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Telepsychiatry and Queuing

One of the characteristics of any part of medicine that I’m aware of is that the work tends to be “bursty,” meaning there is seldom a steady flow of work. Instead, work is often crazy busy for a while, and then not-so busy, then crazy busy again, and so on.

Throughout my medical life, I’ve been in lots of circumstances where crazy busy times have led to some hair-raising experiences. Sometimes there’s some backup (like in a hospital during the day), but a lot of times there isn’t. When I was a resident in the ER, it wasn’t that unusual for me to be responsible for several patients whom I didn’t even know past a five-minute triage conversation. Some really hair-raising things happen when people are sick and nobody taking care of them has had enough time to really get up to speed on what is happening.

Telepsychiatry would be a really good way to handle these kinds of “overflow” situations. Of course, I’m not suggesting that people who are grossly disordered should be taken care of by telepsychiatry exclusively, but I can think of lots of situations where a few minutes of consultation (with either with a staff member or a patient) with someone doing telepsychiatry would be a superior way to handle the crazy busy times and serve the patients better and more safely.

I won’t try to explain the math, but queuing theory suggests that it would make more sense to have multiple consultants available by telepsychiatry to several ER’s (for example), than to try to have a consultant available in every ER because the multiple consultants have more capacity to handle the crazy busy times.

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