Do you have an orthopedic telemedicine evaluation scheduled? This COVID-19
pandemic has made these evaluations a standard part of orthopedic practices.
The concept can be intimidating to some. In reality it's a fairly simple set up.
I'm going to discuss how this examination is performed. First, I'd
recommend you check your internet speed before the evaluation. If you use an
internet speed test a minimum upload and download speed of approximately 5
megabits per second can deliver enough bandwidth to allow a telemedicine
evaluation. If you're not sure, you can search "internet speed test" in Google, and
be able to test. Your doctor will provide a web link to the telemedicine
conference. Make sure to log in 15 to 20 minutes before the evaluation to make
sure you have the proper connection, and you can test your computer, laptop, or
smartphone to see if there'll be any issues. Be sure to contact the office
immediately if you think there may be a problem. Once you establish a connection,
the first part of the evaluation is very similar to what you would do during a
face-to-face evaluation. The doctor will ask you about your questions and your
complaints, and obtain what is called a history. Once the history is obtained, the
physical exam has some nuances that need explanation. As an orthopedic surgeon, my
examination will be focused on the musculoskeletal exam. In order to prepare
for that exam, I suggest you prepare the following: number one, make sure you have
adequate lighting in the room, but the lighting should be directed towards you
not behind you. Number two, you will need the ability to stand between seven and
ten feet away from the camera so I can visualize your whole person in a frame
of the video. If the concern is the neck, upper back, or arms make sure to wear a
slightly snug t-shirt or leotard. This way loose clothing
will not interfere with the viewing of your motions during the examination.
Number four, if the concerns is the legs or feet, I would ask you to wear shorts
or leggings. Please be barefoot. Number five, please
bring a firm chair where you can sit for part of the examination. Number six, you
might position the examination next to a table or wall if you feel unsteady or if
you'd like to hold on to an object for stability. Number seven, bring a paper
clip or a writing pen. I will ask you to touch various parts of your skin to
identify areas of sharpness or dullness. Number eight, if you have an area of pain
that you cannot reach, consider asking a family member or a trusted friend to
touch the specific area for identification before the examination.
Before you begin the physical examination via telemedicine, make sure
to tell the doctor if you're concerned about some of the asked examination
motions. No one wants you to get injured during the examination. No one wants you
to experience the pain unless you would like to demonstrate how the pain
occurred during the examination. Depending on your complaints, expect the
doctor to ask you to stand on your tiptoes and on your heels. The doctor may
ask you to turn in different directions while doing these motions as it can
better visualize from the front, the side, or the back. Oftentimes the doctor may
ask you to walk in place, stand on one leg at a time, bend forward without
bending your knees, squat, move your neck and arms, and other motions. Make sure you
have plenty of space to do these motions without hitting anything.
Remember to brace yourself or hold on to something if you think you might fall.
Remember, you do not need to do everything asked. The doctor will
typically ask you to sit in the firm chair, and move your knees and hips to
assess your range of motion. The doctor will ask you to touch the areas of pain.
The doctor may ask you to test your skin areas for sensation with the
extended paperclip, and tap on areas of the wrist and elbow for any unusual
sensation. The doctor may ask you to flick your middle fingers with these
type of motions, so they can assess various things like the ability to walk,
and make observations about your functionality. Once the history portion
of the examination is finished, and the history evaluation completed, depending
on whether you have forwarded your testing results and provided imaging
studies, the doctor can then move on to discuss your particular findings and
discuss recommendations. In reality, the telemedicine evaluation is an effective
evaluation that will allow the doctor to have a meaningful discussion about your
concerns, and make recommendations based on your situation.
While the telemedicine evaluation did not seem like a viable option a few
years ago, it is now a standard part of many practices. If you have a
telemedicine evaluation scheduled, make sure to consider these steps as you
prepare for your visit. I hope this will help you to have a productive orthopedic
telemedicine evaluation in the future. Thanks for watching.