Psychiatrist Philip Muskin is quarantined at home in New York City because he’s been feeling a little under the weather and doesn’t want to expose anyone to whatever he has. But he continues to see his patients the only way he can: over the phone.
“I’ve been a psychiatrist for more than 40 years; I have never FaceTimed a patient in my entire career,” says Muskin, who works at Columbia University Medical Center, treating outpatients in his clinical practice, as well as people who have been hospitalized. Normally, he says he walks patients to the door, shakes their hand or touches their arm or shoulder to reassure them. “Now I’m not doing that, and that’s weird to me. So it’s a whole new, very unpleasant world.”
The pandemic has already robbed many of his patients of their livelihood, or at least their sense of safety. People literally feel trapped, he says.
That, in turn, is leading to a spike in anxiety, depression and addiction — not just among Muskin’s patients, but across the U.S. To try to address those needs, physicians of all kinds are adopting the techniques and technology of telemedicine, which had been only slowly gaining wide acceptance — until the pandemic forced everyone to isolate themselves, mostly at home. The recent demand for telecounseling, as well as for other types of online medical visits, is causing backlogs of care for many providers who offer it.
There are now also even fewer in-person treatment options for some of the most acutely mentally ill in New York, Muskin says; the psychiatric wards at Columbia, where Muskin normally works, have all been converted to beds for COVID-19 patients.
“That means,” he says, “we have no place to send patients who need admission.”
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