Qualms about tele-psychiatry?

You’re not alone. Although I first completed a video-assisted psychiatry session almost twenty years ago, until just a few years back, I was doing almost all my work face-to-face. Like many clinicians, I believed that was the best way to engage with patients. It was comfortable and familiar. Had the pandemic not occurred, I might still have worked the same way.

But Zoom changed our workplaces permanently, didn't it? Work-from-home will forever be a thing. When the pandemic struck, healthcare had to improvise. During the worst days, a public health emergency was declared, allowing mental health sessions to take place by telephone. Telephone! (In Tennessee, the allowance for those sessions expires mid-year 2023) Of course, audio-visual sessions became ubiquitous, and a curious trend emerged: patients seemed more open to the change than clinicians. I’d hear the mantra repeated amongst colleagues that nothing trumps in-person visits. And yet the research data paints quite a different picture.

The APA (American Psychiatric Association) summarizes the extensive data so: “Telepsychiatry is equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care and patient satisfaction.” Really, numerous studies show solid outcomes, and widespread patient acceptance. The clinician reluctance pops still pops up!

Another exciting thing: access to treatment has improved dramatically for many. If you were looking for a child psychiatrist, and you didn't happen to live in NYC or Boston, you'd be hard pressed to find one. Vast swathes of Tennesee (and most states) are direly underserved by psychiatrists in general. Telepsyhiatry relieves some of that disparity. And from my telepsych patients, I routinely hear about saved commute time, saved gas, more privacy, and more convenience.

At PsychiatryCircle of course, I’ve embraced telepsychiatry fully. I’ve made sure the platform we use is secure, meeting or exceeding regulatory requirements. The physical spaces where each of us is located must be private too, and as comfortable as possible. And then, therapeutic alliance is allowed to flourish, with unhurried attention, honest communication, mutual respect, strict confidentiality.

For further reading: https://www.psychiatry.org/psychiatrists/practice/telepsychiatry

M. Ali, MD