I'm a big believer that this could be a major part of future practice, if we get over the fear of it. There are already internists and surgeons doing hospital rounds via video link with a PA or trained nurse at bedside. In residency, one of my attendings was doing telepsychiatry with those who cannot physically make it into the office. A case mgr was sent out with the video link equipment, and the doc stayed at the office. Patients were adequately treated and improved dramatically, and as soon as they were more able, there was already a relationship with a Case Mgr to help get them out, socializing, taking a greater role in their own lives.