In-person patients

[Psychferlyfe3000]

Hi all,

I really enjoy outpatient psychiatry, however, I do not enjoy seeing people remotely. I am wondering what percent of patients seen in group practices are in-person. Is there any way to request to only see patients in person? Thank you.

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[FlowRate]

The closest you'll be able to get doing this is having a therapy practice, as patients are generally more interested in seeing you in-office if it's for psychotherapy.

For context, we went back to 1 day in-office recently and still end up scheduling people for virtual visits on our one in-office day. The demand for in-person appointments is just not there when it comes to more typical (30 min visit) outpatient psychiatry.

The biggest thing that's lost by the virtual transition is some patients' mind space / preparation / attention when they're joining from the sidewalk / car / sales bullpen.

 

[ObsequiousAplomb]

I agree with FlowRate.

My practice is 90% hour-long sessions, and as soon as I started offering in-person hours all the therapy patients insisted on going in-person. Everyone I'm seeing for intakes wants to be seen in-person. I was a little surprised by it but I'm fine with it, because I also really prefer in-person for most of my patients. Some of the people who are just 20 minute refill visits are fine to see virtually here-and-then, but I'm really moving towards in-person for most of it.

 

[calvnandhobbs68]

I have to say, I do like at least 80%+ of my appointments in person. My schedule today was 2/14 virtual, tomorrow 3/14 virtual, wed 2/15 virtual and friday 1/16 virtual. I do 30 minute followups. I'm child though so most prefer in person anyway....it's also my personal opinion that child is a mess virtual a large amount of the time.

I see all my intakes in person as a rule, so the expectation is that the initial default is in person for me. I think it just depends on how you want to structure things. I don't know what you mean by "is there any way to request" patients being seen in person, it's just going to depend on the practice and how you want to set things up with patients. Certainly allowing a lot of virtual will allow you to capture a larger geographic area.

 

[Sushirolls]

My private practice is adult insured base, really no medicare, no medicaid.
I have about 60% telemedicine, 40% in patient. I let patients choose unless I need to do AIMs, or are on a controlled substance, than I do every other visit in office.

A few people strongly want tele. A few strongly want in office. But most just sway with the breeze for which. I've had a few scheduled as tele but show up inoffice, and more who were scheduled in office, swith to tele because of sick, weather, or other logistics issues.

 

[claypigeon]

You’ll have no problem filling if only offering in person visits. It may take a bit longer to fill, you’ll have higher no show rates, and documentation can’t be as easily done during the visit but the demand is there. I prefer in person, am insurance based, and do a 50:50 split and could easily fill the other 50% with in person visits.

 

[TexasPhysician]

My private practice is probably 60%+ electing for in-person.

 

[calvnandhobbs68]

You’ll have no problem filling if only offering in person visits. It may take a bit longer to fill, you’ll have higher no show rates, and documentation can’t be as easily done during the visit but the demand is there. I prefer in person, am insurance based, and do a 50:50 split and could easily fill the other 50% with in person visits.

My older high school/college kids are terrible for no showing virtual appointments...it's actually one of the things that annoys me most about virtual with teenagers. For some reason their parents seem to take it more seriously if it's an in person appt and actually remind them to show up.

 

[Bartelby]

For a lot of my clinical practice I give patients the option of doing either. I would estimate I am around 80 percent telehealth.

 

[Psychferlyfe3000]

Thank you for all your responses. This is actually quite encouraging to hear with more people being seen in-person than I expected.

 

[tr]

I have two clinic days per week (adult subspecialty), one in-person and one virtual.

I have a requirement that all intakes are done in person; after that patients are welcome to choose virtual or in person for follow-ups.

I would say 80-90% choose virtual for follow-ups. My virtual day is always packed and my in-person day is pretty relaxed.

 

[TheRightMedication]

I've got a solo insurance based practice. I strongly recommend in person visits to my patients but leave virtual visits as an option.

My main challenge is adjusting to all the non-verbal communication that's become a habit for me that I can no longer rely on in a virtual visit. I practice an awful lot of medicine by changing my posture or expression. Half-shouting "I'm curious about - yes I can hear you - so tell me more - wait I lost you there" at my laptop wasn't part of my psychodynamic training.

 

[clausewitz2]

. Half-shouting "I'm curious about - yes I can hear you - so tell me more - wait I lost you there" at my laptop wasn't part of my psychodynamic training.

A good headset and camera set up can help a lot with this (but I agree it definitely does not entirely replicate the in-person experience.

 

[TheRightMedication]

I did get a nice headset, though I may take your advice on a nicer camera. Patient-side wifi, though, is the main issue.

 

[comp1]

My local VA mandates 3/5 time in person for everyone who isn't 100% virtual. The patient desire for in person is much higher than that, but the provider willingness is much lower.

 

[FlowRate]

The patient desire for in person is much higher than that, but the provider willingness is much lower.

Very much tracks with that patient population, I think.

I did get a nice headset, though I may take your advice on a nicer camera. Patient-side wifi, though, is the main issue.

Same, visit quality issues are like 90% of the time due to the patient's connection speed/quality (high speed with high packet loss will still have issues.)