Adapting to Telehealth and Online Consultations – a modern Naturopathic perspective

Written by Alexandra McPhee | 1 May, 2020

Telehealth

Remember when you could get in your car and drive to your appointments, kids in tow, Keep Cup in hand? I still can… just!

As natural medicine practitioners, the way we practice and provide treatment to our clients has been astronomically affected by physical distancing requirements and self-isolation. Unfortunately for some clinics, this means closing the doors practically overnight whilst still having the day-to-day expenses looming overhead. The loss of clients and income for massage therapists and other more manual practitioners is devastating.

Clinical practice and business ownership keeps us on our toes with new challenges, even without a pandemic thrown into the mix! So, for those of us practicing a modality that can be practiced from a physical distance, we are fortunate to have the option of pivoting into the online space.

Some would argue that online consulting defies the traditional principles and philosophies of Naturopathy – the features of the modality that set us apart. These include taking the time to perform thorough physical examination, checking the vital signs, iris and tongue analysis and other more subtle observations of the patient.

As daily life becomes increasingly digitised, the community relies more heavily on the internet to maintain a connection, access to services and essential items. In this new reality, offering online consultations to clients not only makes sense, it may be critical in preventing illness – particularly in smaller clinics with high client numbers.

Logistically speaking, consulting online has never been easier. As a young Naturopath who has grown up using technology and the internet, it is a natural direction to take.

Whilst plenty of the more seasoned practitioners out there do embrace technology and the online realm, there also seems to be a good dose of resistance towards change, and a fear of new technology which is not completely unfounded. Technology is hard to keep up with and can make you want to throw your computer out of the window, even if you are relatively tech-savvy.

But Hippocrates once said that “Life is change and we must adapt, not only to survive, but to thrive as the talented practitioners we are!” Okay, he didn’t really say that, but I think he would if he were still in action.

Before we get stuck into how it all works, let’s weigh things up.

The pros of consulting online:

  • Ability to provide continuity of care to clients during a pandemic
  • Enables self-employed practitioners to stay afloat
  • Location independence – work from anywhere (with a stable internet connection)
  • Serve rural and remote clients with limited access to natural health care
  • Cast a wider net of potential clients interstate and internationally
  • Ability to work from home which can slash overheads and expenses
  • Automation – systems and processes can be streamlined to reduce workload for you and provide a smoother experience for clients

The cons of consulting online:

  • No face to face contact with clients – it can take a little longer to build rapport
  • Sometimes you miss subtle verbal or facial cues and interrupt each other
  • Technical issues that may result in you miming to your client to turn on their audio
  • You may need to get creative around physical examination techniques

I began my business with the desire to consult online. So there was no mad hustle to set up the logistics of an online practice overnight. In saying that, it was fairly straight forward.

How to conduct an online consultation

I use Zoom video conferencing software (no affiliation with any of the products I mention here). When you schedule a meeting, you simply share a link with your client. At the appointment time, the client clicks the link and enters a digital waiting room. When you, the practitioner, is ready, you admit the client and begin the consultation. This is highly accessible for both the client and the practitioner – all you need is a smartphone or laptop. Zoom has recently had to step up their security and privacy features and I recommend researching and exploring other platforms in order to find one that best suits your needs. In my experience, clients are highly receptive to online consultations. The client management program I use called SimpleClinic, is integrated with Zoom. So, when a client makes an appointment, the meeting is automatically scheduled and the link is sent to the client in the confirmation email. I have also adapted my confirmation email to include instructions on how to use Zoom from a client perspective. So easy!

Taking payment for online consultations

There are a few options for taking payments and they probably don’t differ much to what you already have in place. SimpleClinic is integrated with my SquareSpace website, which allows clients to make payment at the time of booking. This really eliminates any risk of clients simply ending the call and going MIA after you have provided treatment. However, you could also manually send them an invoice, collect credit card details for entering into your clinic’s EFTPOS machine or arrange a bank transfer. Whatever you choose, make sure you are storing any client information securely.

Dispensing herbal tinctures and prescription products

This is another part of the treatment process that is easily worked around. If you keep a physical dispensary, you can still dispense your remedies. Of course, extra time will be required to bubble wrap the tincture bottles into oblivion and troop down to the post office in your mask and gloves. On the upside, you can finally re-use the bubble wrap and cardboard you have been hoarding from your supplier orders! You could also explore courier services like Sendle, Officeworks Mailman, WizMe or E-Go.

Whichever you choose, and I learnt this the hard way, keep scrupulous records of which product you are sending to whom, at what address and the tracking numbers. It’s easy to go into autopilot and start questioning whether you did write the correct postcode on that parcel. Remember that until your products reach the client, they are your responsibility in the event of a breakage or disappearance.

If this all seems like too much hard work, set up a wholesale account with an online prescription service like Vital.y, Ariya or Natural Script. At your request, they will dispense and deliver prescription products to your client at home including herbal tinctures.

Physical examination online – getting around the lack of contact

University training dies hard! No-one can deny the importance of physical examination when it comes to providing a duty of care and accurate treatment to the client.

So how to get around this when the client is 2,000 kilometres away and physical signs are being filtered through camera, time and space? As I mainly treat skin conditions, I ask clients to send clear photos of their skin in natural light. I also ask them to send images of their eyes, tongue and nails. You’d be surprised at the level of detail that a phone camera can capture!

Usually, we are not the sole health professional involved in the care of our clients. If needed, I can recommend that the client book with their GP to undergo further investigation. For instance, if a client reports bloating, abdominal pain and diarrhoea, I can write a referral letter to their GP, asking whether stool testing for parasites, blood and inflammatory markers is warranted. I can also suggest that the client simultaneously request an abdominal examination from their GP to check for any abnormalities. As well, some foreseeing and innovative clinicians like Katie Barron have already developed online training programs on how to best approach physical examination during online consultations. There is always a way around an obstacle!

There you have it. There are many advantages to online consulting and telehealth appointments, which begs the question – how many practitioners and clients will return to a physical setting once distancing is relaxed? For the time being, the ability to consult online is a lifeline for small businesses, practitioners and the clients who still want and need natural health care and support.


Alexandra McPhee

Alexandra (Lexie) McPhee is an Endeavour College of Natural Health Alumni and qualified, practising Naturopath. Her special interests include writing, communication with the natural world, the history of medicinal plant use and creating her own herbal oils and salves. 

Read more by Alexandra McPhee

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