AAP Voices

As a pediatric ophthalmologist with a non-urgent practice, I ventured into telehealth during COVID-19. Vision checks can be done via apps on parent’s phones, and preverbal children’s vision assessed by observation. 

The patients I have seen on shared screens are more at ease, and their parents are too, not having had to wrestle the child into the car, fight traffic, and then sit in a waiting room. 

Much is conveyed via the screen through conversation and observation, the age-old, inexpensive yet irreplaceable tools of the medical examination. 

In-person exams are still needed, but a mix of the old and the new could improve both. 

As our practice volume has dropped, I have heard many providers talking about limiting Medicaid patients to make up for lost revenue. Part of this is due to concern about missed appointments. 

We should lobby to continue telehealth after the pandemic for all patients as an option. Online, office hours become less rigid, as visits are no longer tied to a particular building in a particular location, or to office staff being present during the exam. 

A missed appointment no longer costs the provider time that could be spent with another patient, as another patient could be called to fill the gap. 

Evening or weekend hours — which might work better for some providers or patients but not be worth the overtime staff salary — could become a realistic option. 

Parents would miss less work and their children less school. Money would be saved all around — on transportation, on office overhead, on lost revenue for doctors and lost income for parents. 

More providers would be able to continue to afford to see Medicaid patients. And, do we dare hope, the rising cost of medical care that fails to flatten despite our best efforts could start to respond as savings trickle down.

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