Virtual Care Q&A with Erika Dobson, MOT, OTR/L, BCG, CDP

How has telehealth helped make you a better clinician? 

I think telehealth has helped me become more concise and accurate in the way I cue certain movements and has helped me cut out a lot of the extraneous cueing I frequently did in person. We’ve all heard “less is more” and I think it’s so true, especially in geriatrics!

Telehealth has also helped push my clinical skills by allowing me to be more thorough in providing health management education – often when I’m in person with someone, they expect to be moving constantly. But being on a telehealth platform, I find that they’re more willing to talk through what they’re experiencing, which opens the door for helping them understand and more fully navigate their disease or health condition.

How do you build a strong rapport with your patients over telehealth?  

Mostly the same as in person! I always try to lead with a smile, ask how their day is or how they’re feeling, make them feel important and understood. I’ve found that at the end of the day, empathy and compassion are the same, whether in person or virtual. Telehealth is also nice because we can connect over certain things that we can’t in person – for example, my cat has made some guest appearances – we call her the “cheering section.”  

Do you think telehealth has facilitated patients to be more independent with their daily routines? 

Absolutely! I think providing care through a telehealth platform empowers patients and caregivers to understand that their buy-in and commitment to THEMSELVES is the most important piece to their success – something about being virtual helps patients “own” their care and recognize that I’m a partner, but they’re the leader. Because of that, my telehealth patients have been more adherent to their exercise and activity programs, more willing to bring up struggles in their routines (which allows us to problem solve), and more aware of the difference between performance vs. true independence. That combination of ownership and awareness has been really huge.

Do you have a telehealth success story that is memorable or special to you? 

Yes! I currently have a telehealth patient that I’ve been seeing for knee pain and generalized deconditioning – she has a complicated medical history including some prior TIAs, cardiac events, obesity, fibromyalgia, and depression. We worked a lot on functional strength training to address her knee pain but also built in health management strategies – we focused on health literacy training so that she could understand her medications and conditions, make better decisions about nutrition, understand the connection between her mood, activity level, and behavior, and safely self-monitor during exercise. We frequently used motivational interviewing and goal scaling to help create an activity plan that felt doable for her. We also problem solved for some of the social determinants of health that were affecting her, like access to safe spaces and social isolation.

After about 20 visits, she texted me that she reached a milestone – she walked a mile with her son and felt good doing it! This was huge for her and helped generate even more excitement and buy in – during our next visit, she was independently goal scaling to get even further on her next walk and referencing some of the health management tools we had worked so hard on. She kept saying “I haven’t walked that far in 10 years!”.

This case was also super memorable for me, because this is a patient I would not have been able to see if not for telehealth (based on her geographic location) – so it really hit home that what we’re doing matters, and that every patient we get the opportunity to treat is a potential life changed!

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