Testosterone replacement therapy in the era of telemedicine

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Nelson Vergel

Founder, ExcelMale.com
The events of the 2019 SARS-CoV2 virus pandemic have all but ensured that telemedicine will remain an important aspect of patient care delivery. As health technologies evolve, so must physician practices. Currently, there is limited data on the management of testosterone replacement therapy (TRT) in the era of telemedicine. This review aims to explore the potential benefits and pitfalls of TRT management via telemedicine. We also propose a theoretical framework for TRT management via telemedicine. Telemedicine provides patients and physicians with a new mechanism for American Urological Association guideline-concordant TRT management that can increase patient access to care and provide a safe space for men who may otherwise not have been comfortable with in-person evaluation. However, there are significant limitations to the use of telemedicine for the management of TRT, including the inability to perform a physical exam, inability to administer specific medications, technological barriers, data security, and medical-legal considerations, and both patients and providers should engage in shared decision making before pursuing this approach. Understanding and acknowledging the potential pitfalls of telemedicine for TRT management will enable both patients and providers to achieve optimal outcomes and satisfaction.

 
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I may be old school but I do not like this telemedicine at all. I feel like doctors are just taking cookie cutter approaches to medicine and all personalized treatment has gone out the window. My last cardiologist loved this method and gave me exactly 10 minutes of his time and was gone. Cha ching....Most of the time he was not even prepared for the conference and I am not even sure he knew who he was talking too. Just going through the motions for money.


This to me needs to go the same direction as online teaching which as been a great disservice to students. For years educators have been wanting to go to online teaching. So we got our chance, kids in the meantime dumbed down to the point standardized test scores are at the lowest in history and dropout rates were at their highest. We lost a generation of kids with this experiment.

When medicine comes to the point where there is no longer face to face communication then the human factor has been completely lost and patients will not get the quality care they need. I refuse to see a doctor under these circumstances. The Covid 19 excuse was just that. You are a doctor, you see sick people so get over it.

Honest.....I was waiting to get in to my appointment at a Quest in Katy on a Saturday morning, next door to them was a doctors office. On the door they had a sign, if you have symptoms of Covid 19, do not come in this office. REALLY? So you refuse to see and treat sick people? Why do they think people go see a doctor, because they are healthy?

Not many doctors left that have any bed-side-manner any more. It’s very hard to have any at all when you are dealing with a computer screen.
 
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This to me needs to go the same direction as online teaching which as been a great disservice to students. For years educators have been wanting to go to online teaching. So we got our chance, kids in the meantime dumbed down to the point standardized test scores are at the lowest in history and dropout rates were at their highest. We lost a generation of kids with this experiment.
Someone has some test re-centering to complete.

 
Exactly @readalot. The same thing is coming to medicine. I get telemedicine now for no cost with my insurance policy, I refuse to use it. For a $5-$10 co-pay I can have a face to face office visit. Of course I am goinig to use up much more than 10 minutes of their time.


 
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I like the web portals all doctors use now. You can set up appointments, see the results of a recent vist, refill prescriptions and even email your doctor. Last week I saw my PC doctor, he came in and shook my hand and sat and talked. The first conversation was about how the Pharmaceutical industry in America was ripping American off so badly. He is from the Dominican Republic. Then we went into the FDA trying to get into medicine and tell doctors how to take care of their patients. He suggested I watch a couple of documentaries on Youtube about this same subject. I must have spent 30 minutes with the guy, then we talk about my issues. I walk out feeling like this doctor is a good friend and truly cares about my health. Most other doctors have the bed-side-manner of a executioner. Like I said, I am old school in a lot of thing, my wife worse. In Buenos Aires they will still make house calls. She had the same doctor her entire life.
 
Beyond Testosterone Book by Nelson Vergel
Older men would prefer in person instead of telemedicine

I think most men would prefer face-to-face visits with their doctors, but in the era of TRT with limited knowledgable providers, this is where telemedicine shines.

Telemedicine is convenient, but not ideal.
 
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