In Arizona, Sara Gibson, MD, a psychiatrist with Northern Arizona Regional Behavioral Health Authority in Flagstaff, was the first to practice psychiatry via telemedicine.
It was November 1996, and Gibson had just returned to work after being on maternity leave. “I was covering Apache County, on the New Mexico border, where there are only two towns, St. Johns and Springerville,” she recalls.
“Travel is always an issue – and it was even more so after the birth of my son. My husband is a physician who’s on call a lot. And so NARBHA approached me and said, ‘This is totally new, would you be willing to pilot this?’”
The entire state of Arizona is a federally designated "mental health professionals shortage area." Gibson saw telemedicine as a way to bridge the gap between her and many of her patients.
While some other psychiatrists have resisted the option of seeing patients via videoconference, “that was a barrier I didn’t have,” Gibson says. “I was enthusiastic and willing to make it work.
“It’s still about getting the care to the patients, and sometimes that means trying different things. And this way, I can see two patients in the time it takes to drive three hours round-trip. And it dramatically increases compliance with appointments if you can be seen in your own community.”
Gibson has found telepsychiatry to work well for her pediatric patients, 4 and older. “Kids are just really comfortable with technology in a way their parents may not be,” she says. “I have a little stuffed toy Eeyore that I use to get their attention. And they play with me. They hide under the desk. I can follow them around the room with my camera and see all I need to see. I can zoom in, zoom out, and run around the room with them.”
Gibson also has found that adults who have been abused or traumatized are often more comfortable with telemedicine than with face-to-face sessions.
“I really believe that a telemedicine evaluation is equivalent to face-to-face,” Gibson says. “I don’t feel like I’m making compromises at all. I feel like I’m doing what’s best for the people I serve.”
