In this post I’ll go over my telemedicine workflow for physicians. This should help you with patient efficiency and increase your income.
The Teladoc Platform
I enjoy the Teladoc platform. It’s one of the easier ones to use and it doesn’t have glitches like some other platforms.
With Teladoc you don’t have to pick up shifts, you log in whenever you want and if there are patients, you click on them and handle the visit. Done.
As for the company itself, I think it’s a solid company with very realistic understanding of the current telemedicine scene in medicine. I have never had issues communication with them and they have always been fair.
My Teladoc Workflow
I have gotten very high patient satisfaction scores and have averaged 10-12 patients per hour. It’s a much higher hourly income than I can earn in the urgent care.
If you use this Teladoc workflow then I’m sure you’ll maximize your income. I have create a 46-minute audio recording which should help you drastically improve your income on the Teladoc platform.
1. Logging in
Logging in is easy and you can do it from your laptop or your phone app. I prefer the computer because the app requires more clicks and takes more time to navigate.
2. Taking Patients
The video environment is way too busy and it takes forever to complete those visits. I don’t recommend you waste your time with them. They pay you only a tiny premium to do it.
However, sometimes they run promotions and pay you a lot more in states where there aren’t enough providers. In those situations, it’s a reasonable value proposition.
I can’t give too many details because I don’t want Teladoc nagging me for giving away company secrets. But when you log on, you’ll see how many patients are available and you will always get the next one in the queue.
3. Calling Patient
I have a dedicated Google Voice phone number which I use to call patients. This is for security reasons.
Otherwise, if you are using your cell, just press *67 before dialing their number.
One trick is to use your cell’s voice command say: “Dial *67 503 880 5672”. I do this from my headset and don’t even have to look at my phone at all.
4. Verify Patient
Verify the information about the patient by asking them to say everything including their name, DOB, and which state they are in.
Don’t create a headache for yourself, if the information doesn’t match then tell them they will need to contact customer service or go back into the app and verify the information and request a new visit.
It’s very easy for them to do this. But don’t take the consult, you’ll get chewed out by Teladoc if you do and it creates pharmacy issues on the back-end which you may not be aware of.
5. Identify Yourself
“Thank you for verifying that information. Again, my name is Dr. Mo and I’m board certified and licensed in your state in Family Medicine. I saw that you are calling about a possible sinus infection, please tell me what’s been going on in more detail and I’ll see what I can do for you.”
6. Let Them Talk
The goals with a telemedicine visit with Teladoc is as follows:
- help the patient
- be efficient with your time on the telephone
- get the highest patient satisfaction scores
- minimize the need for intervention (ordering referrals, tests, or meds)
To achieve the above, let the patient talk. Give them uninterrupted time to talk. I promise you it will be less than 3 minutes.
This is the only time to ask an open ended question. Everything else from here should be guided questions.
My average time on a call with a patient is 6 minutes. It will be lower during the cold and flu season.
7. Get More Information
Next, ask all the questions you need to ask to get context. Social hx, PMHx, current meds, allergies. Do not trust what’s in the chart. The last thing you want is giving amox to a patient on MTX and then have to deal with a pissed off patient or a QA case from the pharmacist.
8. Guide A Self-Exam
I have the patient press on their abdomen, tap on their kidneys, palpate their own lymph nodes, describe to me their oropharynx, and I have them walk around if needed.
Do this because it helps you rule out meningitis or exertional chest pain. Do it because it will greatly satisfy the patient and because it will have them have much more faith in your final diagnosis or clinical decision.
9. Give Your Impression
You’ve gathered all the information. You’ve let the patient have the floor. You should have everything in these first 4-5 minutes to deliver your impression.
This should be the word of god. Don’t leave it open to interpretation or open it up for discussion. Offer clarification if needed but that should be it.
- I will go on a 45-second rant to tell them exactly why I think what they have
- Exactly what I think they should do
- What treatments I recommend
- What meds I might prescribe
- What the common side effects are of that medicine
- Where they need to go to get that medicine
- What to look for if they get worse
Don’t get fancy here. If I give Augmentin then I’m telling them to look for signs of allergies such as a rash or severe diarrhea and to call us back if they get that.
That they need to go to the CVS pharmacy which they indicated as their pharmacy of choice and ask them about how to obtain the medicine. And that if they get higher fevers or shortness of breath or anything else that wasn’t there before we talked to call us back.
10. Complete the Visit
Don’t make the big mistake of not ending the visit. By this I mean, ask if the patient has any other questions or concerns or worries. Sure, it might be another 60 seconds for the few patients who want more clarification but it’s well worth it.
If you don’t do this as part of your Teladoc workflow, the patient will open the whole visit back up and you’ll be on the phone for another 5-10 minutes. It will happen right before you’re about to hang up and you thought you explained everything, that they understood everything. But, all of a sudden, they ask “So you don’t think this sore throat is from a cancer?”
If you officially completed the visit by checking in with them for any further questions then the patient will have faith in you. They will believe that you were thorough and that it’s unlikely you missed anything.
Hope this helped you improve your Teladoc workflow. Now you can be traveling while earning money on the road as a physician.
Download the audio recording and listen to it before your next Teladoc shift. You’ll lower your risk of practicing telemedicine and you’ll earn more money on that platform.