Telemedicine 101: Tips to Help Get the Most Out of Your Virtual Dermatology Visit and Ensure that You are ‘Seen’

With COVID-19 cases and hospitalizations still at high numbers, staying home is one of the simplest and most effective way to minimize your COVID-19 exposure. However, staying home should not be an excuse to skip scheduled medical appointments or treat new skin issues. Many skin conditions can be evaluated and managed ‘virtually.’ Your dermatologist can use photographs and video conferencing to examine your skin issues, discuss treatment options, and even send prescriptions to your pharmacy all from the comfort of your own home.

Below are some tips on how to get the most out of your Teledermatology appointment:

1. How can patients best prep for virtual appointments? 

• Make sure that you have submitted all of your intake forms, personal information and medical insurance information ahead of time, so that your doctor can get right to the medical part of the visit. 

• Be ready at your computer, tablet or smartphone, waiting for the call/text/email link to come into the virtual patient room. You are being scheduled as if it is an office visit, so please be on time! Make sure that you know how to turn on the microphone and camera, and that you are facing the camera.  You should be able to see your own face in the picture-in-picture in the corner to help you arrange yourself. 

• Make sure that you have internet or WiFi set up. 

• Sit in a well-lit room, preferably with a closed door and closed windows. Any music, tv or background noises should be turned off. There should be no one else in the room with you, unless you need someone else listening quietly as the doctor gives their treatment recommendations or needs help with questions that you cannot answer. If multiple people try to speak at the screen at once, it can be quite distracting.

• If you are showing a skin lesion, take clear photos from far and close-up, and send them to the doctor, so that they can examine them ahead of time, or during the visit, if they prefer. The video is not always of good enough quality to examine skin findings up close, and it can be difficult to move your computer or smartphone around to show them properly. 

• Have a list or even the tubes/bottles of your medications with you, so that you can show them to the doctor during your visit.

• Have a written list of what you need to discuss at the appointment.

2. What questions should patients ask in virtual appointments? 

• When scheduling your appointment, you may want to ask if it is covered by your insurance, or if you will expected to pay a fee.

• This is the same as a regular doctor appointment, so ask the questions you would ask in-person. 

3. How can patients make sure all their questions are answered? 

• This is the same as a regular doctor appointment, so you would approach it the same way.

• Most doctors will allow for 1-2 problems to be discussed at either an in-person or virtual visit. Let your doctor know if you have more than one issue and what they are before you begin, so that they can allocate time and/or let you know that multiple appointments will be needed to address all of your concerns.

• Take a list with bullet points of what you need to discuss that day, so that you don’t get distracted or spend too much time on one point. The appointment time is limited. There is someone waiting for their appointment after you. 

4. What is different about a virtual visit that could pose obstacles or challenges, and how can patients deal with these issues? 

• It can be difficult to show close-up or detailed physical findings to the doctor during virtual appointments. The doctor cannot see close-up details on video. The doctor cannot examine things with their special magnifying tool (called a dermatoscope) or use special black lights if needed. It is also hard to look inside the mouth, throat, eyes, ears or scalp. 

• The doctor is also unable to do skin scrapings for exam under a microscope (for fungus, mites, lice) or send scrapings for viral, bacterial or fungal cultures. 

• The doctor cannot perform skin biopsies or excisions. They cannot give injections or provide other physical, in-person treatments, like in-office phototherapy. 

5. What types of visits can be virtual and which really necessitate an in-person visit? 

• If specific lesions are concerning, that would require up-close exam with a magnifying tool and/or needs a biopsy, then you would need a visit. Sometimes you can send a photo ahead of time, to determine if you can be seen virtually. If there is any concern for skin cancer or melanoma, the doctor would need to see it in-person.

• If you have something that needs to be lanced, cultured or removed, or if you require an injection, you would also need an in-person visit. 

• If you need a full-body mole check, it needs to be in-person.

• Virtual visits can be great for follow up visits, like making sure a medication is working or to discuss issues. This can work very well for chronic, well-controlled conditions. 

• If a treatment hasn’t been working, especially if you were initially seen as a virtual appointment, you might need to be seen in person. 

To Schedule your virtual Dermatology appointment at SkinSafe Dermatology and Skin Care, click HERE.