Telemedicine Then and Now

Jul 1, 2021
By
Michale McClure
Cardiologist, Gracie Square Hospital

Telemedicine Then and Now  

An insight into David Zlotnick’s Telemedicine journey

 

I was born in Montreal in 1977- I am married with five kids and have always known I wanted to be a doctor.

Ever since an early age I’ve known that I wanted to go into medicine- it was really either that or farming. I mean, it dates back to grade9/high school when I realized my favorite science was Biology, so being interested in it from an academic perspective was one of the earliest signs that this was the field for me.

It’s always been about connecting with people and helping them by decreasing their pain with the skills that I’ve learned. So, putting together the science and human aspect of medicine, it was a relatively clear choice for me.

I began my journey at McGill University, where I got my Bachelor’s in science and human physiology. After completing my undergraduate studies, I went on to McGill medical school where I completed a residency in family medicine in 2006 as well as a fellowship in emergency medicine in 2007.

I really believe that, although seemingly very different, both these practices (family and emergency medicine) do really complement each other. I never really wanted to be super specialized in any singular aspect of medicine. I’ve always been fascinated by many different areas of it which is why family medicine really spoke to me. Family medicine gave me a broad insight into all different kinds of issues that might come up in a case. On the other hand, I was also very drawn to emergency medicine because of the urgency involved in what people needed at any given moment and the challenge involved in solving cases under time tough constraints. Emergency Medicine is always exciting because it involves new and exciting cases which are all pathology rich, but due to circumstances, are information poor and you need to use whatever you’ve got in order to get the right diagnosis to the patient.

This relates back to telemedicine in many ways. You never know who’s going to show up and what problem you’re going to have to solve. I find these two practices crucial for my role within telemedicine, or medicine in general, because it allows me to view cases and build protocols from different angles, I view each case from a family doctor perspective but also through the lens of an emergency doctor. Using both these angles allows me to build protocols to guide and train our doctors at M&B in order to examine each case from a holistic perspective, taking into consideration all possible scenarios.

My experience in telemedicine really started during my fellowship at McGill Medical School around 2006, where I started my experience moonlighting in northern Canada with the Inuit population. The health care system was distributed in such a way that there would be one ‘big’ village(around 1,500 people) with all the doctors and then a few smaller villages across the coast that would only have nurse practitioners. Doctors would then go over to the smaller villages once a month, but if there were any emergencies, the nurses would need to call the doctors who would then instruct them on how to take care of the situation.

In situations like these, your medical and practitioner abilities are severely limited because you can’t see the patient- everything was done over the phone. You can’t imagine how frustrating this was. It was the first time in my career where I had to make big decisions without even looking at the patient over video. Handling these situations have allowed me to gain the experience needed to build the foundation of my expertise within the telemedicine industry.

I took on this challenge for 3-4 years, flying to northern Canada about five times a year to one of those big villages where I would assist the nurses over the phone. In some cases, when a patient’s life was at stake, I would fly in with an air rescue plane in tempestuous weather to care for them.

While continuing telemedicine practices up north I also continued in my regular practice, working as a family doctor in a clinic as well as an emergency physician in a tertiary care academic hospital.

In 2008 I moved to Israel, where I became the Medical Director at Terem, an immediate care center across Israel. Around this time, I also began practicing telemedicine to help treat Canadian veterans by prescribing medical cannabis as traditional medical therapy had failed in managing their PTSD.I found this ability to help those who had no one else to turn to, to be extremely rewarding and have continued offering this service till this day.  

This whole journey has brought me to where I am today, at Med&Beyond, a company I’ve co-founded.

The level of telemedicine that Med&Beyond offers is a culmination from other forms of telemedicine I’ve had experience working with. By utilizing my past experiences, we have been able to build a platform that exudes patient-centered care and empathy using the best technology available today. Some studies that even show how

more compassionate and human consultations improve patients’ responses to treatment.

The application Med&Beyond lets people see a doctor within minutes wherever they are. This kind of service was unimaginable a few years ago. The ability to see a doctor within minutes without having to make the effort to go somewhere if they just subscribe to our service is amazing. Aside from this, the technology we use (like our AI chatbot) allows patients to enter symptoms which are then sent as alerts to our doctors and provides a whole other level of patient-doctor interaction that makes the experience so much more accurate.

All in all, I’ve found Med&Beyond to be highly unique in the sense that we are made up of a team of super-skilled and professional doctors who I have had the pleasure of working with and who exhibit the qualities that I really care about, like empathy and compassion while also being amazing diagnosticians.

Taking all that I’ve learned over the years in this telemedicine journey and using it as the foundation for being a good team leader and establishing this unique and driven community has been unbelievably fulfilling.

 

FUN FACT ABOUT DAVID: He loves farming- his dream is to retire on a farm one day and grow his own crop.

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