- Associated Press - Wednesday, July 8, 2015

ROCKFORD, Ill. (AP) - There’s a room at the Rosecrance Ware Center in Rockford where patients have been going for six months to see Dr. Michael Kuna even though he’s not there.

Kuna, who lives in Naperville, appears to them on a television screen. The psychiatrist for 30 years speaks to them as he would patients he sees in person. His patients speak to him as if he were sitting across a desk from them. The only difference, Kuna said, is the 160-mile round trip he doesn’t have to make to see people who desperately need his services.

The nation is experiencing a shortage of psychiatrists that started in the mid-1990s and is expected to last through 2020, according to the American Psychiatric Association. For several years, there’s been a significant drop in the number of students entering psychiatry residency programs.

According to a recent study, the country is short about 25,000 psychiatrists.

What Kuna participates in is called telepsychiatry, and it’s helping treatment centers and hospitals across the country as well as private-practice psychiatrists serve patients in underserved areas and places where demand outpaces the number of available appointments.

“Psychiatry is one of those branches of medicine that really lends itself to this type of interaction,” Kuna said. “I don’t have to listen to your heart. . And Wendy is there. She can do the basics for me.”

Wendy Hall is Kuna’s nurse. She attends all of Kuna’s sessions. She sits at a desk in the room with the patient and the TV screen. She can take a pulse or otherwise assess or assist a patient in need. She greets the patients and gets them situated in the room. After the session, she sends them off with helpful reminders, such as “Get that lab work done” or “See you next Tuesday.

“Rosecrance offers telepsychiatry services at its Ware Center on North Main Street and the Mulberry Center downtown. Rosecrance also runs the psychiatry unit at SwedishAmerican Hospital and recently started offering telepsychiatry there. Other area hospitals are taking notice.

“We understand that Rosecrance is piloting the program. We would love for them to expand it more into the community and over here,” said Dr. Harneet Bath, chief medical officer at OSF Saint Anthony Medical Center. “Telepsychiatry is a great way to overcome the shortage. We’re looking into options ourselves.”

OSF has one full-time psychiatrist on staff and several more who work in the hospital as needed. Rosecrance also has a partnership to provide some services at OSF.

“Even if you have a staff of psychiatrists, there are always weekends, holidays, overnights,” Bath said. “If you have telepsychiatry set up, you have a bigger pool of psychiatrists that you can turn to. All you have to do is turn on a computer screen and you can talk with a provider.”

Kuna, who also has a private practice in Wheaton, still sees some patients in Rockford on Fridays. Most of his patients, however, have happily switched to seeing him over the Internet on a secure audio and video system.

“It’s been a shocker for me how well it’s been accepted and how comfortable they are in this setting,” he said. “I’m not feeling like I’m compromising anything.”

Telepsychiatry allows centers and hospitals in cities where it’s harder to hire psychiatrists to get services to their patients.

“Sometimes, we’ll hear that it’s hard to get in to see psychiatrists or that they have a hard time seeing them in a timely way,” said Dr. Thomas Wright, a Rosecrance psychiatrist. “We have a system where we can get people in pretty quickly, but it may not be who they want to see.”

Rosecrance has seven full-time equivalents in psychiatry. The center is in constant recruitment mode because vacancies are so hard to fill. “We struggle with it all of the time,” Wright said. “Telepsychiatry is just one of our answers.” The only drawback, Wright said, is that most insurance companies won’t cover it. Right now, most of Kuna’s telepsychiatry patients are on Medicaid.

Telepsychiatry is not without its bugs.

“You have to rely on an Internet connection. Sometimes it’s slow. Sometimes it’s faster,” Wright said. “If it’s slow, it can make the conversation disjointed or difficult to follow. It can be costly, too. You have to have someone in the room while you have the psychiatrist online.”

The technical side of telepsychiatry gets better all the time, Kuna said.

“In the beginning, we had some technical problems. As we keep doing it, we have less and less. We also have backups on backups on backups. If the audio goes out, I can call on my office phone. I also have a cellphone.”

Kuna’s patients have adapted well to seeing him over the small screen, he said. People open up to him about their problems through the TV the same way they would in person.

“There’s a box of Kleenex there for a reason,” Hall said, motioning to the tissues at the edge of her desk.

“It still feels very intimate,” Kuna said. “It doesn’t feel like you’re talking to some robot. . People tell you what they want to tell you whether in person or through the screen. You work with what they tell you.”

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Source: Rockford Register-Star, https://bit.ly/1FlcpPR

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Information from: Rockford Register Star, https://www.rrstar.com


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