Telemedicine Thursday is Moving Up

    Because there’s only so much of me to go around, check out my telemedicine blog at YourTelemedicineCommunity.com New insights regularly shared. And I’m now teaching clinicians at all levels telemedicine at TelemedicineMastery.com Engage with our new mini-experience and set yourself on the path to success. You can also follow me on LinkedIn to get all the latest tactics in how to use telemedicine to set yourself free.

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How to Quickly Assess Mucous Membranes During an Audio Encounter

    Kids with fevers should always be assessed for signs of Kawasaki’s.   Doing that over an audio encounter can be time consuming.   Simply ask, “Do his lips and eyes look ok?”   If Kawasaki’s is present the informant will start describing the change in appearance.   Once they do that, you know you’re going to have to refer.   Usually they won’t. Usually they say they look “ok” or “a little pink.”...

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Tell Your Patient “I’ve Got You Covered.”

  A lot of times patients are just calling for a note because their supervisor told them to.   These calls are easy.   Start them off right away by telling them “I’ve got you covered.”   The chances that you’re not going to give them a note are very low.   Once they know that you’re probably going to give them what they need, they will relax and the entire encounter will go very...

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Telemedicine is Competing With Your Day Job

  More employed clinicians are moonlighting in telemedicine.   Employers are trying to unilaterally amend non-competes to prevent them   They usually can’t do this unless you agree.   If they try to slip one by you, use it as an opportunity to ask for more money.   You can’t usually negotiate with your employer over your compensation, but this is one opportunity when you can.   Don’t waste it.   Don’t give up this...

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Conversational Dyspnea

  If the patient is conversationally dyspneic at the time of a telemedicine encounter, refer them on for immediate evaluation and treatment.     Briefly check to see if they are having any other symptoms that would trigger a recommendation for a 9-1-1 call and then tell them they need to see a clinicians “right now.”     Some telemedicine service providers will hassle you over this, criticizing you for not triaging the patient fully...

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Steepling

  When you’re performing a video encounter that includes the top half of your torso, let the patient see you put your thumbs and forefingers together in front of your chest.     It’s called “steepling” and it communicates engagement and expertise better than any words will.   They will let you take charge of the visit and they will also have a higher chance of actually doing what you suggest.   Try it.  ...

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Traveling and Working

    Many telemedicine services won’t let you perform encounters outside of the U.S.   Create your own Virtual Private Network, perform your encounters through it, and they will never know.   You can perform encounters anywhere you have an internet connection.    

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No Non-Competes—Ever

    Never sign a contract to provide telemedicine services as an independent contractor which contains any kind of non-compete.   Ever.   If you’re getting hired for a regular job with a regular paycheck then some sort of non-compete as part of that deal  is a reasonable trade in exchange for the stability of a steady paycheck.   But a non-compete as an independent contractor?  Never.   Never, Ever, Ever.   Ever.    

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Trust Yourself

      I’m credentialled with multiple telemedicine services.     One does not want me to manage tick bites but will allow me to prescribe muscle relaxants.     On the spectrum of risk, that makes no sense.     Use each telemedicine services list of “don’ts” as the foundation of your care plans. Then, rely on a generally recognized resource such as Up To Date for your care plan decisions.      ...

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