E-Consults
Every patient visit ended the same. Sincere gratitude, followed by this dreaded refrain: “When are you coming back? Who will help me after you leave?”
I’ve left the island. But I established a rheumatology electronic consultation (e-consult) service prior to departure. E-consults are essentially HIPAA-compliant curbside consults.4 Although imperfect, a lot of care can be provided via simple chart review and PCP-to-specialist correspondence. With guidance readily available, PCPs at the clinic feel more comfortable managing rheumatic conditions. As comfort levels grow, patients reap the benefits.
Figure 3: Post-clinic sunset over Gun Beach, Tamuning, Guam.
Want to help?
Providing rheumatologic care on Guam was one of the most rewarding experiences of my life. I helped patients in need. I watched the sun set over the ocean every night (see Figure 3). I learned how to scuba dive. I made a difference. You can help too. Embrace your inner island doctor, and go for it. Tell them I sent you (see sidebar below).
Samantha C. Shapiro, MD, is the executive editor of Harrison’s Principles of Internal Medicine. As a clinician educator, she practices telerheumatology and writes for both medical and lay audiences.
