Make sure your administrative staff gets all the pertinent information — better done ahead of time — including the pharmacy information for a potential prescription, email address to provide patients with information, and insurance information.
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 interviewingYuna Rapoport, MD MPH.
Dr. Yuna Rapoport is a board-certified ophthalmologist with extra fellowship training in refractive, corneal, and cataract surgery. Having trained at Mass Eye and Ear of Harvard Medical School, the Accelerated Honors Program in Medical Education at Northwestern, and Vanderbilt, she has accumulated a fund of expertise that she now brings to each patient. Her work regarding advances in eye care and surgery has been published in leading peer-reviewed medical journals and presented at major ophthalmology meetings. She is the Founder and Director of Manhattan Eye, a boutique private practice in Manhattan.
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 share the most interesting story that happened to you since you began your career?
One of the most interesting stories was being asked to appear on Dr. Oz to discuss refractive surgery.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
A good motto I am trying to implement in my own life is to do 10% less and enjoy everything 100% more. By committing to slightly fewer obligations, both personal and professional, we are able to perform what we are supposed to perform with more focus and diligence and enjoyment. Our colleagues, family, and friends will benefit.
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?
My ophthalmology residency program director, Dr. Laura Wayman, inspired resilience in me more than anybody, and I believe that overall trait is more important than any one piece of knowledge or technical skill. It takes such incredible dedication to teach surgery and now that I teach it I realize how much patience one needs to have. Each step of the surgery she would guide us, and I still hear her voice in my head at various points of the procedure instructing me.
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 most tangible benefits are that certain medical subspecialties, particularly ophthalmology, rely heavily on measurements, imaging, and an in person slit lamp exam that just cannot be replicated via telemedicine. Measurements are taken to prescribe glasses, contacts, and do calculations for cataract and LASIK surgery. Imaging is done to assess risk of glaucoma, macular degeneration, and corneal irregularities. A slit lamp exam (a microscope) along with dilation is used to detect inflammation and microscopic irregularities in the cornea, as well as damage to the retina from common diseases such as diabetes and high blood pressure. If you have these and other systemic diseases, an in person dilated exam is necessary yearly.
The other reasons why an in person exam are beneficial span across many specialties. There is a connection that is created in person that is difficult to replicate via video. Certain general assessments of the patient’s overall well-being are better assessed in person as well- for example if they lost their spouse and are depressed, if their leg is broken and have difficulty mobilizing.
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?
Certain challenges arise when a patient is not in front of the doctor. Besides not being able
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.)
- Try to take a look at the entire patient’s appearance. Oftentimes the social situation/ general health is best assessed by an overall view of the patient. It’s a good idea to really zoom out and take a look at the patient’s entire surroundings.
- Make sure your administrative staff gets all the pertinent information — better done ahead of time — including the pharmacy information for a potential prescription, email address to provide patients with information, and insurance information.
- Look through their previous history/ chart to better assess their current needs.
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?
Telehealth was a savior for patients during COVID times for those patients who felt unsafe coming into doctors offices or had moved away from the primary location of their doctors office. My practice is based in Manhattan and many patients had moved out of the city during COVID. Even though things have started opening up, many patients have enjoyed living and working remotely and telehealth allows them the flexibility to continue their medical care remotely. I had several patients move internationally this past year and they were not able to find health care in their new locations, I conducted telehealth visits this past year with patients in Spain, Israel, Hong Kong, Aruba, and United Arab Emirates. Besides helping my patients, it was culturally interesting for me to learn what the COVID situation was was like in each of these locations.
Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. If you could design the perfect Telehealth feature or system to help your patients, what would it be?
A perfect light from the camera that would illuminate their eyes perfectly and zoom in at the correct specification.
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?
Please treat this like a real visit. Show up on time, have your insurance card/ pharmacy information available, and be prepared to discuss your symptoms. Also, having good lighting is important because it helps the doctor see what they need to see in the exam.
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?
Foretell Reality is putting together an Extended Reality platform on Oculus for shared virtual space in a medical setting. I am quite excited by this.
Is there a part of this future vision that concerns you? Can you explain?
No- I think it’s great. Medicine historically has been behind the times in terms of adopting new technology and I think it is high time that medicine adopt new innovations in the technological and systems- based space.
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. 🙂
Within ophthalmology, intraocular lenses do not need to cost a fortune, and medications/ drops do not need to be placed at artificially high prices by pharmaceutical companies. A movement I would inspire would be to bring drug and medical device prices down.
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.