With American workers increasingly choosing to work from home, one South Carolina woman is following suit, though in a profession still trying to find its place online.
Sherlonda Adkins, a Charleston-area physician assistant, began a psychiatry practice tailored to exist almost entirely on the internet.
Solutions that allow patients to access health care from the privacy of their homes or just about anywhere else are on the rise. Hospitals are developing ways to connect specialists to other medical centers, schools and patients' phones. Urgent care visits via a laptop have seen widespread adoption by the likes of pharmacy giants CVS Health and Walgreens. And inmates in South Carolina can see a mental health care provider from inside prison walls.
It's not just patients whose routine may be changing because of the telehealth trend. For Adkins, having the option on the table also gave her new flexibility in her job.
She graduated from the Medical University of South Carolina's physician assistant program in 2014 and went to work for a local psychiatry practice. Her patient base began to grow, she said, in part, because of the long wait times for psychiatrists in Charleston. In 2019, she came up with the idea to begin her own practice, called PsychConnect Health, which lives on the web.
"As long as I have internet, I can see patients," Adkins said.
As a physician assistant specializing in mental health, she said she knows some people are reluctant to show their faces at a psychiatry practice. Many also prefer after-hours appointments, she said, and the software Adkins uses allows people to book their own appointments at a time that's convenient for them.
For now, her clients will be South Carolina residents.
Citing frustrations with the reimbursement process, Adkins will not accept insurance, meaning patients will need to pay her directly. Initial visits will last one hour and will cost $250. Follow-ups are designed to be shorter and will run between $75 and and $130. Patients can submit their own claim to their insurers if they wish.
But finding ways to be paid for virtual health care remains "a major frustration" for providers, according to the consulting firm Foley & Lardner. South Carolina is one of just eight states that hasn't passed any law governing how insurance companies should cover telehealth.
Adrian Grimes, manager of external affairs for the SC Telehealth Alliance, said public insurance programs Medicare and Medicaid are ahead of the private sector in their approach to paying health care providers for telehealth visits.
Expanding access to virtual mental health care is one of the alliance's strategic goals. Telehealth works well for mental health appointments, Grimes said, because it's possible to evaluate a patient from a distance. Overall, the rise of telehealth is empowering for patients, she said.
"You're talking about less hospital stays, and people being able to manage their own health more," Grimes said.
The alliance provides funding for independent physicians and other providers who want to try to incorporate telehealth into their practices. South Carolina providers choosing to work entirely via the internet is still uncommon, Grimes said, but patients should expect to see a trend of more professionals attempting it.
Adkins said she wouldn't have been able to start her practice without the aid of a bill passed into law earlier this year. The legislation changed the physician assistant profession in South Carolina. Among those changes was a provision that changed the rule requiring assistants to practice a set distance from their supervising doctors.
Lifting the geographic restriction makes it possible for Adkins to practice across the state.
"This time last year, I never would have thought of this," she said.