Advanced training is nothing new for doctors. It takes four years of medical school, three years of residency and for some specialties up to three years of additional training before a physician is fully qualified.
But when it comes to virtual medicine and digital healthcare, physicians may need to train even more and perhaps train for an entirely new role—the virtual specialist. In an editorial published this week in the Journal of the American Medical Association, Dr. Michael Nochomovitz, senior vice president and chief clinical integration and network development officer at NewYork-Presbyterian Hospital, argues that physicians may lack some of the skills needed to deliver care amid the shift toward more consumer-driven and web-based healthcare.
As evidence of the shift, Nochomovitz points out that the global telehealth market is projected to increase at an annual compounded rate of 30% between 2017 and 2022, achieving an estimated value of $12.1 billion, and that some recent market surveys show that more than 70% of consumers would consider a virtual healthcare service.
“The preponderance of higher income and privately insured consumers indicate a preference for telehealth, particularly when reassured of the quality of the care and the appropriate scope of the virtual visit,” he notes. “Telemedicine is being used to provide healthcare to some traditionally underserved and rural areas across the United States and increased shortages of primary care and specialty physicians are anticipated in those areas.”
By some estimates as much as 50% of traditional office visits may one day be done by telehealth, Nochomovitz says. But many physicians are not well trained in digital doctoring and may even need a new specialty—in virtual medicine. Digital advances within healthcare and patients acting more like consumers have resulted in more physicians delivering virtual care, Nochomovitz says.
“In the traditional physician office, answering services and web-based portals focused on telephone and e-mail communication,” Nochomovitz says in his editorial “The advent of telehealth has resulted in incremental growth of video face-to-face communication with patients by mobile phone, tablet, or other computer devices,” he writes. “In larger enterprises or commercial ventures, the scale is sufficient to ‘make or buy’ centralized telehealth command centers to service functions across broad geographic areas including international.”
The coordination of virtual care with home visits, remote monitoring, and simultaneous family engagement is changing the perception and reality of virtual healthcare, Nochomovitz writes. “Commercialization is well under way with numerous start-ups and more established companies and these services are provided by the companies alone or in collaboration with physician groups,” he writes.
As a result of the changing and accelerating market for digital healthcare services, Nochomovitz says the U.S. healthcare system and medical schools need to train doctors that specialize in telehealth.
“It is possible that there could be a need for physicians across multiple disciplines to become full-time medical virtualists with subspecialty differentiation,” he says in his editorial. “Examples could be urgent care virtualists, intensive care virtualists, neurological virtualists, and psychiatric or behavioral virtualists. This shift would not preclude virtual visits from becoming a totally integrated component of all practices to varying extents.”
But the training for more digital doctors also needs to formal and certified. “Medical virtualists will need specific core competencies and curricula that are beginning to develop at some institutions,” he says in his editorial. “In addition to the medical training for a specific discipline, the curriculum for certification should include knowledge of legal and clinical limitations of virtual care, competencies in virtual examination using the patient or families, ‘virtual visit presence training,’ inclusion of on-site clinical measurements, as well as continuing education.”
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