Uscher-Pines Lori, Rudin Robert, Mehrotra Ateev
1 RAND Corporation , Arlington, Virginia.
2 RAND Corporation , Boston, Massachusetts.
Telemed J E Health. 2017 Jun;23(6):533-535. doi: 10.1089/tmj.2016.0174. Epub 2016 Nov 28.
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute. Given the projected shortfall of physicians in the United States, recruiting retired and semiretired physicians to provide care through telehealth increases the total supply of active physicians and the capacity of the existing workforce. However, programs typically use volunteers in a limited capacity because of uncertainty about the level and duration of commitment. Acknowledging this reality, most programs only use volunteer physicians for curbside consults rather than fully integrating them into longitudinal patient care. The part-time availability of volunteers may also be difficult to incorporate into the workflow of busy safety net clinics. As more physicians volunteer in a growing number of telehealth programs, the dual benefits of enriching the professional lives of volunteers and improving care for underserved communities will make further development of these programs worthwhile.
许多弱势社区缺乏足够数量的当地初级保健医生和专科医生。然而，成千上万的医生，尤其是那些已退休或半退休的医生，渴望有意义的志愿者机会。多个项目已开始利用远程医疗来弥合志愿医生与服务不足患者之间的差距。在本简报中，我们描述了正在使用这种模式的项目，并讨论了其前景与问题。参与这些项目的医生志愿者表示，这项工作既充实又令人兴奋，是一种前沿且便捷的方式，能让他们继续参与并做出贡献。鉴于美国预计的医生短缺情况，招募退休和半退休医生通过远程医疗提供护理可增加在职医生的总数以及现有劳动力的能力。然而，由于对参与程度和持续时间存在不确定性，项目通常对志愿者的使用有限。认识到这一现实，大多数项目仅让志愿医生进行电话咨询，而非将他们全面纳入患者的长期护理中。志愿者的兼职可用性也可能难以融入繁忙的安全网诊所的工作流程。随着越来越多的医生在越来越多的远程医疗项目中志愿服务，丰富志愿者职业生活和改善对服务不足社区护理的双重好处将使这些项目的进一步发展变得值得。
