This podcast features Penn Medicine neurosurgeon Dmitriy Petrov, MD , discussing the creation of the remote second opinion program at Penn Neurosurgery and the approaches the department adopted to address patient care during the COVID-19 pandemic.
Welcome to the podcast, Siri's from the specialists at Penn Medicine. I'm Melanie Colin. Today we're discussing remote second opinions at Penn Medicine Neurosurgery. Joining Me is Dr Dmitri Petrov. He's an assistant professor of neurosurgery at Penn Medicine. Dr. Petrov, It's a pleasure to have you join us today. You're associated with a new program at Penn Medicine that's offering remote second opinions to people who have received brain and spine diagnosis. Tell us a little bit about the program and why you saw a need for this type of program. At this time, a program focuses on providing second opinions to patients that have seen a neurosurgeon for any of the spine vascular brain, peripheral nerve disease processes that are seen by neurosurgeons. This really arose out of our shift to telemedicine after the covert epidemic brought our clinics to a halt, and we saw this is an opportunity to really improve access to Penn specialists and neurosurgery and to make it more convenient for patients to get a expert consultation. Well, then, tell us first. This is a question that referring physicians and patients Havas Well, our doctors insulted when a second opinion is requested. I feel like that's a common opinion, and nothing could be further from the truth. I think if a doctor ever tells you that you should not get a second opinion, you should run for the hills. You should be an informed patient, and our job as physicians is to really layout what we think is happening and what we recommend. And then the really decision is made between the doctor and the patient, and the patient should be as informed as possible. All of my complex patients, I always say, If you'd like to get a second opinion or a third opinion, that is your prerogative, and I encourage you to do it because it's always good to have as much information as possible and to go into something as serious as neurosurgery with confidence that you're choosing the right path. Well, it certainly does. In Dr Petroff, as you have all gotten so creative in this pandemic in these unprecedented times is not being with the patient in the same room anus issue. Given the gravity of what you may have to tell the patient about their situation, it is so much of our interaction happens in person and before scheduling something for a procedure like a neurosurgery. It's still our policy that we need to see the patient in person prior to surgery to really decide and to really make sure that we're all on the same page. But it does take away something from the interaction that's for certain, especially the neurological exam. A lot of it is so physical that sometimes we still need to bring patients in for in person visits to really give a full on assessment. But on the other hand, I really do think that this providing telly opinions really improves access and improves health care overall, because for the most part, you can give a patient a really good insight and what you think the pathology is and what you think the next step should be just based on their image ing and their story that they're telling you that's oftentimes 90% of the picture anyway. So covert forces to innovate and move us a telemedicine. But now, looking back on it, it seems that we should have been doing this for a long time prior because the capabilities were there. We were just so stuck in our old paradigm that this wouldn't be effective that we really didn't consider it as a medical field. I would think now patients are very satisfied and it also helps. Our patients aren't able to take days off of work to come travel and see a pen physician or they live further away but still want the expertise of a coronary center like we have really expands access and makes things much more fair. Well, then, tell us about your experience team of neurosurgeons that offer these remote second opinions. And how is the program all working with your team? Our team at Penn Medicine is top notch. I feel very privileged to be part of the talented group of neurosurgeons that work in our department. We have subject matter experts, essentially in any sub specialty of neurosurgery that you can think of that our world leading experts and can offer the best of care as far as how the process works. When we were first discussing how to implement this best, we wanted to make the impediments to seeking the second opinion as small as possible. And so, if you're patient calls in or fills in the online prompt to get a second opinion immediately. Within 24 hours, you're contacted by a coordinator that asked you a certain set of questions that are very basic. Have you had a consultation before? Have you been offered surgery? Have not been offered surgery, sends you a link to upload your image ing. And then within 48 hours, you're scheduled to see one of our specialists via telemedicine. Or actually, if you choose, if you are in the area, you can come in and see them in person. We leave that up to the patient. So the ease of getting in consultation was our primary goal. Dr. Petrov, tell us what conditions are considered for this program. And what do you typically seeing? Any conditions that are treated by neurosurgeon are eligible for this. We've seen a number of patients with spine problems. We've seen a number of patients with brain tumors. We've seen patients with aneurysms. Any and all of those can tell a second opinion patient through our program, essentially the full gamut of neurosurgical care. Dr. Petrov, you said for brain and spine conditions. People have gotten a diagnosis, and maybe they're very concerned. So they ask their referring provider about the second opinion. What are some other reasons that they might be doing it? Is it to validate their diagnosis or two? Find out what you could do for them rather than what they've already found out from their provider. Sometimes I found that patients don't have a very good sense of exactly what's being offered exactly what's wrong with him and their style of communication, but not necessarily messed with the physician style of communication. And they might seek out somebody else to sort of explain it to them. Sometimes they're looking for unanswered that they would prefer that they're looking for somebody to tell them something different. Sometimes patients that were treated in centers that aren't large academic centers may not get the same opportunities to enroll in trials to try experimental therapies. And so oftentimes patients will contact us to really get access to the interest in cancer center, and two are excellent ecology and radiation oncology and your surgery teams and really get the full spectrum of what's out there for the specific DS. Dr Petrov as we wrap up, tell us your vision for this program and what you see happening in the future do you think that telemedicine is going to stick around after this pandemic, and it's going to be something that's really adapted and adopted by other centers around the country and wrap it up for us and what you'd like referring providers to know about the remote second opinion program, Akpan Medicine. I think invariably telemedicine is here to stay. Now that we've made this change, we've seen how far our reach can expand, how much more convenient that is for patients, how much they prefer it. I don't think there's any looking back. My vision for this program is to expand it, to make it the way that patients really access specialists because it doesn't have to be the only visit that you have with the clinician you could have in person visits. But the initial visit is much more convenient, definitely get a sense of where things were going, what else is needed? What are the diagnostics or needed? It's a better utilization of time practicing in the city, patients often complained about the difficulty of getting in this city. Things like parking are a huge headache for a lot of patients taking off work, managing their schedule around doctor visits, which may take longer than they would anticipate. All of these things are impediments to care, and I think overall decrease the level of health care that our population gets. And so I think this is a way to really level the playing field to really meet the patients where they need us to be, to give them expert opinions and to provide them really top notch care and do it in a way that works with their lives. Our vision for this program is to provide patients quick and easy access to our neurosurgeons. Moving forward. Thank you so much, Dr Petrov, for joining us today and telling us about the program at Penn Medicine that offers remote second opinions to refer your patient for a remote second opinion at Penn Medicine Neurosurgery. Please visit our website at penn medicine dot org's slash Refer or you can call 877937 pen That concludes this episode from the specialists at Pan Medicine. Please remember to subscribe, rate and review this podcast and all the other pen medicine podcasts. I'm Melanie Call
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