Patients who live outside of cities don’t always receive the best quality of care. And sometimes it may seem that delivering positive health outcomes just isn’t possible.
For urban doctors with patients in remote areas, recognizing this inequality can be difficult – even heartbreaking. Many wish they could do more to help, but geography gets in the way.
Luckily, there are factors that physicians can control – even from a thousand kilometres away. It’s possible to both monitor patients and coordinate the services they receive from a distance. Finding the most appropriate way of delivering remote care is the first step.
This post will delve into the biggest problems doctors with remote patients experience. We’ll also look at some of the ways innovation has developed to bridge the gap.
When Patients Are Out of Reach
Canadian city dwellers tend to have much better access to health services than those in remote and rural areas. This fact is indisputable. Recently, policymakers have been devoting more effort to understanding just how big the gap is.
In April, Dr Mike Kirlew told a parliamentary committee about the health care inequalities he sees in the Indigenous communities he serves. One of many issues he described was a total lack of specialist care in areas such as mental health and autism.
When it comes to quality of care, First Nation communities are often hit particularly hard. Understanding the root causes of this disparity is critical.
That said, one of the biggest obstacles to better care – geographic distance from city centres – can impact anyone living in a rural or remote region.
Consider this: 18% of Canada’s population resides in rural regions, but just 8.5% of the nation’s doctors do. With regard to specialists, the shortages are even more pronounced. And the consequences can be serious.
Studies have shown that poor access to general practitioners and specialists takes a toll. As just one example, remote dwellers with diabetes and chronic kidney disease are more likely to experience adverse health outcomes than those who live closer to relevant experts.
In a perfect world, every patient would have continuous access to the health care practitioners most capable of caring for them. But we don’t live in a perfect world.
Too often, rural patients have to make a daunting choice: the serious inconvenience of long-distance travel, or the frequently-inadequate care offered in their own communities.
If you’re a doctor, you want better for patients. And if you treat people who live far away from your practice, the issue of remote care is probably close to your heart.
Caring Long Distance – It Isn’t Always Easy
Most physicians love what they do. Nobody goes into health care without truly wanting to help people. But taking the health of patients in hand is far from easy.
If you suffer from work-related stress, you’re not alone. In an American study, over 7000 primary care physicians were asked questions about how their careers impact their lives. Nearly half reported suffering from at least one symptom of burnout.
We all know that stress can be caused by heavy workloads. But for those who provide the medical care patients need, it can also be associated with feelings of helplessness.
“Helpless” may seem like an odd way to describe a highly-competent professional. After all, it’s doctors who often take on the weight of those who are ill, in pain, and even dying. But knowing that some patient outcomes are outside of your control can lead to precisely this feeling.
Recent studies have confirmed what most physicians already know – struggling with grief after losing a patient is common. But death isn’t the only situation capable of producing empathy-based frustration.
For many doctors, there are feelings of regret that go along with being unable to see a patient in person. Sound familiar?
Do you have long-distance patients who aren’t able to see you as often as they should? Are you worried about whether they’re adhering to lifestyle plans and medication instructions? Do you wish you could play a more active role in monitoring their conditions and coordinating their care?
Whether you’ve encountered them or not, you’re likely aware of many of the challenges associated with caring for people in remote and rural regions. Due to funding limitations and other obstacles, it’s difficult – and in some cases impossible – to provide the same level of care for patients in these areas.
Addressing these issues will require a lot of work from policymakers and healthcare leaders. But doctors who treat patients remotely can do their part.
For those who are ready and willing to improve how they deliver remote care, there are innovative options available.
Bridging the Distance with Remote Care Innovation
The challenges associated with treating remote and rural patients are significant. For doctors who treat their patients from afar, there’s no substitute for timely remote care – especially during follow-up.
Recent technologies can help. Remote patient monitoring technologies can help doctors track the health statuses of their patients. Wearables that provide true health insight in real-time are especially exciting. Devices that continuously monitor and transmit blood sugar levels to the right health care professionals are a great example.
Understanding the potential of technology developed in the past is also important. Take telemedicine. For decades, telemedicine has held a lot of promise. But many health care practitioners once dismissed these technologies as a fad.
Part of this lack of enthusiasm relates to the limitations of outdated tools. Not long ago, connecting doctors and patients through video required special equipment and third-party facilitators (the health care workers who were present with patients during these sessions).
But videoconferencing tools have advanced in the last decade. They’ve become portable and easy to use. Patients no longer need the aid of healthcare workers to videoconference with doctors and other circle-of-care members. They can answer calls on their Smartphones and iPads at the click of a button.
Videoconferencing platforms – along with other useful communication tools – are also more comprehensive than they once were. Features that allow circles of care to share health information and update care plans represent a giant leap forward.
Technology hasn’t always been viewed as the most sensible health care investment. In the past, connecting urban doctors to a few remote or rural patients may not have seemed like a justifiable priority.
But that’s changed. The low cost of many digital technologies means it’s cost-effective for care practitioners to check in with remote patients, even if they just have a few.
The Most Important Shift
The critical change will consist of a shift in attitude. Health care practitioners have been hearing about the importance of patient-centred care and cross-discipline collaboration for years.
But now, a new era in health care has actually begun. Expanding care into new environments – especially patient homes – is becoming the norm. Chronic disease rates are going up, which means health service providers needs to scale. They need to serve more patients, many of whom have complex and ongoing needs.
Remote care is playing a critical role. As more physicians adopt these technologies, their use will become almost universal across Canada – including in communities that aren’t close to urban centres.
Innovative government-funded projects across Canada suggest that many leaders are ready to embrace new methods of delivering remote care.
Doctors who devote themselves to caring for rural and remote patients have taken on a monumental set of challenges. But what about those who practice in urban centres while treating patients who live far away? These practitioners often feel disheartened when they face a whole new set of health care barriers outside of the city.
Luckily, remote care has never been more advanced than it is today. Armed with innovative tools and the right attitude, doctors can deliver better care to Canadian patients – no matter where they live.
Feature image courtesy of NEC Corporation of America