Trust that we won’t go back

As a patient with multiple chronic diseases, I have been so grateful for the ability to have telemedicine visits with my specialists. In many ways, these visits have been deeper and richer than in-person appointments. Both the doctor and I seem calmer, not having rushed to travel, and having every note, journal article, and past test result at our fingertips. Our entire time is spent engaging directly with each other.

Still, with all this attention, I ended up in the ER. I needed to be connected to yet one more specialist, but none was accessible on an emergency basis. We were able, though, to re-stabilize me and to set up a productive telemedicine visit where we outlined a very detailed and mutually satisfactory plan.

Thirty days later, a nurse called to schedule the follow up. “What state do you live in?” she asked. “Why are you asking?” I responded. “Because after June 25 the emergency waiver is expiring, and we can’t conduct a telemedicine visit for a patient in another state,” she said.

An in-person appointment was not available for several months – a non-starter for a medical regimen that we were calculating in days. I happen to live four miles away from the doctor’s office and one mile from the state line, so we arranged for a telemedicine visit from a friend’s house a mile down the road on the right side of the border.

What if I had lived 40, or 140, miles away? What if I wasn’t confident and quick on my feet to propose a solution? Why would we undermine a successful, established, efficient doctor-patient partnership and put my health in jeopardy? Why would we increase the patient burden to receive care? Why would we make it harder for people for whom taking time off work means losing income or having to arrange child care (which is impossible to find nowadays)? Why do we wonder why patients don’t trust the health care system that demonstrates that it can deliver high-quality, effective care and then chooses to withdraw it?

Donna Cryer, JD is founder, president and CEO of Global Liver Institute, a non-profit organization promoting liver health and high quality care for all liver patients, and a 26-year liver transplant recipient.

This essay was written in July 2021.