“Can telemedicine fill the gap when Samantha loses her doctor? She learns more than she bargains for while trying to keep her family safe.”
We took the “business fable” genre and turned it ninety degrees, using a fictionalized journey of discovery to educate consumers about the potential and perils of getting their healthcare without actually having to be in the physical presence of their clinician. The book concludes with a specific checklist and guide that every patient can use before any type of telemedicine encounter, so they can engage their telemedicine clinician with safety and success.
Tell us something about yourself.
I count myself lucky as being one of the last of a dying breed. My generation was certainly the last to be able to put up a shingle and invite patients in. In my little rural town, I was the ER, the fertility clinic, the OB clinic and everyone’s family doctor. I was the medical director of the local nursing home and took care of patients while they rehabilitated and as they passed away.
Some weekends at the local hospital (200+ bed) I was the back-up for the ER doctors, I delivered babies, cared for the newborns, worked the ICU, took care of all of our inpatients admitted from our practice and admitted all the patients who did not have a doctor of their own—I was a very fortunate young physician indeed.
I knew my patients, and my patients knew me
This, of course, led to lots of phone calls after hours. No problem, in residency, I was specifically trained in telemedicine—it was just considered part of being a small-town doc. When I began writing this book, I tried to figure out how many calls I took over 30 years of medicine. I stopped once I got to six figures.
I’ve been a board-certified Family Physician since 1994, coming out of residency to join a three-person single-specialty group in rural Missouri where I stayed for 23 years. My partners and I were fortunate to work under one of the first total-risk Medicare Advantage contracts in the nation. We took that opportunity to create a multi-specialty health system that eventually numbered 100 physicians complete with Urgent Care, cancer, surgery and diagnostic centers and a three-bed hospital. We merged with another health system in 2012.
That led me to writing this book.
What inspired you to write this book?
Patients need a consumer advocate to help them figure out these telemedicine services.
And when you search the internet, there are none.
As one of the few physicians who is not an employee, it’s my responsibility to fill that gap.
When I left my practice, I started working in a telemedicine service. They pay doctors a fixed fee per telephone call. With my experience in creating efficient patient care experiences, the whole idea intrigued me. So I broadened my reach and started working for a number of them, each with a different model.
Now that healthcare is run by the financiers and venture capitalists, the entire process of delivering healthcare is devolving to an industrial model— that is reducing process down to its constituent steps and execute each step as efficiently and cheaply as possible. It worked when these folks owned companies that built cars or developed software, so why not use it to deliver healthcare. Having random patients call random doctors for random, if simple, medical problems is the ultimate expression of that philosophy.
Healthcare, however, is not an industrial product, it is an emotional one. No matter what the circumstances, it requires a connection between the clinician and the patient to be delivered safely and effectively. Forcing clinicians to provide healthcare using the industrial model, something we’re not equipped for by predisposition or training, is resulting in a disengaged, burned out workforce that is increasingly turning to suicide.
I decided to work both sides of the problem. I’m teaching patients how to use this new service that’s being pushed on them as well as teaching clinicians how they can earn a very nice living taking phone calls on demand while increasing their discretionary time.
Having looked around on the internet for information regarding the safe and effective use of telemedicine, all I found was corporate PR—some well-intended, some in the service of the corporation’s rather than the patient’s goals. There is very little unbiased research on how whether these services are effective or safe. You would never realize this if simply went by what is being written.
Since physicians are no longer setting the direction in healthcare, the least we can do is guide our patients so they can use this new tool safely.
How did you celebrate when you finished writing the book? When it was published?
When I finally hit “send,” I took a deep breath in, held it for a moment behind pursed lips and then blew it out slowly and gently.
And I said to no one in particular, “I will never, ever do this to myself ever again.”
Of course, I’ve already started on my next one.
Are you a pantser or a plotter?
I engaged Dan Janal as a writing coach, and he found the subject matter engaging enough that he came up with using the “business fable” approach. We collaborated on the plot and the language.
He was a wonderful coach and co-author.
How many drafts did you write before publishing your most recent book?
What software do you use to write?
We used Word and passed it back and forth.
If you were doing it all over again, what would you do differently?
I would enjoy the process more as it unfolded.
Do you read reviews?
No. I put the work is out there and there it is, people can make of it what they will. Each work is individual and a gift to the reader. I get my feedback from those who I know are engaged and whose opinion I respect.
What is the best advice you could give other writers about writing or publishing?
Don’t underestimate how much effort it takes to deliver your best work.
Put everything you have into it, don’t be afraid to change course while creating.
Then, ship it and don’t look back.
Who is the perfect reader for your book?
If they or someone they love are going to consume healthcare, then they need to have a copy of this book in their home. Telemedicine is NOT an office visit, and the telemedicine doctor is NOT your doctor. These services are just too tricky to use without some knowledge.
Our main character, Samantha, takes a journey to learn that and more in our book—the reader is invited along.
Where can readers learn more about you and your book?