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Comment & Response
June 26, 2018

Virtual Care as a Specialty—Reply

Author Affiliations
  • 1Weill Cornell Medicine, New York, New York
  • 2Department of Emergency Medicine, New York Presbyterian/Weill Cornell Medicine, New York
JAMA. 2018;319(24):2560. doi:10.1001/jama.2018.5674

In Reply Dr Schwamm disagrees with our proposal for a new specialty focusing on virtual care. We think that there is a gross underestimation of the competencies required to be an effective medical virtualist. Although we agree that most physicians will use telemedicine for more routine communication with patients (eg, changes in medication, postoperative follow-up), the slow pace of adoption nationwide suggests that expecting all clinicians to become competent in and use virtual care is flawed.1 The technology is not a unique technology and is fast becoming a commodity. The allocation of a random number of slots in the physician’s schedule for virtual visits does not appear to be scalable, whereas dedicated resources for virtual care such as in urgent care settings or third-party–provided resources seem to be more predictable, consistent, and less disruptive to workflows. Part-time or full-time virtualists (physicians and other clinicians) would be able to use the virtual medium as a professional environment for their practice of medicine. In addition, with the increased focus on clinician wellness, virtual care is an additional practice opportunity providing structured and flexible options.