Psych Congress NetworkThe Pros and Cons of Telepsychiatry Practice

A discussion on how to overcome potential barriers to effective virtual therapy, as well as circumstances where in-person visits may be the best option in the end.

In an exclusive video interview, Dr. Marc Agronin, a geriatric psychiatrist and CMO of the MIND Institute at Miami Jewish Health, discusses the benefits and challenges of telepsychiatry, particularly for older patients. He provides insights into the potential of virtual psychiatric care and the circumstances where traditional in-person consultations might be more appropriate.

Key Points:

• Advantages of Telepsychiatry:
  • Improved access for individuals in rural areas, prisons, and ICUs.
  • Flexibility in scheduling and location for patients.
  • Increased frequency of consultations, especially for those with anxiety, mood disorders, and adjustment disorders.
  • Cost-effective and allows for consultations with caregivers or multiple family members.
  • Provides insights into the patient’s home environment.
  • Expands access to specialists for specific diagnoses.
  • Higher adoption rates among older individuals.
• Limitations of Telepsychiatry:
  • Requires technological proficiency.
  • Cannot replace the depth of in-person physical and neurologic examinations.
  • Potential for decreased privacy, especially for older patients.
  • Easier for patients to hide things or be resistant.
  • Potential for fraud and concerns about prescriptions for controlled substances.
  • The DEA is considering more mandates for in-person visits for certain prescriptions.

Additional Points:

• Telepsychiatry can sometimes feel intrusive, especially when imposed on older individuals by caregivers or family members.
• The power of physical presence during a session can be significant and its absence can change the dynamics of the consultation.

Conclusion:

• Although telepsychiatry offers numerous advantages, especially in terms of accessibility and flexibility, it’s essential to consider its limitations, particularly for patients who value the physical presence of a psychiatrist or have specific medical needs.

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