Don't change the channel, this may be important to your health

The NY Times ran an article about psychiatrists and their use of Talmudic in "TV Screen, Not Couch, Is Required for This Session" on June 8, 2006.

To me it seems psychiatry lends itself better to telemedicine than other specialties since shrinks do not conduct physical exams on patients.

Dr. Gibson said the lack of smelling and touching, at least when it comes to psychiatry, has proved to be a good thing. Being physically in the presence of another human being, she said, can be overwhelming, with an avalanche of sensory data that can distract patient and doctor alike without either being aware of it.

"Initially we all said, 'Well, of course it would be better to be there in person,' " she said. "But some people with trauma, or who have been abused, are actually more comfortable. I'm less intimidating at a distance."

States are pushing the trend since they want more mental health services for underserved rural citizens.

Psychiatry, especially in rural swaths of the nation that also often have deep social problems like poverty and drug abuse, is emerging as one of the most promising expressions of telemedicine. At least 18 states, up from only a handful a few years ago, now pay for some telemedicine care under their Medicaid programs, and at least eight specifically include psychiatry, according to the National Association of State Medicaid Directors. Six states, including California, require private insurers to reimburse patients for telepsychiatry, according to the National Conference of State Legislatures.

Does the use of telemedicine harm the personal connection made when doctor and patient are in the same room? No, according to the interviewees. (Of course, this is anecdotal evidence; there should be real research done on this question.)

"I just feel like she's here," said a 24-year-old mother of three who asked to be referred to as C. C was struggling with depression, anxiety and fantasies of suicide. "I sometimes forget we're not in the same room."

Dr. Gibson spoke up from her room in Flagstaff: "That's funny, I would say that I feel the same way."