Landmines: Do we really want Telemedicine Wellness Checks?

There has been talk of Telemedicine for Wellness Checks and work arounds. It may sound like a good idea just to keep the wheels rolling at this time. However, knowing how payers want to reduce cost we may be walking into a landmine. Some Private Payer executives could ship our wellness checks "out’ to the cheaper provider in another County or State. How will that affect Pediatricians?
I have not heard anything to that effect but going by how knowledge work seems to migrate to cheaper manpower, I will not put it past the gatekeepers.
I think we should do our best to maintain the health of our patients, but let us consider leaving wellness checks as wellness checks.
The Telemed vendors will most definitely push for it as it increases their marketshare but it may not be in our best interest or in the best interest of the children we serve.


Wow. Scary thought. Excellent perspective.


Please forgive typos; sent from Android


I’ve had several conversations in yesterday where I came to the same conclusion: Pediatricians need to focus on conveying their “value proposition” of the medical home to families. For some families, the message will resonate with them…for others, it will not stick.

Many families simply don’t want to leave the house to goto an office and risk the chance of getting sick…it’s a very hard sell that the Pediatricians have to get creative with overcoming. Tune in to tonight’s webinar to hear how three practices have faced this exact challenge.

Many of our patient have left the city and are quarantined hardcore but they know (because we tell them) that vaccines are very important and we do not want to get out of this crisis and come on to the other side with a bunch of vaccine preventable illnesses coming back. So, we do our appointments via telemedicine. We get parents on the scale with the babies to get close weight checks and then we encourage them to get the shots with a local pediatrician. We have talked some practices in to coming out and just giving our patients shots in the car. Others go early morning just for shots, in and out. Sometimes we have to call around to a few offices before someone agrees to see our kids. I thinks patients appreciate it. Being flexible is key.

Some families (not stablished patients ) have asked to come by our apartment (we don’t have an office because we make house calls ) in their car to get vaccines from us because their regular pediatrician can’t accommodate basically touch less encounters. I agree that getting creative is going to be important the next 6-12 months or longer. Maybe telemedicine and drive by vaccines could help?? If the geographical coverage allows maybe send a nurse in full PPE to make house calls. They don’t have to go in, we give shots at the door for older kids who don’t need extensive physical checks.

For the patients we are still seeing at home, especially newborns because we must see them we make the encounters fast and do the teaching via phone. Being in NYC we have to protect ourselves and the patients to the highest degree.
Education education education, we spend so much time drilling the importance of vaccines and development checks that our families are calling us to make sure they stay on track. We have families in almost every state right now so if anyone one of our families calls looking for vaccines, please consider helping them out :-).
I would offer to do the same but I bet no one is heading to NYC to scape COVID-19 lol

Just a thought…What is the liability of performing medical and vaccines in vehicles and parking lots as per malpractice policies?

1 Like

I have been interested in this question for years, since the local hospitals started doing drive-through flu shots. Any feedback?

I completely agree with all that have been so creative and flexible in making sure well visits are completed and vaccines are administered. I’m also very concerned about how the insurance companies will pay for telehealth once were on the other side of this pandemic. Much advocacy will need to take place all over the country to maintain payment parity.

In any case, I truly believe that practices would be wise to take advantage of this tool where it makes sense for their patients/families. Not every community will see telehealth in the same light. It’s up to the practices to meet their families where they’re at and help them gain confidence in telehealth where appropriate.