The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Have your clinicians received training for webside manner in virtual visits?”
- 15% said “yes”
- 85% said “no.”
The poll was conducted July 20, 2021, with 385 applicable responses.
Although there are some concerns expressed by healthcare groups about the Centers for Medicare & Medicaid Services’ (CMS) recently issued CY2022 Medicare Physician Fee Schedule (PFS) proposed rule, one promising aspect is the expansion of telehealth reimbursement for certain services through at least the end of 2023.
In a July 13 advocacy statement, Anders Gilberg, senior vice president, MGMA Government Affairs, noted that, “MGMA is encouraged that CMS heeded our call to expand coverage for audio-only mental health services and views this proposal as a positive step to increase access to vulnerable populations that would otherwise go without care.”
Consumer desire for telehealth services is reflected in a recent McKinsey report, which revealed that telehealth use is 38 times higher than pre-pandemic levels — between 13% and 17% of visits across all specialties — and that 40% of those surveyed stated that they intend to continue using telehealth. Furthermore, a Feb. 16 MGMA Stat poll pointed to patient satisfaction with telehealth growing in the past year.
Despite the widespread adoption of telehealth during the COVID-19 pandemic and the continued demand, the level of comfort in communicating via videotelephony may vary among physicians. As with bedside manner, webside manner does not often come naturally and may require physicians to train for better performance.
Best practices in webside manner
In the July issue of MGMA Connection magazine, Neel Naik, MD, director of Emergency Medicine Simulation Education, Weill Cornell Medicine, an early adopter of telemedicine education, detailed how its Center for Virtual Care helps train medical students and physicians alike. Naik stresses that they need to regard webside manner in the same fashion as bedside manner — essentially focusing on everything that isn’t the medicine itself. But that’s easier said than done when physicians don’t control the environment, as they typically do during an in-person hospital or office visit.
“When the patient walks into a hospital, they’re mentally primed to have a medical encounter,” says Naik. “They see signage, they have a greeter, they register … And you know, the best example of this is, we tell the patient to change into this really flimsy gown and sit on a cold table and they do that without hesitation.”
The nonverbal communication that may come naturally in person may take more effort in a virtual environment. Naik says it’s the provider’s responsibility to work to establish a connection at the beginning of the telehealth visit, along with an environment that makes the patient feel comfortable, regardless of their location. “If they’re calling from the diner, or from a car, or from their bathtub, which we’ve all had patients call from, we have to figure out a way to optimize that to be conducive to medical care,” says Naik. “That includes making sure there’s privacy … if there are people next to the patient who are off camera, we know who that is.”
Naik expresses that webside manner should be viewed holistically, which includes training on everything from creating a comfortable environment and verbal and nonverbal communication to empathy, lighting, camera work and scripting, all of which lay the groundwork for a successful telehealth encounter.
Ultimately, physicians need to be at ease to ensure patients are, too. “If we can teach them to feel comfortable doing the physical exam over this medium … they’re able to have a lot more confidence in their ability to conduct these visits,” says Naik.
Another key aspect of training that Weill Cornell Medicine emphasizes is that telehealth visits are a 50/50 proposition between provider and patient. “You really have to work with the patient for the visit to go well,” says Naik. “They know the pharmacies and the drugstores and the laboratory sites around their area better than you do, so you really have to partner with them and make it a two-way street.”
To learn more about best practices in virtual care competency, access “Building care connections digitally.”
Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at firstname.lastname@example.org.
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- “Building care connections digitally: Best practices in virtual care competency are grounded in simulation training and education” — Many providers and practices are still getting up to speed with telehealth, but like bedside manner, proficiency in webside manner and other virtual care competencies requires training and education.
- “Sizing up your telehealth services: How your plan for post-pandemic virtual care delivery requires measuring performance now” — How you plan for post-pandemic virtual care delivery requires measuring performance now. Learn about key patient experience metrics and ways to assess provider competency.
- Improving telemedicine by training effective “medical virtualists” — In this Executive Session podcast, hear from two experts who have been at the forefront of developing the “medical virtualist” as a specialty.