At Pelican Pediatrics in Charleston, SC, telemedicine is brand new. As for many pediatric practices responding to the pandemic, it was a quick introduction, but owner-physician Dr. Eliza Varadi and her staff feel they’ve got the hang of things. With all of Pelican Pediatrics’ staff at least bilingual, Dr. Varadi encourages other pediatricians to welcome non-native English speakers into their practice to give accessible care to every child.
Telemedicine Offers Ease to Complex Care Kids
If payment structures remain the same as they are now during the emergency phase, Dr. Varadi hopes to continue telemedicine, as they make certain visits much easier for the practice and even more for families. She hopes that Medicaid and other carriers see that these appointments improve the access to care for complex patients and patients without direct access to transportation, and may even prevent ER visits.
“Specifically, our complex care kids may have ventilators or home oxygen feeding tubes. Some of their visits we're doing with telemedicine, with a home health nurse at their house. So she's grabbing the vitals, she's giving us an assessment for the physical exam while we're interpreting that and doing the visit that way.”
She continues, “For some of those families, it takes about two hours to get out of the house, come to the office, then probably another half an hour to get into the office. And then they're seen, and then it’s probably another two hours to get home. So that can be a five hour ordeal for somebody who's already kind of complex.”
Complex care patients aren’t the only beneficiaries of telemedicine. Other pediatricians report that they’re using telemedicine for many types of visits, such as for behavioral health, controlled substances, mental health, lactation, and nutrition.
To keep patients safe during the pandemic, many pediatricians have also performed telemedicine visits prior to seeing a patient at the office -- this may be billed as an E&M visit during the emergency. For more information on coding and billing during the pandemic, visit PCC’s COVID-19 Resources page.
A Multilingual Practice
Charleston is an incredibly diverse community home to many U.S. immigrants, with nearly 5% of South Carolina’s population born abroad. Many South Carolina communities have primary languages other than English -- 7% according to the U.S. Census Bureau. Dr. Varadi explains that transportation is also a major concern for many families, who may rely on ridesharing services such as Uber or depend on one relative to drive everyone at once. Pelican Pediatrics is particularly suited to meet the needs of this diverse population; all of the staff is at least bilingual, and Dr. Varadi herself speaks Russian, Spanish, and Hebrew as well as English.
This multilingual practice -- all of Dr. Varadi’s staff is at least bilingual -- allows the staff and providers to better understand the needs of their community, and make access to their help less stressful. They can even guide them through telemedicine processes that often only offer instructions in English: “When we tell them when we set them up for their telemedicine appointment, we actually explain to them in their language, what they're going to do. When they've received a text, sometimes we stay on the phone with them and explain to them that, ‘You get this text, this is what you need to click, that's what you need to do once you get it.’”
Can Your Practice Be Multilingual?
Dr. Varadi is all for other pediatricians seeking to offer multilingual and diverse care to their communities. “If you're in a community that has large populations that speak a different language, even if you don't, definitely look for staff that can speak that language. It opens up not only, I think a much larger patient population to you, but it offers services to a population that might otherwise be underserved that has good access to care in your office.”
Multilingual or bilingual business-owners may see benefits like better management and patient communication. According to a 2013 statement from the AAP, evidence shows that diverse pediatric staff, including those who are multilingual, disproportionately practice in underserved communities and treat more minority, Medicaid, and uninsured patients. Essentially, creating a diverse practice directly leads to caring for patients who may have limited options to healthcare otherwise.
“The patients see you trying, even if you can't do it at a hundred percent, they recognize the effort that you put into it and it definitely gives them a stronger trust in you and in the medical profession. And having come here myself as an immigrant who did not speak English, I definitely recognize the importance of that.”
Her reasoning is simple -- she wants to provide the same care for all of her patients, regardless of their family resources and background. “We should attempt to help all the children in our community, not just one group. So if we're living in communities with such, varied populations, many of whom may not speak English, it's important that we give them access to the same services that we would have for our English speaking patients.
“And we may not be able to achieve that at a hundred percent, but we must try our best to do as much as we can to help those kids, even if their parents don't speak English, as much as we would try to help any other kid.”
For telemedicine resources as well as coding, billing, and many more COVID-19 related resources, be sure to visit PCC’s COVID-19 Links and Resources page for the latest links and information.