his mid 80’s, is the Infectious Disease specialist I referred to earlier. He worked with Mother Theresa in the streets of Calcutta, took care of Pope John Paul II, was the Chief Adviser for Humanitarian Affairs of the President of the United Nations General Assembly, and Director of the Institute of International Humanitarian Affairs (IIHA) at Fordham University. His dedication to medicine and helping humanity has been a beacon of light, always reminding me of the greater purpose for practicing medicine: the journey of healing and the human spirit, combined with the importance of humanitarian action. Restoring health and hope for humanity, we are here to help each other.
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?
There is human connection while in each other’s presence. For the doctor, much of diagnosing is observation. When a patient is in front of you, it reveals the quality of their health through their appearance. Are they rested or exhausted? How are they walking or moving? What is their attitude about their health? How well are they communicating? What is their discomfort or pain level? Physical presence helps establish a level of trust and relationship with the patient. They know you are there for them, to listen, to guide, and to be a resource to help them restore their health.
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?
The biggest challenge is not being able to do a full physical exam, such as listening to breath and heart sounds, or an abdominal exam to distinguish the nuances of physical symptoms and health conditions, although much can be gained through observation. As technology advances, having more digital medical exam kits available for in-home use with transmittal to a clinical setting will be of great help.
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.)
- First, realize that the Telehealth appointment is just like being in office, we are still in front of each other, it’s just on camera. We may be in different locations, but we are still together. After a few minutes that distance disappears and our communication is more relaxed as we focus and address current issues, next steps, and lifestyle habits to improve health and well-being.
- The Telehealth appointment enables vital continuity of care during and post pandemic. It is a focused time to address priority concerns and build a customized treatment plan. As the priority issues are addressed in each Telehealth visit, patients can implement their customized plan, keep track of their progress, and feel reassured knowing how best to care for themselves.
- An important tool for a successful Telehealth appointment is to have patients complete a Telehealth form prior to their visit. This helps patients focus and expedite their healthcare by detailing their main health concerns, changes in medical conditions or medications, along with challenges of Quarantine lifestyle or emerging post pandemic. It helps both patient and physician prioritize and tailor each step.
- This is an opportune time to address lifestyle management habits, improve immunity, and optimize steps for self-care across all areas: physical, mental, and emotional. Patients are empowered to learn, implement, and maintain a healthier lifestyle when they know it will improve their health, quality of life, and enjoyment.
- In a Telehealth appointment, since patients are more relaxed at home, without the stress of commuting to an appointment, they can focus on their health issues. More importantly, they can focus on the steps they can take to improve their health and well-being at home, with family, and at work. Plus, they discover creative ways to have balance in their lives, while staying healthy, even in a pandemic. They can then enjoy the benefits of their new health and lifestyle habits post pandemic.
Telehealth is an expeditious way to direct patients who need to be seen in urgent care, the emergency department, or have a specialist consult. In a telehealth appointment, a well-known patient in rural Vermont, was experiencing atypical chest pain, but wasn’t sure if it was something that needed attention. It became very clear during the appointment that it was urgent and needed immediate care in the emergency department, which was lifesaving.
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?
In the comfort of being at home, patients become more aware and engaged in their healthcare. Their healthcare is even more relevant and applicable when they are in their home environment vs. sitting in a doctor’s office. In a doctor’s office they receive information or guidance, but it is in their home where those recommendations are implemented. It is outside the doctor’s office where they take responsibility and live their lifestyle choices and habits.
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?
Between pandemic restrictions and following COVID guidelines, being able to sit in front of a patient and speak without a mask and face shield offered an opportunity to be better connected. I have had the privilege of seeing many new patients during the pandemic, meeting them for the first time in a Telehealth appointment. The ability to continue helping people during the pandemic via Telehealth appointments has helped both the care-provider and the patient to establish a relationship of trust and create a treatment plan within a short amount of time.
If you could design the perfect Telehealth feature or system to help your patients, what would it be?
It would be to have an exceptional internet connection that is clear, uninterrupted, and easy to use, as well as a Telehealth service that is HIPPA compliant for privacy, with the added technology to do more extensive physical exams.
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?
The Telehealth appointment is the office visit component. It is the same as being in the office, we are still present with each other, only we are looking at each other on a screen. We can focus on the problems, health issues, and questions they would like to address during the Telehealth visit to help us tailor the appointment for their current needs.
The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?
Purdue University and the Indiana University School of Medicine are developing a System for Telementoring with Augmented Reality (STAR). Here’s how it works… A remote specialist is able to guide surgeons on the battlefield and field hospitals so they can treat complex trauma cases. Using video markup on a transparent display with the same field of view as the field surgeon, the specialist guides them through the surgery.
This technology is also being applied to first responders in emergencies where they are being guided to perform life-saving procedures. First responders are wearing an augmented reality headset lined up with the field of view of the remote physician. A live video stream is broadcast to the physician and using a remote touch screen TV, the physician points to different parts of the body and guides the first responder through life saving procedures. This technology can be applied to rural clinical settings as well. In all settings, this technology will change outcomes in emergency situations.
Is there a part of this future vision that concerns you? Can you explain?
It is important for us to remember that while technology is a great and useful tool, especially in rural areas, combat, and disaster zones, it does not replace human presence and connection. While Telehealth has revolutionized healthcare during the pandemic and going forward, the physical presence of the physician, healthcare team, and patient ensures human physical contact and interconnection.
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. 🙂
If I could inspire a movement it would be to bring internet capability and computers to underserved populations and seniors who are technologically challenged, providing simplified access and use of Telehealth world-wide. Expanding medical care reach to those underserved would bring greater global health and the opportunity for us all to live on a healthier planet.
How can our readers further follow your work online?
Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.