COVID-19 is shaking things up, and the sudden surge in telemedicine is one piece of the fallout. Even in The Dermatologist, we have explored telemedicine from multiple angles more now than ever before 2020. Sure, some teledermatology has been done since at least the mid-1990s, but widespread use never took off, until COVID changed that.
What accounts for the sudden change? Perhaps a large part of the motivation for seeing our patients by telemedicine has been our desire to see our patients. When pandemic-driven lockdowns were in in place, we did not have much choice if we wanted to give our patients care. We might see emergent patients in the clinic, but beyond that, teledermatology was a safer way to address skin problems. But as pandemic restrictions gradually subside, teledermatology use continues at a rate far beyond what we did before.
At least three other factors contribute to continued teledermatology use. First, we’ve started doing it, and we’re getting used to it. We have the technology and protocols in place for getting it done—that makes a huge difference. Second, the federal administration relaxed privacy restrictions, making it easier to initiate telemedicine visits; specially secured systems are not needed (well, until the end of the public health emergency declaration). All it takes is a FaceTime or Skype call to do video teledermatology now. Third, insurers are paying for the visits. Take away the reimbursement, and I suspect teledermatology will fall away rather quickly.
While there was a huge wave of telehealth in response to the pandemic, that wave will subside. Seeing patients by teledermatology, even with insurance coverage, is less efficient than seeing patients in the office, and with no procedures performed in teledermatology, those visits do not generate nearly the level of reimbursement typical of the average office visit. Teledermatology may remain at higher than pre-COVID levels, but I suspect it will be relegated to visits that rarely require procedures (such as acne follow-up visits).
Our issue this month covers a variety of issues, including a case report on cutanea larva migrans (page 46), protecting the skin from visible light (page 26), and the need for liver disease awareness in patients with psoriasis (page 28). But we’ve still got telemedicine, too, including how to help patients with acne look their best through telemedicine (page 44).
Steven R. Feldman, MD, PhD
Chief Medical Editor
