Telehealth Best Practices: Dr. Michael Mazius of UWM-Milwaukee On How To Best Care For Your Patients When They Are Not Physically In Front Of You

Get present, skip multitasking: When I notice whoever I’m working with isn’t in the moment, I almost always ask him or her to let go of whatever else he/she/they is doing and just focus. I remind my patient unless we’re really present with each other, the psychotherapy is unlikely to be of much benefit. I’ve found people respond well to this instruction, although kids from time to time continue to multitask.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Dr. Michael Mazius.

Director of North Shore Center, Dr. Michael Mazius specializes in the treatment of children with Attention Deficit Disorder, Academic Underachievement Syndrome, and stress and mood disorders. Dr. Mazius also provides marital and family therapy. Dr. Mazius is active in working with school systems providing teacher consultation and is active in the community, speaking to parents on a wide variety of topics pertaining to child development, parent-child attachment and neuroscience-informed parenting. Dr. Mazius is an adjunct faculty member in the Department of Psychology at UWM-Milwaukee.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

Way back in 1981, I became a law school dropout. While trying to find myself, I enrolled in group therapy, and while there, discovered my interest in psychology (which began during my undergraduate school years) was a real thing. After talking to a psychologist who encouraged me to return to law school, I decided to buck that advice and head into a PhD program in clinical psychology.

Can you share the most interesting story that happened to you since you began your career?

It’s not one interesting thing, it’s far more than a handful of gratifying and memorable moments with patients in psychotherapy sessions. Just yesterday I spoke to a parent looking for a psychotherapist for her son. At the end of the conversation, she told me she attended one of my lectures 20 years ago and that a simple message I shared stayed in her mind all these years: let your kids fail and never lose faith in them. That kind of feedback fulfills me and makes the work I’ve chosen to do gratifying. It keeps me going, even during a pandemic.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

One of my favorite life lesson quotes is “live with patience and confidence.” If we’re lucky, our lives are long and we’re unlikely to hit our stride for quite awhile. Even when we do, trip ups are inevitable. If we live with patience and confidence, we can find it possible to keep going and enjoy most of what happens day-to-day.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

I’m particularly grateful for having a warm and supportive relationship with my high school biology teacher. It was a tough time for me, my mom was dying of lung cancer, and he made time for me. I hung out in his classroom almost everyday after school and just laughed, which made a difficult experience a little easier. We reconnected after 40 years recently and I was able to thank him for what he did for me when I was in high school. My appreciation for teachers runs deep; my mom was a teacher, and I know first hand the important role teachers can play in students’ lives. Much of my practice involves underachieving kids, and in treating them, I almost always work closely not just with their parents but their teachers. Without teachers, I wouldn’t be able to reach kids like I hope I do.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

The pandemic has taught me that when you share space with a human being, there is something about the experience that translates into knowingness. Telemental health isn’t not effective, because it is, but there is a different feel from being physically present with another person. The screen does create some type of meaningful barrier, whether or not renders psychotherapy a little less powerful, I’m not sure, and maybe not. But being with someone virtually isn’t the same as in person. This is still completely new, so I’m still figuring it out as I go.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

There are two significant challenges. The first is young kids, even adults, are prone to multitask when working with someone virtually. The research on this is very clear: you learn less when you multitask. Personally, I’m tired of telling kids to turn off the video game and please try to focus on us. I haven’t said that to adults yet, but I’m close. The second, on a more somber note, when I’m sitting with someone who is crying, it feels like I can’t be as helpful if I’m not in the same room. Maybe that’s true or untrue, but that’s just how I feel. Therapists are trained to be thoughtful about touch — when to, when not to. Clearly, that’s out the window when you’re working virtually when someone might need a reassuring touch.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)

1. Get present, skip multitasking: When I notice whoever I’m working with isn’t in the moment, I almost always ask him or her to let go of whatever else he/she/they is doing and just focus. I remind my patient unless we’re really present with each other, the psychotherapy is unlikely to be of much benefit. I’ve found people respond well to this instruction, although kids from time to time continue to multitask.
2. Give a virtual hug: When I’m talking to someone who I think would benefit from the appropriate use of touch, I will say to him/her/they, “I wish I could give you a hug right now, because I think you need it,” and that seems to have helped.
3. Get out there, virtually: My common practice when working with kids is to work with their parents and teachers if that’s needed. Even though I’m not in schools right now, I’ve had a countless number of virtual sessions with kids’ teachers and that has proven effective. Just because we can’t get into the same office doesn’t mean we can’t get into conversations with critical people in our patients’ lives. We can and should do this with telemental health.
4. Don’t be a Luddite: Those of us who haven’t grown up with technology now find ourselves in a position to learn how to be tech-savvy. Don’t be afraid to share screens, play video games during sessions. This is the perfect time to be creative with technology. Don’t fear the opportunity, embrace it. What’s the worst that can happen? You hit a wrong button.
5. Power down and recharge: When your virtual day is over, stay away from screens. The neuroscience teaches us excessive screen use slows down the amplification of our brains; it actually can wear out the white matter. We need to take care of ourselves in order to take care of our patients. Zoom fatigue is real (so is Doxy.me fatigue), so when you’re off-duty, read a good book, take a walk, disconnect from screens as much as possible. When you’re out (safely) with a friend, make sure you share, because you need to talk, too. Fill yourself up so you can fill others.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

Licensing laws may make it impossible, even with telemental health, to work remotely. However, if your patient is moving away but will reside in the same state as you or if he/she/they move to a state where telemental health is authorized, now you can keep the therapy alive rather than terminating early. I have patients who go off to college; before, I may not have been able to keep the therapy alive. Now I can. The patients can keep our relationships and progress moving forward.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

I use Doxy.me, a HIPPA-compliant format. It has worked wonderfully. There have been few if any technical glitches and the screen-share application helps me and my younger patients stay engaged.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

I’ve been very impressed with Doxy.me. I can’t think of any meaningful enhancement to the platform.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

I hope people know that telemental health is a highly effective form of psychotherapy and shouldn’t inhibit them from seeking it.

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

I’ve embraced telemental health because of what it has done for people during a pandemic and what it may mean for people who live in remote regions of the world and may need psychotherapy. At the same time, I’m looking forward to returning to the old ways and working with people in person.

Is there a part of this future vision that concerns you? Can you explain?

It’s unclear how we’re going to function when we get to the other side. I’m fearful, and maybe I shouldn’t be, that people will choose to remain at home for work and go virtual more of the time. I believe we’re social organisms who derive positive energy from each others’ presence. I plan to continue to bang the drum for getting out there and being with people more than we’ve been able to once we are on the other side of this pandemic. Virtual interaction is fine, but compared to the real thing, I believe the differences are meaningful.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

The movement would be all about the contagion of giving. The pandemic, hopefully, has taught people how much they and others benefit when we put ourselves second. Wearing masks, making time to help others less fortunate than ourselves, this is what life, in my view, is really about.

How can our readers further follow your work online?

By subscribing to my YouTube library through my clinic North Shore Center. Our last series was called Figuring It Out Together where we tackled timely COVID-19 mental health questions. We’re currently working on a series about anxiety and how to make our lives more meaningful.

Youtube Channel: North Shore Center LLC

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.