Plastic surgery in the age of telemedicine: Challenges and opportunities
The integration of telemedicine into plastic surgery marks a significant paradigm shift in how healthcare is delivered. Adding this approach to communication has transformed the traditional methods of patient consultations, follow-ups and overall patient interaction.
Insights from two leading figures in the field – ASPS President Steven Williams, MD, and ASPS Member Surgeon Roy Kim, MD – offer invaluable perspectives. Their thoughts and experiences shed light on the multifaceted impact of telemedicine in plastic surgery, illustrating how it's reshaping patient care, altering the dynamics of surgical consultations and setting new standards for patient-surgeon relationships in our increasingly digital world.
The empowering role of telemedicine
Reflecting on his practice in the tech-forward city of San Francisco, Kim sees telemedicine's growing significance and acceptance.
"Telemedicine is a fantastic tool that's becoming very popular," said Kim, emphasizing how it has become an indispensable part of his patient interactions after surgery.
Kim's experience highlights the increasing reliance on telemedicine for efficient and effective patient care, especially in post-operative scenarios where frequent check-ins are essential.
Williams complemented this perspective by discussing the broader implications of technological advancements in healthcare. He underscored the crucial role of technology in overcoming healthcare challenges and meeting the needs of an expanding patient population.
"Like everything, technology tends to empower solutions for people to be able to help more patients and affect more lives," said Williams.
He emphasized how improvements in internet capabilities and camera technology, coupled with a general acceptance of digital platforms, have made telemedicine a feasible and highly effective solution in healthcare, particularly in the nuanced field of plastic surgery.
Enhancing patient experience and engagement
Telemedicine is not just for long-distance patients. According to Kim, the adaptability of technology has positively impacted all patients' experiences.
"It varies by doctor," said Kim. "It allows for efficient communication, even for patients living nearby. The ease of starting a video call quickly is unbeatable."
This convenience factor has fundamentally changed how patients engage with their healthcare providers, making interactions more accessible and less time-consuming.
Williams further delved into the transformative nature of telemedicine in patient engagement.
"Patients really want to be met where they're at," said Williams. "The power of telemedicine and this kind of digital outreach is that patients begin to be able to get validated information."
Williams emphasized how telemedicine has revolutionized the initial stages of patient interaction, allowing for a more informed and comfortable patient journey from the outset.
Challenges and limitations
Yet, telemedicine does have some challenges and limitations. Williams pointed to the need for continued development of appropriate digital tools and interfaces.
"When we thought about telemedicine 15 years ago or 20 years ago, we were really talking about phone calls in some ways, or you know, 'Why don't you mail in pictures and I'll call you, and we'll talk about it,'" said Williams. "But with video technology being so prevalent now, we're using it to do this very interview. Most of these modalities now include some sort of face-to-face contact the minute you're doing that. Not only does that make it easier to communicate with the patient, and that it makes the patients more comfortable sharing things with you, but it also means you can start doing some elements of physical exams. It's not the same as being in person, but some data can be gained from a video consultation. So, we're really looking to leverage more and more of those technology modalities to make these patient interactions more productive, safer, getting more information and it's something that continues to evolve."
Kim spoke candidly about the technical challenges, such as video quality affecting detailed assessments, particularly in areas like the nose and eyes where precision is paramount.
"Also, the need for physical presence to understand body language and establish a psychological connection can't always be replaced by telemedicine," said Kim. "You still need that sometimes with certain situations and certain patients."
Telemedicine vs in-person consultations
Addressing the comparison between telemedicine and in-person consultations, Williams notes the inherent limitations of the former.
"They have some limitations, so you can't actually feel something that may be part of the physical exam," said Williams, acknowledging the trade-offs between convenience and the comprehensive nature of traditional consultations. "Sometimes patients take these exams less seriously and they may be in distracting locations or not as able to focus as clearly as they could in the physician's office. So, those are some of the limitations, but again, technology continues to make some strides in terms of how we can answer some of those challenges right now."
Kim offers a nuanced view on the effectiveness of telemedicine, suggesting that its success largely depends on the doctor's involvement and information exchange during the consultation.
"If you're engaging, asking them good questions, trying to figure out what's going on, it's very useful," said Kim, highlighting the importance of active participation and communication in telemedicine sessions to ensure their effectiveness.
Selecting patients for telemedicine
Both surgeons stress the importance of understanding patient preferences when incorporating telemedicine into their practices. Williams believes that patient demand and expectations should guide the adoption of telemedicine in surgical practices. He highlights the need for surgeons to be responsive to their patient base and to adapt their methods accordingly. Kim adds that telemedicine's effectiveness is often more pronounced after an initial in-person connection.
"You have to read the personality because some patients like the in-person more," said Kim. "If you've never met someone in person, it's a little awkward."
Postoperative care and surgical outcomes
Telemedicine also can have a role in postoperative care. Williams spoke about its convenience and the necessity of maintaining a high standard of care.
"I think, again, it provides a more comfortable touch point for some patients who elect to have communications or interactions with their doctor in that manner, because again, they're at home, or their loved ones around them, or their husband or wife, spouse, significant others are able to be with them and have those conversations," said Williams. "So, it's really a convenience thing. For physicians, it's our obligation to make sure that we're not giving them a second-rate experience in terms of being able to do a true exam or communicate the things it would be able to more effectively make it in our office. With the current technology, some things we still need the patients to come in and do."
Kim views telemedicine as a crucial tool for reinforcing communication about the surgical process, recovery and potential risks.
"I mean, we're still talking about our candidate," said Kim. "What are the technical things about the procedure? What's the day of the surgery? What's the recovery? What's the risk of benefits? So, I do think that as long as you're good with eye contact, as long as you're good with the bond with the patient, I think you're fine."
Future of telemedicine in plastic surgery
Looking towards the future, Williams expresses enthusiasm about the potential of artificial intelligence (AI) in enhancing patient interactions and improving medical record-keeping. He anticipates that AI will play a significant role in managing and analyzing patient data, thereby optimizing the telemedicine experience.
"The amazing thing is that plastic surgeons are technology leaders – we tend to be innovators," said Williams. "I think we all recognize the power of technology. So, it's difficult to predict what the next big thing is going to be, but it's clear that technology is going to have a role in supporting our patients and our practices going forward."
Kim foresees advancements in smartphone technology, such as lidar and built-in lasers, as being pivotal in improving the precision of assessments in plastic surgery.
"This is significant because I, as a doctor, rely on accurate assessments," said Kim. "These advancements will be incredibly useful both for patients and for plastic surgeons. Of course, with the world of AI coming, I mean software's already enhancing their photos. You already know that AI can enhance photos and video it'll be able to tell us, for example, exactly how you're healing how much swelling there is, all that good stuff."
Telemedicine has emerged as an essential component of modern plastic surgery, enhancing patient engagement, convenience and care. It promises to further enhance the patient experience and increase the efficiency of plastic surgery practices as technology continues to evolve.
Plastic surgeons like Williams and Kim advocate for embracing these technological advancements while ensuring that patient care remains at the forefront of all innovations. Their insights highlight the transformative impact of telemedicine on plastic surgery and the healthcare industry at large, signaling a new era of digitalized patient care.
To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.