Telemedicine for Kidney Patients

Stirred by necessity during the pandemic, the use of telemedicine to allow patients to access their physicians has enjoyed great popularity and has become widely accepted as an option to facilitate patient care.  Patients with limited mobility, or those that must travel greater distances to see their doctor particularly appreciate this option.  

Another niche area in which telemedicine is especially beneficial is in connecting Nephrology or kidney physicians with their dialysis patients which are often spread out in various clinics several miles apart.   Nephrologists typically manage critically ill hospital patients as well as stable patients coming for routine follow up who often have very complex medical problems.   In addition, these patients are usually scattered across numerous facilities and it is not uncommon for a single physician to travel to 7-8 or more different places of service to see all their patients in any given day.  

Challenges related to the complex care of kidney patients coupled with increasing physician travel time have directly contributed to the decline in number of practicing nephrologists.   In fact, nephrology is now an underserved specialty with fewer and fewer physicians opting to pursue it as a specialty and those that are already practicing it quite often citing “burnout” as a reason to retire early.   Fewer physicians for patient care as well as the continuing increase in number of patients who have kidney disease is putting a strain on the system and will inevitably lead to a decline in quality of patient care.

While telemedicine has been widely adopted to connect patients and their physicians in other aspects of medicine, antiquated provisions in the code of regulations regarding dialysis rounding in the State of Texas prohibit continued use of telemedicine at this time.   As advocated by the American Medical Association, Renal Physician Association and other groups of physicians, we wish to see this changed.  

When I started practicing nephrology in Houston in 1999, my practice provided care to patients in 4 dialysis clinics.   Today, our physicians have increased from 3 to 7 and we have had to add 3 nurse practioners to provide care to patients in 53 and counting separate dialysis clinics scattered out across Houston and the surrounding areas.    A much appreciated benefit of telemedicine that was allowed during the pandemic, helped us streamline our practice and be much more efficient and effective in providing care to this vulnerable group of patients.  

On a personal note, I had a major car accident in 2007 while running between the hospital and dialysis clinics while caring for my patients.   I was unable to work for 6 months.   So as you can see, limiting wasted windshield time has additional meaning for me as well.  Telemedicine can limit unnecessary driving, potential accidents, and lessen traffic on the roads, which will have benefits for the environment as well.

Please join me in advocating for a change in current state regulations governing dialysis rounding in the State of Texas by allowing telehealth so that Nephrology physicians can better care for their kidney patients.