One in four Americans carry a diagnosis of arthritis, a significant cause of limitation from basic life activities to disability. One in ten adults has to limit their activities due to pain caused by this disease. Yet, a massive shortage of specialist physicians and geographical and licensure barriers restrict access to specialized medical care, especially in rheumatology offices. Also, the cost of arthritis is 303 billion dollars yearly in medical expenses and lost wages. With all this in mind, we need more accessible ways for patients to access medical care and get appropriate help when they need it the most. But how?
Years before the COVID-19 pandemic began, I struggled to convince my peers of the incredible tool that is telemedicine. The field is ripe for opportunity to improve access to medical care for our arthritis patients. Why are we all so comfortable with online banking, shopping, and entertainment, but an online medical consultation is where we draw the line?
Telemedicine was a concept rejected due to fear of liability, fear of using new technology, and especially because there was no way to collect payment from insurance companies. Today, however, telemedicine and telehealth are no longer new concepts for patients and physicians; it became our reality.
The unfortunate lockdown due to the COVID-19 pandemic forced many to accept that telemedicine is a viable solution, allowing patients to connect with doctors by live video or telephone. This was a safe solution and often the only solution for patients suffering from flare-ups from inflammatory arthritis like rheumatoid arthritis or psoriatic arthritis.
Early in the pandemic, the federal government passed laws expanding access to telemedicine. Rapidly, insurance companies, hospitals, and private clinics adapted to support patients needing medical attention, no matter how. Many states allowed physicians in good standing to practice telemedicine without going through the entire process of getting a medical license in that state. Just a few months into the pandemic, the use of telemedicine was about 90 percent.
This was a unified effort to help patients.
Now, two years since the pandemic’s beginning, we are dialing back that progress. Many states have already removed telemedicine licenses. We are returning to a world in which we have more barriers for our patients instead of trying to make health care simple and improve access to care.
This is not the solution for arthritis patients.
The number of arthritis patients is rising rapidly. In 2020, there were about 62 million arthritis patients in the US. This number is estimated to increase to 78 million patients by 2040. We need to care and prepare for these people, but where are we now?
There are only about 6,500 practicing rheumatologists in the United States. Many of them are working part-time, so there are even fewer physicians who can treat our citizens.
In addition, most practicing rheumatologists are located on the West or East Coasts in high metropolitan areas. Many physicians carry just one license to practice in their state, so they cannot care for people from other states. This leaves out a significant amount of arthritis patients who reside in the Midwest, Southern states, and rural areas. Many physicians carry just one license to practice in their state.
Even with this, rheumatology clinics are overloaded by unnecessary consultations, creating a bottleneck in the system. As a result, the estimated waiting time in most rheumatology clinics is between 4 and 6 months. This is never an option for people suffering from autoimmune conditions like rheumatoid arthritis. Patients in need of care are forced to wait and suffer through many painful months as their condition deteriorates. This results in chronic pain, stress, sleep disturbance, mental health issues, and permanent damage to joints. Add all that to the cost of all these complications on top of the arthritis treatment, and for what? No more than ten minutes with a specialist. No rheumatologist can address a patient’s situation and concerns in such a small amount of time.
Our current system is not working. So, how can we help these patients access specialists when in need?
I wanted a solution for my patients, so I started my own telemedicine company to offer quick and easy access to patients with arthritis, breaking geographical barriers. To expand access for patients in multiple states, I had to undergo complicated licensure procedures in each state where I saw patients. But, I was willing to go through it. Telemedicine was a solution, and I wasn’t the only one who knew it.
Patients adopted telemedicine early. So many patients needed access but could not find it via the “in-network” options offered by their insurance companies. Patients are not sitting ducks: waiting for 4 to 6 months for care is unacceptable. Instead, they searched for solutions and found telemedicine practices, including my own company.
Telemedicine changed lives. It offers increased access to patients, convenience, and avoids unnecessary traveling, especially when in pain. Reading through many of my patients’ reviews, I see how my company was able to positively impact the lives of these people that were living in pain and severe stress.
Expanding care options for patients across the country is in the best interest of our health care policies. From marginalized communities to rural families to elderly patients with mobility issues to underserved populations unable to make long commutes to a doctor’s office to people with weak immune systems: telemedicine makes health care fast, convenient, comfortable, and safe well beyond the COVID-19 pandemic. It allows every American to receive care.
As Steve Jobs famously said, “the people who are crazy enough to change the world are the ones who do.” Let us join together to put our patients first. Let us create a society where we make our health care easy, not hard. Let us pave the path to the future of health care with telemedicine.
Diana M. Girnita is a rheumatologist and founder and CEO, Rheumatologist OnCall. She can also be reached on Facebook, Instagram, and YouTube.
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