“Expert Interviews” is a recurring feature on the Spruce blog where we put you directly in touch with expert opinion and leadership on important topics in telehealth, value-based care, and medical practice at large.
Spruce: What was your earliest experience with teledermatology? How has the field changed over time?
Dr. Fung: Prior to Spruce, my teledermatology experience was of the more informal variety: a family member or friend emailing me a photo of a growth, for example, or a physician colleague texting me pictures of a patient’s rash. I recall starting to do this in the early 2000’s, but the field of teledermatology has grown substantially since then, as technology has improved and the rate of communication has accelerated.
Spruce: How do you feel about synchronous (live video) technology for use in teledermatology as compared to asynchronous (store and forward) technology?
Dr. Fung: To me, the asynchronous nature of a store-and-forward system is far preferable. Live video requires the alignment of two busy individuals’ schedules, a challenge that can be just as significant for a virtual visit as it is for an in-person one.
Spruce: Are there any patient populations you feel would benefit from teledermatology that you haven’t been able to reach yet?
Dr. Fung: There are plenty of patients in plenty of states that still have poor access to a dermatologist. Hopefully, interstate medical licensing regulations, insofar as they pertain to teledermatology, can be amended in the future to address this continuing problem.
Spruce: Do you have any favorite teledermatology success stories?
Dr. Fung: My favorite moments are always the ones in which I have been able to use teledermatology on Spruce to provide care for patients who either don’t have health insurance or don’t have access to a dermatologist in their community. For many of these patients, this is their inaugural encounter with a dermatologist, and they are so thankful! It definitely feels good to be in a position to help them out.
Spruce: Do you have any tips or tricks you’ve picked up for successful teledermatology?
Dr. Fung: I approach each teledermatology patient with the mindset that I would like to provide care at or above the same level as I would provide in the office.
Spruce: Have you noticed any pitfalls to avoid in teledermatology?
Dr. Fung: Patients sometimes come in with an unrealistic idea of what can be accomplished via a teledermatology platform. It can be a tricky process to educate them, readjust their expectations, and connect them to in-person care (if necessary) without losing their trust or frustrating them.
Spruce: What academic research is most needed in teledermatology?
Dr. Fung: Studies on patient access would be welcome, as teledermatology in theory can offload lower-acuity patients from the clinic schedule and allow patients with more complex issues to receive care sooner.