Valley physicians keep appointments by video link

Valley physicians keep appointments by video link

Dr. Gary R. Gibson, part of the Steward Medical Group, conducts a telehealth video visit from his office in Bazetta. Video visits help keep patients who don't need to risk being out during the COVID-19 pandemic safe at home and away from possible infection. (Submitted photo)

Ed Monroe lives only a mile and half from his doctor’s office. A drive there wasn’t such a big deal.

Until the coronavirus pandemic hit. Going out — perhaps especially to a medical center — became a risky, possibly fatal, proposition.

That’s why Monroe just completed his annual physical a week ago Friday from the comfort of his own home by video conference. It’s the difference of sitting in the waiting room reading the doctor’s old magazines and sitting in your living room reading your own old magazines, he said.

“It worked for me,” Monroe, 58, of Bazetta, said. “Right now, with everything going on, it’s definitely a good thing to try as a first step. It’s much better than going out with all the coronavirus, or waiting 3 1/2 months for everything to settle down.”

Monroe took his own blood pressure, temperature and weight. “There wasn’t a lot of change from last year,” he said.

Had there been any rashes, swellings or irregularities to show, primary care physician Dr. Gary R. Gibson of Bazetta was right there looking at him through the video connection on their laptops.

“It’s suitable in the current circumstances because there’s no way I can give you coronavirus over a video,” Gibson said. Nor will an infected person be in the office spreading the virus to staff and other patients, he said.

“A number of things people come in for can be handled over the phone.” Adding the video component enhances the interaction between doctor and patient, he said.

“I work by teleconference,” said Monroe, who is in engineering and sales. “I’m used to working with people, sharing information that way. In this case, this was a video. He could see me and I could see him.”

“I think telehealth is here to stay,” said Dr. Maria Kowal, chief medical officer for ONE Health Ohio, with locations including Youngstown, Warren, Cortland and Newton Falls.

“A pediatric patient inched up super close to the camera today so I could take a look at her itchy rash up close on my computer screen. I can diagnose a rash via video and clearly I have to adapt with the changing times. A happy patient and a thankful parent who got an answer without leaving home,” Kowal said.


Gibson is part of the Steward Medical Group, which includes Trumbull Regional Medical Center in Warren, and like other health systems across the Mahoning Valley, has reported a tremendous increase in telemedicine — conducting routine doctor visits by telephone and video conferencing.

“Everybody is learning as they go,” Gibson said. “I think it’s a good tool.”

And it remains private. “There are strict rules about not recording any of it,” Gibson said. There are no video files lying around that someone else can get into. The program Steward Health uses, Microsoft Teams, is known as one of the most secure video conferencing sites, he said.

“We’re not going to try to do everything through telehealth,” Gibson said. “But from talking here (by video), we can get a sense of what the urgency is.”

Gibson said he used to see about 20 patients per day in his office. Since the coronavirus pandemic, he sees about six to eight people per day in the office and another six to eight by teleconference. Overall, total appointments have dropped off by about 20 percent, he said.

“Some people are more afraid of coming in than others. It’s important to give them that latitude.


Video medical appointments are not a new thing. Neurologists and other specialists have been using this method for years, especially in rural areas where facilities are scarce.

Rod Neill, chief operating officer of the Physicians Group at Mercy Health-Youngstown, said video medical appointments is the newest in an array of options that also includes the MyChart online patient portal, e-visits and telephone encounters.

“The one that has taken off in the last two weeks is video visits,” Neill said. “Three weeks ago, we averaged three a day. Now it’s about 300 a day, and we expect that to increase.

“We don’t want patients to come to a doctor’s office if they don’t need to.”

Mercy Health facilities include St. Elizabeth hospitals in Youngstown and Boardman and St. Joseph Warren Hospital.

Neill said he doesn’t expect video visits to go away.

“When the COVID pandemic settles, we expect this to be a staple,” Neill said. “Going forward, it will be a tool in the toolbox.”

He noted that insurance companies have loosened a number of requirements about copays, deductibles and face-to-face visits, making it easier for patients to have video appointments.

Appointments are made just the same as for face-to-face visits — call in and set up a time for the doctor to see you.


At ONE Health Ohio, Kowal said, “Our clinicians have embraced the new tool of telehealth quickly, recognizing that it has immense value and patients are relieved and grateful to get care from providers they know, from the comfort of their own homes.

“Our telehealth appointments — medical, adult and pediatric, behavioral health, Medication-Assisted Treatment and Dietetic — are growing exponentially as the word is spreading amongst our patients.”

Behavioral and mental health therapists across the Mahoning Valley have been using the telehealth tool to keep in touch with patients, and have face time, even if by video.

Especially in a time of isolation, stress and uncertainty, people need to be in contact with their doctors and counselors, they say. Telehealth applications allow that to happen.

Dr. Ronald Dwinnells, chief executive officer for ONE Health Ohio, said, “Yes, telehealth will become a valuable part of our health care delivery system by helping to decrease unnecessary visits to emergency rooms and medical offices. It will have a positive impact on the economy and improve health in people more efficiently and effectively.

“Nothing, however, will ever replace the hands-on-approach of health care perfected by doctors over centuries of taking care of people,” Dwinnells said.


Dr. Joe Eschman of Eschman Physical Therapy in Howland said his office is among those that offer virtual sessions, especially with established patients.

“They can show me how they are doing an exercise,” he said. He can watch it and suggest corrections or modifications. Plus, he can demonstrate those exercises and others for patients to see.

“What I’m also finding out is I can actually teach people how to do their own manual therapy techniques,” Eschman said. “The other day, I had a lady who had a headache and I could demonstrate some of the pressure points.”

He showed her where to put the pressure and what movements to perform around the eyes, over the ears and at the back of the head, and could watch her perform those techniques to make sure they were done correctly.

“An increasing number of patients are interested because a number of people don’t want to come in,” he said. “It’s a great supplement to — and not to replace — face-to-face visits.”

Eschman said he sees continuing supplemental video visits after the pandemic is over. Some of his patients need to arrange for rides, or some have difficulty getting out of the house. With telemedicine, treatment could become a mixture of face-to-face and screen-to-screen visits.

“I think it’s not only going to change health care but education as well,” he said. His wife is a teacher who has been discovering new ways to coach her students by video, he said.


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