- Department of Emergency, Australian College of Emergency Medicine, Brisbane, Queensland, Australia.
- Department of Orthopaedics, Fiona Stanley Hospital, Perth, Western Australia, Australia.
- Recover Injury Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
Bradley Robert Richardson
Recover Injury Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
DOI:10.25259/SNI_911_2020Copyright: © 2020 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Richardson BR1, Truter PM2, Russell TG3. Response to: Two telemedicine consultants miss foot drop: when to see patients in person. Surg Neurol Int 20-Jan-2021;12:26
How to cite this URL: Richardson BR1, Truter PM2, Russell TG3. Response to: Two telemedicine consultants miss foot drop: when to see patients in person. Surg Neurol Int 20-Jan-2021;12:26. Available from: https://surgicalneurologyint.com/surgicalint-articles/10535/
We have read the case report entitled “Two telemedicine consultants miss foot drop: when to see patients in person” by Professor Nancy Epstein published in Surgical Neurology International (2020: 11). We want to congratulate the author on this successful article, and offer further congratulations for continuing to practice clinical medicine during a global pandemic.
We wish to make some contributions toward the commentary on the case study. There are two significant issues; (a) the case report does not include clinical examination findings from either telemedicine consult and (b) the telemedicine treatment plan is lacking more than referral for imaging and specialist follow-up. Our concern with this case study is that the issues raised are a reflection on the clinical reasoning and decision-making process of the general physician and not with the medium through which it is delivered.
Telehealth is a viable tool for examining, initiating treatment programs and managing patients with neuromusculoskeletal conditions.[
In terms of a physical examination, we acknowledge that there must be adaption to the telehealth medium and engagement to support guided self-examination by the patient. Many aspects of a telehealth mediated physical examination have demonstrated validity and reliability,[
Rightfully so, the author appears to be upset in that this patient was not referred on to a medical and/or spinal surgical consult, which we agree is a failure of the general medical-physician. We would add that education and advice on prevention would also have been appropriate in this circumstance. However, again we feel this is an issue in the clinical service provided by the medical-physician rather than a failure of the technology per se. Provision of onward referral and advice are both trivial through telehealth.
We would like to state that telehealth, like any other new advancement in delivery of healthcare, requires training to both providers and patients in how to manage the interaction to ensure positive outcomes for patients.[
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2. Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S. Interactive telemedicine: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2015. 2015: CD002098
3. Mani S, Sharma S, Omar B, Paungmali A, Joseph L. Validity and reliability of Internet-based physiotherapy assessment for musculoskeletal disorders: A systematic review. J Telemed Telecare. 2017. 23: 379-91
4. Richardson BR, Truter P, Blumke R, Russell TG. Physiotherapy assessment and diagnosis of musculoskeletal disorders of the knee via telerehabilitation. J Telemed Telecare. 2017. 23: 88-95
5. Serhal E, Lazor T, Kurdyak P, Crawford A, de Oliveira C, Hancock-Howard R. A cost analysis comparing telepsychiatry to in-person psychiatric outreach and patient travel reimbursement in Northern Ontario communities. J Telemed Telecare. 2020. 26: 607-18