Luke Gumpert’s doctor guides him through a series of leg stretches, squats, toe touches, leg lifts and balance exercises as part of his ongoing physical therapy to recover from a recent knee surgery.
But instead of being in a gym or doctor’s office, Gumpert might be in his Naples apartment, his parents' home in Bonita Springs, in a park or on a public walkway. And his physician will be miles away, issuing exercise instructions through Gumpert’s phone or laptop.
"It is limited. Because, there (at the clinic), they’re helping me and there’s a lot more equipment,” said Gumpert, 29. “Here, it’s more creative.”
Such “telehealth” services, until very recently a little-used service offered to Southwest Florida patients, have exploded in popularity in recent months as COVID-19 social distancing has kept many away from medical clinics.
With video conference technology, such as Skype or Zoom, patients can now talk to doctors remotely — even during the overnight hours — to get advice about symptoms or in place of routine office visits.
And well after the pandemic is over, many Southwest Florida health care providers expect this service to make up a significant part of their business.
Lee Physician Group, the outpatient health care subsidiary of the Lee Health hospital system with offices from Charlotte to Collier counties, launched its telehealth services in May 2019.
From then until February, it counted 388 remote patient visits. Between March 30 and April 22 — well into new pandemic social distancing norms — Lee Physician Group had 5,300 visits.
“I actually think this is one of the silver linings that have come out as a result of this pandemic," said Kristine Fay, chief administrative officer for Lee Physician Group. "Prior to the COVID pandemic, although we did provide some telehealth services, they weren't routinely used.”
According to the American Hospital Association, at least 76% of U.S. hospitals now offer some form of telehealth services, compared to 35% a decade ago. The Trump administration has also expanded Medicare payments for such services.
Millennium Physician Group, which employs 500 health care providers throughout Florida, has counted more than 40,000 such virtual patient visits. The telehealth program fully launched March 26.
"At the height of the 'safer-at-home' order, more than half our visits were being conducted through telehealth," said Millennium spokeswoman Liza Fernandez. "Now, upwards of a third are telehealth."
Gumpert’s physician, Jeremy Beasley of FYZICAL Therapy & Balance Centers in Fort Myers, recently started offering the service. It’s allowed Gumpert to continue his physical therapy unabated.
Beasley said he's not sure how many patients will continue to use telehealth services once the pandemic ends.
"I don't know if telehealth will still be available once the pandemic ends," he said. "If it does, it will just be another option for patients who can't make it to the clinic for any reason."
The growth in telehealth was boosted by the pandemic and, in the case of Lee Health, a temporary suspension of their $49 fee for such visits (the fee resumed May 18). But will patients actually prefer substituting office visits for virtual ones?
Fay thinks so, even if most patients are likely to continue in-person visits. Many, particularly older patients, have a longstanding relationship with their doctors that they'd like to continue, she said. But many will likely prefer the convenience of it, she added.
"There's no going back frankly," she said. "We've got folks who are very busy who want to talk to you from their couch. The key is to give patients options. We definitely see this as appealing, valuable for both patients and physicians, and we absolutely see it rolling into the future."
Lee Health telehealth services are also available 24 hours a day, seven days a week with physicians Lee Health has contracts with. Lee Physician Group doctors are available during normal business hours.
Mental health providers, such as Park Royal Hospital in Fort Myers, has also launched a telehealth program. It is also offering virtual visitations for family members of patients.
Jose Orellana, an internal medicine physician for Lee Health in Cape Coral, said he was initially skeptical about this new way of seeing patients.
But he said he's come to see it as a "useful tool" to reach patients in remote areas and elderly patients who don't have reliable transportation. He predicted that telemedicine will account for 15% to 25% of his practice in the future.
Still, there are limitations, he said, adding that it's not as good as an office visit, particularly when patients have symptoms that require a closer examination.
"It's not as valuable when we have to actually put our hands on the patient," he said.
And there are technological limitations.
When a reporter first visited Gumpert for a telehealth visitation, he had trouble getting the video chat to work. The video froze, and his doctor couldn't see him. He eventually decided to reschedule.
"Think about people who are trying to do this who are older and trying to navigate the technology," he said.
J.T. Holbrook, 68, a patient of Millennium Physician Group, is a fan of the service. Holbrook used the service to get a referral for a COVID-19 test from his Fort Myers-based doctor. (He tested negative.)
"I'm not the most techie person in the world. But we got through it," Holbrook said. "I think that this thing is probably going to catch on and grow."
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