For the 5th post in the doxy.me "Voice of Telemedicine" blog series we're joined by Dr. Joe Krainin.
This is an opportunity for telemedicine professionals to share their experience with telemedicine.
About Dr. Krainin My name is Dr. Joe Krainin and I'm the founder of Singular Sleep, the first (and so far only) sleep telemedicine practice. We launched just 3 months ago. Contrary to what many people think, this does not involve me watching people sleep at night! We diagnose and treat a wide array of medical disorders that make it difficult for people to either sleep at night, stay awake during the day, or both
What's your background? Specialty? How long have you been practicing? Where is your primary location?
I'm a sleep medicine physician with a background in neurology with board certification in both of these specialties. I graduated from Tufts University Medical School in 2004 and have been practicing sleep medicine since 2008. Our offices are based in Mount Pleasant, SC. I've had a diverse career thus far, including serving as the medical director of both a large sleep lab and a professional sports team. Sleep is my passion and I have an entrepreneurial streak that I probably inherited from my father, John, who founded several successful businesses. Singular Sleep allows me to practice sleep telemedicine in 17 states, and we are rapidly expanding throughout the country. We're excited about entering the New York and Illinois markets soon. Our plan is to be nationwide by the end of this year.
How long have you been practicing telemedicine?
During my tenure at Medical University of South Carolina (MUSC), I was part of the team that launched the tele-neurology program in 2014. The value of telemedicine and its disruptiveness, in a good way, to what I call the "hospital-insurance complex" were immediately apparent to me.
What motivated you to start practicing telemedicine?
I'm convinced that today's medical landscape will be almost unrecognizable in 20 years. Telemedicine will be a huge part of that change. I see tremendous opportunity to use telemedicine to increase access to healthcare and reduce its costs. Sleep medicine is vastly underserved throughout the country and we are trying to change that.
How has telemedicine changed your practice?
In a word: freedom. Freedom from the tyranny of being told how to practice medicine by hospital administrators and insurance companies alike. I did not go to medical school to be told what medication to prescribe my patient by a healthcare administrator with a clipboard.
How do your patients like meeting with you by telemedicine?
So far they have been very responsive. We do deal with a select group of people who are comfortable using the Internet to solve problems, including medical ones. I don't think that direct-to-consumer telemedicine is for everyone.
Do you have any insightful, interesting, funny, or notable experiences using telemedicine?
Yesterday I received a letter from United States Congressman Mark Sanford! I thought it was going to be junk mail and was shocked to see that he had written me a very kind, supportive note. To me, this is further evidence that the promise of telemedicine is captivating the minds of our best and brightest.
Regarding clinical telemedicine, there is one case that stands out. A middle-aged woman, we'll call her Linda, scheduled a consultation with me because she wanted to talk about alternatives to CPAP, which is the traditional, first-line treatment for obstructive sleep apnea. She gave up on talking to her regular doctor about the problem because he didn't have any other solutions for her besides sleeping pills, which just made her feel worse. It's very common that patients are not compliant with CPAP for a host of reasons. Linda had really been suffering for years; she was unable to sleep well at night and felt like crud during the day. A review of her previous records indicated that she had severe sleep apnea that was worse in REM sleep. When we started the conversation, she had less than zero interest in ever trying CPAP again, but I was able to quickly detect what the problem was by picking up on a few key details of her history. It was just a matter of the machine's settings. I explained to her what I thought was going on and she agreed to try CPAP again. We tweaked her machine and now Linda tells me that she feels 20 years younger! She sleeps peacefully at night and told me that she has "1,000%" more energy during the day.
What challenges have you experienced practicing telemedicine? How did you overcome them?
The biggest challenge is getting patients to log into their consultation on-time! But seriously, there is an attitude in America that, when you have a medical problem, you go to the doctor and the doctor tells you what to do. This is a barrier for people in adopting telehealth solutions but I see that the wind of change is upon us. Patients are fed up with paying too much money and waiting too long for unsatisfactory results, and they are increasingly open to new, innovative solutions.
What advice would you give to other healthcare providers interested in starting telemedicine?
There are many ways to incorporate telemedicine into your practice. Start now! To all the providers out there who might be reading this, think of it like electronic medical records. Everyone hemmed and hawed and resisted EMRs but now they are ubiquitous, and you know what? They have actually, for the most part, made our lives easier and improved our medical practices.
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