Then everything changed. “When the pandemic started, telemedicine replaced virtually all in-person visits,” says Raymond Cross, MD, director of the Inflammatory Bowel Disease Program at the University of Maryland School of Medicine in Baltimore. Stay-at-home protocols aside, telehealth became much more popular for both doctors and patients after March 2020, when the U.S. Department of Health & Human Services made sweeping changes to the services. HIPAA rules became more flexible and included multiple platforms for providing care. The number of telehealth services also increased, among other measures. Today, while in-person appointments are making a comeback — doctors’ offices take measures to help keep patients safe — many people with inflammatory bowel disease (IBD), such as Crohn’s or ulcerative colitis (UC), are sticking with telehealth. One bonus of telemedicine: It can be easy to find and visit specialists and other doctors, especially if you’re looking for a second opinion. Telemedicine can connect people to specialists located hundreds of miles away, which is not always easy, or even possible, to do in person. “One-third of our patients travel 50 or more miles away to come to us for their appointment,” says Dr. Cross. What’s more, if you are seeking a second opinion at a large IBD center, you will also have access to comprehensive care, including dietitians, psychologists, social workers, and surgeons (if necessary). Virtual visits expand your potential health network so you suddenly have more options. For many people an IBD diagnosis is straightforward, confirmed by imaging, endoscopy, colonoscopy or blood tests, says Cross. But if you have a question about your diagnosis or a newly diagnosed loved one who is struggling to accept it, then hearing it from another specialist or expert can help you or your loved one move forward and start treatment, says Cross. Learning you have IBD is life changing, and a confident diagnosis can help you forge ahead. “For new patients, I prefer to meet them in person for the first visit,” says James Marion, MD, a gastroenterologist at the Feinstein IBD Clinical Center at Mount Sinai in New York City. “It could portend a pretty important change in their treatment chapter,” he says. Of course, if telehealth is the only option for you, the specialist can work with you to make that happen. More commonly, says Cross, people want to seek a second opinion when they’re unsure of which treatment to try next, such as having surgery vs. starting a new medication. At that point, it can be extremely valuable to know you have a specialist (or two) who is helping you make decisions. “For patients who live in areas where there are no specialists, I urge them to join up with their local GI doctor or internist so I, too, can partner with the doctor,” says Dr. Marion. This will streamline your treatment. For example, you might meet with your primary doctor first and then see the specialist for a virtual appointment. If imaging or other tests are ordered, your primary doctor can facilitate that. You can then access a specialist’s knowledge and resources without having to leave your area. Try to resist getting so much input from doctors that you feel overwhelmed. With telehealth, it can be less burdensome to get several more opinions, hoping you’ll find the perfect solution to your treatment question. “It’s possible to get too many opinions, which can make it hard to move forward and make a decision,” says Cross. “If you see 10 specialists, you might get seven opinions. There’s no recipe for care; there is an art and nuance to it,” he says. Prepare for the second-opinion telehealth appointment in advance so you can make the most of it. “The time you save on the drive to the appointment should be spent in preparation for the meeting itself,” says Marion. Here are some ways to do just that.
Give the doctor some background information. This includes not only your health records, but also a summary of your health history. “Your health history is about 90 percent of what gets you to a diagnosis,” says Marion. While tests are crucial to confirm what the doctor suspects, telehealth lends itself particularly well to the doctor-patient conversation. Ask yourself what your backstory is with IBD (or potential IBD) and how your symptoms impact your quality of life and ability to function day to day.Know your goals. Tell the physician what your first doctor said, including what you disliked about the diagnosis or what you want clarified. You should also speak up about what you want for your future, whether that’s avoiding surgery, minimizing symptoms, or something else.Recruit a partner. Ask a trusted family member or friend to jump on the call if you’d like. Telemedicine makes it even easier to connect with others, as your loved one doesn’t even need to be in the same household as you. Just make sure you announce to the doctor everyone who is on the call.
