Human World

Marc Goldyne uses technologies to deliver medical care

Marc Goldyne is a California dermatologist who uses his computer to work with patients who live hundreds of miles away. He practices what’s called telemedicine.

Marc Goldyne: My waiting room is essentially my email box.

If a rural patient needs to see a specialist – for a skin problem, for example – she may have to travel for hours to get a 15-minute consultation. Dr. Goldyne said this is not uncommon in his field.

Marc Goldyne: Forty-two percent of Americans are considered to be living in areas underserved by dermatology.

Using telemedicine, a local doctor collects relevant medical information and images from the patient. It’s sent through a secure email system to Dr. Goldyne’s computer. He makes a diagnosis, and then follows up with the doctor and patient to recommend treatment.

Marc Goldyne: The goal is to really move data, and not move people, whenever it’s possible.

He believes this adds efficiency to the healthcare system.

Marc Goldyne: You’re allowing more timely access. You can prevent delayed diagnosis. You can prevent multiple office visits. You can prevent wrong medicines being prescribed. All of these factors can lead to millions to billions of wasted dollars.

According to the National Center for Policy Analysis, many patients find it hard to see their doctors, overuse emergency rooms when they can’t get timely access to care, and do not think that they are receiving adequate information from their doctors. Dr. Goldyne believes that increasing the use and frequency of information technology in healthcare might improve access to timely care, while reducing costs and improving the quality of care.

Marc Goldyne: In my field of dermatology, if you want to see a dermatologist, it’s an 8 week wait. If you have an acute problem, 8 weeks is just inappropriate. Whereas, if the doctor can send a consult to a specialist, the turn around time can be 24 – 72 hours.

Dr. Goldyne said that the lack of overhead – offices and support staff are not necessary to practice telemedicine – allows him to operate at 50% of the traditional cost. Plus, he is able to help more patients.

Dr. Goldyne: If I’m seeing people in person, I have only a limited number of office hours. When I’m doing telemedicine, I can come home in the evening and take care of consults. I can purely look at the data that’s been sent to me, and the pictures, and then let the primary care provider know what I think of the diagnosis, what therapy should be instituted, and how to follow the patient up. It requires no sacrifice of time on the patient, other than visiting the primary care doctor.

Dr. Goldyne said that he has seen 2,500 patients via telemedicine in the past six years. He described one patient’s treatment.

Dr. Goldyne: I looked at images on the electronic medical record, and it looked like malignant melanoma. I said she needed to see someone to have this taken care of. I got a call from the patient the next day, and she said she had a two month wait in the rural area where she lived. I called the University of California San Francisco Melanoma Center, and I was able to get her in not in eight weeks, but in two days to have it removed. That’s an example of where we saw a patient and it was determined we really needed to bring her from her hometown, to the city for more timely care.

Areas applicable to medicine include dermatology, ophthalmology, cardiology, psychiatry, and neurology. Dr. Goldyne added that telemedicine is intended as a support, not an alternative, for regular doctor visits.

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August 31, 2009
Human World

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