COVID has brought about the widespread adoption of telemedicine. This technology can be a lifeline, particularly for smaller and rural facilities. For example, KershawHealth in Camden, South Carolina has thrived since it implemented a sophisticated telehealth system after losing many of its specialists to bigger facilities. The hospital has relied heavily on the system during the coronavirus outbreak. The technology allows patients to be monitored 24 hours a day by physicians in remote locations who can track vital signs, view medical records and scans, and discuss treatment plans with local staff via two-way video. In the event of an emergency, a physician can be reached with the push of a button.
The limitations of telemedicine
Many have benefited from KershawHealth’s program and programs like it, but telemedicine is not without its limitations. Beyond the fact that there are things providers cannot do virtually, it’s not a viable option for everyone. As we learned in our podcast series, “Perspectives on a Pandemic,” many patients don’t have access to the required resources. There are also concerns regarding the number of patients being monitored by remote physicians given that a high patient to doctor ratio can lead to a lack of attention and a lower quality of care.
In a recent Reuters article on the rise in telemedicine in ICUs, a Los Angeles filmmaker, Steve Burrows, is quoted as saying, “Telemedicine is fantastic if it’s used properly, but I think replacing doctors at the bedside with technology is insane.” Burrows’ 2018 documentary, Bleed Out, chronicles the story of the medical errors that left his mother with a host of conditions from which she never recovered. Judie Burrows suffered permanent brain damage after a routine hip surgery in 2009. In the ICU, she was under the care of a remote physician who was monitoring over 150 other patients.
Continued need for local providers
It’s clear that emergency departments still need local providers to help facilitate care delivery in their communities. As such, administrations will continue to see demands for call pay in the age of telehealth. In fact, we expect to see those demands increase as telehealth exasperates one of the most enduring issues surrounding call pay: a perceived lack of fairness.
Telemedicine and call pay fairness
If one speciality is receiving support in the way of telemedicine, other specialties may interpret this as a decrease in the specialty’s call burden, leading them to ask for additional or increased on-call compensation. A similar phenomenon occurred in conjunction with the rise in hospitalist programs. Agitation around call pay almost always boils down to a medical staff’s desire for fairness. Once there’s a perceived lack of fairness, it can be hard for administrators to regain the trust of staff members. A low-trust environment can impact hospital culture, physician recruitment, and even quality of care.
Seek proven solutions
The Physicians’ Call Committee, which is the foundation of our Call Pay Solution, addresses the issue of fairness by providing a platform for physicians to openly discuss their call burdens with their peers and administration. These discussions lead to a deeper understanding and greater appreciation among staff for the burdens of other specialties. By welcoming physician participation, an organization can create a fair call pay program that will align its medical staff rather than divide it.
With regards to telemedicine, a physicians’ call committee will be able to discern its impact on a specialty’s call burden and arrive at a mutually agreeable standard of fairness that can be applied to call pay arrangements going forward. One of the benefits of having a call committee is that it can ensure the ongoing suitability of a call pay program and keep potential issues at bay.
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If you would like to discuss your organization’s call pay concerns, schedule a call with a member of our team.
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