Resilient Seattle

The Doctor Will Zoom You Now

Dermatologist Melanie Clemenz went all in on telemedicine.

Edited by Allison Williams By Melanie Clemenz August 4, 2020 Published in the July/August 2020 issue of Seattle Met

The doctor is in—though Clemenz takes video calls both from her home and her office.

The multi-office Polyclinic, made up of more than 200 doctors, had never used telemedicine before March 2020. When inpatient visits ceased, her department was part of the first wave to explore doctoring via video call; the entire clinic soon provided virtual visits through a program called VSee. Clemenz walked us through her introduction to remote care.

Dermatology is uniquely situated to be well equipped for telemedicine. The way we study it is looking at photos. Fifty-plus years ago, doctors would put slides in slide projectors and ask residents, what is this rash? That prepared us to be able to do it.

I was on vacation at the very beginning of March, and I sent a message to my colleagues: Do you think we should start getting telemedicine ready? I don’t think I was the only catalyst, but only three weeks from that, we were doing our first telemedicine visit.

The administrative side of things took work. I couldn’t just FaceTime my patient, it has to be on a platform that’s organization-approved. It has to be HIPAA compliant, has to be easy for the patient to use.

My first telemedicine day was March 24 and I saw 11 people that day. My first patient just rolled with it, told me I was the fifth in line of telephone or video encounters he had that day. We just did it like a visit in the office, he went on with his day. Video is okay for facial rashes or lesions, not so great for things that are behind people. But the megapixels in most people’s camera phone are awesome, so I get the vast majority of the information from a photograph they send. 

It felt soul crushing to not be able to care for people when everyone needed to stay home to flatten the curve, so everyone was really eager to adapt. I think patients who may have been skeptical at first are pleasantly surprised. They learned the visits were as comprehensive and personal as they are in person. People are so grateful for care.

I’m absolutely going to incorporate telemedicine in some manner after this. Telemedicine is beneficial to patients who want to avoid traffic hassle, or who live outside the city and can’t make a long commute into Seattle. Or to help a provider who’s closer to the patient but doesn’t have the same level of training and specialization [as a doctor in Seattle]. The technology hasn’t been developed that could let me take out skin cancer over video. Still, it’s tough to speculate on how it’s going to change everything. —As told to Allison Williams

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