Virtual health care is here to stay. It’s not just a convenient option — for some, it’s empowering. And, for those of us working in addiction treatment, it’s just in time.
Drug-related deaths in the US climbed to record numbers in 2019, and this year, in the midst of a pandemic, the situation has grown worse. According to a new analysis of state and local health data, drug deaths so far this year are up 22% in Minnesota, 32% in Wisconsin and 13% nationally. Because addiction is a disease of isolation, physical-distancing efforts aimed at slowing the spread of the coronavirus have created new challenges. That is why virtual health care is so important right now. But what value is there beyond this moment?
Amid the COVID-19 pandemic, health care has quickly transitioned — out of necessity — from hesitance about embracing telehealth to jumping in with both feet. In some situations, virtual care is the only game in town. Where I work, we are now providing virtual outpatient care to thousands of people around the country, with very early outcomes suggesting it has been just as effective as on-site outpatient care for most people. While we still have much to learn, telehealth is bringing benefits I did not anticipate.
As a physician and addiction therapist, I seek to observe as much as possible when interacting with a patient. Picking up on non-verbal language, body postures and even micro-expressions is important — and much different in virtual appointments. For that reason, I was cautious in March, when my organization transitioned 1,300 patients from on-site, outpatient addiction treatment and mental health programs to virtual services. It’s one thing for virtual care to supplement brick-and-mortar services. But I wondered how it would fare as a standalone substitute.
It turns out our therapeutic connection has remained strong. And what I didn’t account for is just how empowering virtual care can be. We clinicians forget it can be intimidating — especially for new patients — to leave the house, navigate directions and parking, and show up to an office or a hospital. The people we love and care for are often anxious or introverted already, sometimes besieged by shame. Even when others aren’t judging them, it is not uncommon for them to interpret asking for help as a sign of weakness, or to fear it as a reckoning of all the things they despise about themselves.
That’s heavy stuff to overcome just to get to the front door.
With virtual care, it’s easier to show up, and many need less prompting to be assertive. Patients have commented repeatedly about how much more confidence they have visiting from their own sofas, in the comfort of their homes — and that’s great news.
Our organization has now served several thousand patients and families virtually, and the benefits have gone far beyond commonly cited advantages about distance and technology. If virtual care can be a safer “on-ramp” that lowers the threshold for help-seeking, it will be a blessing to many for years to come.
Joseph Lee, MD, ABAM, works in Plymouth as medical director for the Youth Continuum at the Hazelden Betty Ford Foundation.