Many modern doctors’ offices have offered patients the opportunity for virtual consultations using FaceTime and Skype for several years now. “Now, with Zoom being widely available, it is even easier with the added tools of easily sharing our desktop screen for slideshows, recording the session for later replay, and having multiple individuals easily participate using any connected device,” says Glen Burnie, MD plastic surgeon Adam Summers, MD.
“Telemedicine is definitely here to stay, and aesthetics are no exceptions,” says Vero Beach, FL plastic surgeon Alan Durkin, MD. “Traditionally, telemedicine has been used for distance aesthetic programs, where people are flying in for treatments or surgical procedures. With the pandemic, an entirely new group of people have been introduced to telemedicine, and they like it!”
Although online consultations are commonly performed with patients in the convenience of their own homes, there are several important things patients should know in order to optimize their experience. These are the top five:
Prior to your consult, you should have completed all of the necessary forms provided by the doctor’s office, such as your medical history. “This is no different than an in-person visit,” says Spokane, WA dermatologist Wm. Philip Werschler, MD, who has done hundreds of teledermatology visits for both aesthetics and skin disease. “Additionally, it is very helpful for the patient to email any photographs prior. This is because during the visit there can be a considerable time delay to upload/download photographs, so having them available beforehand can be the difference between a successful and disappointing consult. The patient should also write down any relevant history, timeline or other facts (such as previous treatments, medications used, etc.) pertinent to the condition being evaluated. This helps to minimize the risk of forgetting important information.”
Dr. Summers recommends preparing a list of questions ahead of the virtual visit as well. “Whether your consultation is in person or virtual, people tend to forget important questions that they want to have answered, so having them written down is helpful.”
If you have makeup on and your treatment area is on your face, doctors advise removing it before, not during, your consultation. The same goes for your choice of clothing. “Be prepared to show the body area of concern,” adds Dr. Summers. “Due to the inherent limitations of a virtual consultation, the examination is limited to what we can see. If you are unable to show your doctor the area of concern, they will not be able to customize their recommendations.”
Set the Scene
Selecting a location that is conducive to a virtual exam is very important. “Choose a private area where you can avoid background noise such as pets, other people coming in and out of view, children crying, etc, which can detract from the visit,” Dr. Werschler explains. Dr. Durkin says a strong internet signal is critical, too. “Recognize that your internet connection is just as important as your physician’s. Try not to do these consults while skimming the free WiFi at the local coffee shop. The better your connection, the better the information you and your doctor will share.”
Mind Your Lighting
Make sure your lighting is adequate so your doctor can properly see any photographs you may show, as well as your treatment area or concern. Dr. Werschler says the bathroom may actually be a good location, as bathroom lighting is typically the best in the house. “The door can be closed and locked for privacy, and the smaller room is generally better for sound quality, too. Outdoors is usually not recommended.” For some lesions, having a flashlight handy can be of great benefit, notes Dr. Werschler. “Also, sometimes wetting the lesion or rash can help us with visualization. In the office, we typically use an alcohol pad to increase transparency.”
Ask for a Recording
Don’t be afraid to ask for a recording of the consultation. “We encourage patients to have a support system when they are having a surgical procedure,” says Dr. Summers. “Recorded consultations are a great way to review things again, and, if desired, share the information with your ‘significant other.’ Also, if you know that you will have a copy of the consult, you can focus on the conversation and not worry about taking notes during the visit.”
Schedule a Follow-Up
Your follow-up options will typically depend on the reason for your virtual consult. If you have a rash or lesion, or area of concern that is disease-based, Dr. Werschler says a follow-up visit should be scheduled prior to the end of the consult. “Making an agreed-upon plan for another virtual visit or an in-person visit is necessary,” he advises. “A timeline should be set too, such as ‘In two weeks if the rash is not significantly better or resolved, I would like to see you again.’” If the consult is for an elective aesthetic treatment like fillers, a call to action may not be necessary. “The aesthetic patient may simply be shopping, have an indeterminate timeline or needs to take time to consider options,” Dr. Werschler adds.
For out-of-town patients, Dr. Durkin’s office now also offers all postoperative appointments virtually after the 30-day mark. “While the convenience of telemedicine cannot be dismissed, the perioperative 30-day period following surgery is critical to the outcome,” he explains. “For our nonsurgical patients, we have found virtual consults to be an effective litmus test for whether or not further therapy is needed, but high-definition photography is a must so we can clearly see results.”