Telehealth Best Practices: Michael Gorton of Recuro Health On How To Best Care For Your Patients When They Are Not Physically In Front Of You

An Interview With Dave Philistin

Convenience is one of the one of the things patients look for above everything else. From making appointments to viewing their medical records, patients want staying healthy to be easy. It’s essential to offer digital tools that allow your patients to conveniently receive care off-site. Virtual visits via telemedicine and telehealth tools can minimize the hassle with travel or wait times.

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 Michael Gorton.

A quintessential entrepreneur, mentor, and company builder, Michael leads the Recuro Health team which includes several leaders from Teladoc, where he served as the founding CEO and pioneered an industry-changing health care model.

Michael’s decades of experience as a strategic visionary, impacting the telecommunications, music and healthcare industries include a leadership role as a founder of Principal Solar.

He has served as a partner of the Texas Acceleration Group (TAG), an entity formed to assist startup companies and participated as a founder of Palo Duro Records. He is also credited as a founder of Internet Global. Prior to this, he worked as a project engineer at Dallas Power & Light.

Michael earned a B.S. in engineering from Texas Tech, an M.S. in Physics from the University of Texas at Dallas and a Juris Doctorate from Texas A&M.

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?

The backstory for Teladoc begins on Kilimanjaro, Africa’s tallest mountain. After I built and sold a company in 2000, I called a few friends to go climbing the mountain. One of those friends was Dr. George Byron Brooks, a NASA flight surgeon who sits at the control panel in Houston to look after the astronauts. When we were climbing, he tells me about a story from the 1990s about the state of Texas having to set up a program that gets inmates a doctor within 24 hours. Dr. Brooks was called into make that work.

He was thinking that I had just built and sold a company for $122 million and he said we should do this and build another company and call it Cybermedical Services. I didn’t like the name and it almost killed the deal. We filed for articles of incorporation, doing business as Teladoc. Dr. Brooks was convinced that the name Cybermedical Services would be remembered but I am glad Teladoc won out. Our consumers are patients who want simplicity. Teladoc has a dual meaning: tell a doctor and use a telephone to do it.

If people look at the history of Teladoc, they see a telemedicine industry we created. But for me, we really created efficiency where there was none before. In between this time, I worked to build other companies, but remained connected to the telehealth industry. Ultimately, I was being asked to get back into the business full-time.

Then COVID began and I realized the next step of efficiency was to make healthcare better for patients as well as doctors. Through Teladoc, we built a national network of telehealth physicians serving over two million members who could connect in 12 minutes or less for $35 and also provide more income and less actual work time for doctors. Meanwhile, the cost of care keeps going up and people are diagnosed with illnesses as they are dying. I thought maybe it’s time to bring more efficiency to a much broader perspective and that’s the beginning of Recuro, an integrated digital health solutions company that transitions the U.S. healthcare system from a reactive, disease-focused model to a population health, outcomes approach. We want to catch things before they become an issue, be preemptive and make money at the same time. We want to keep people healthy and keep healthcare costs down while helping people live longer and work longer if they chose to. Now we say 60 is the new 40 but in my perspective in the next 10 years we will have technology that 100 is the new 35. It also involves doing 15–30 key things to stay healthy.

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

Back to Kilimanjaro, the young generation is always looking for unicorns: a company that is worth $1 billion from the onset. From a simplicity perspective, there are unicorns on Kilimanjaro. I found one and it is called Teladoc. These things begin with an idea when you are climbing a mountain.

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

Success in the entrepreneurial world is three p’s: a plan, people and persistence.

1-Have a transformational plan to change the world.

2.Surround yourself with people who are smarter than you. There are a couple of aspects to that people part: You can’t bring your ego into the boardroom, if you do, you fail. The company has to be priority №1. On the people side, you don’t just bring a whole bunch of smart people together. You need a corporate culture. You can’t have one person who thinks they are smarter than everybody else that destroys the corporate culture. Everyone has to know each other’s strengths and weakness and how to lift each other up. The football analogy is the quarterback doesn’t throw to the tackle because the tackle isn’t designed to catch and run if he catches. Remember to fortify the weaknesses and rely on the strengths.

3. Persistence is key. For every single company I have ever built, I have been knocked down and kicked in the teeth and told this is never going to work. If you get knocked down and kicked in the teeth, you stand up, put a smile on your face and go again.

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?

When I was building Internet Global, I found out that there was a man in my network by the name of Nathan Morton and Nathan was sort of famous because he had been a store manager at a new, small department chain called Target. And he had this idea to turn Target into a major store. So, he went to the owners of Target, and he told them his plan and they said they think it’ll work. And when it did work, he got written up in some papers and this guy, who was building a hardware store company, he called Nathan and said, “I want to build this hardware store called Home Depot and I’d like you to come help.” And Nathan designed a plan about how to grow a company.

And then in the late eighties, some geek in a plaid suit and a pocket protector said, “I want to build a computer store.” And in this particular case, Nathan had already done it twice. I think that I will do it, but I need to be the CEO. And he said, okay. And that became Comp USA, a $4 billion entity when it was sold to Carlos Slim. I met Nathan when Radio Shack was trying to turn around their computer store, which was a knockoff of Comp USA called Computer City. I called Nathan and we had good chemistry. What he said to me was: “I will help you and when you’re successful, I expect you to go out back and for the rest of your life, find young people and help them.” And I have over and over and over again, I’m always, no matter how busy I am, always trying to find somebody and give back. It’s those mentors I know that help knock down some of the walls and open the doors for us. And, we have to return the favor.

Bruce Quinnell was another person who helped get me where I am today. Nathan was on my board in the beginning of Teladoc, and Bruce was on the board all the way through Teladoc. And Bruce’s the guy who made Border’s Books, the giant that it used to be. Bruce and Nathan Morton became my mentors and the ones who helped open the doors.

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?

A patient is at ease given the familiar experience of just being in front of one another as patient and provider. For the provider, it is easier to read emotions and subtle cues in a face-to-face examination.

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?

Patients may feel uncomfortable because they aren’t in a typical person-to-person interaction, and the technology may create obstacles to the ease that in-person interaction can generate. The technology needs to be easy to use and set up before the appointment begins so the patient feels comfortable at the start.

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.)

My five recommendations for providers to best care for their patients NOT physically in front of them are:

1. Convenience is one of the one of the things patients look for above everything else. From making appointments to viewing their medical records, patients want staying healthy to be easy. It’s essential to offer digital tools that allow your patients to conveniently receive care off-site. Virtual visits via telemedicine and telehealth tools can minimize the hassle with travel or wait times.
2. To establish a strong patient-provider relationship, there needs to be a regular connection that often monitors and responds to patient feedback regarding what is and isn’t working. Real-time feedback can address patient concerns within a timely manner, which shows them that their provider cares about their experience and their health.
3. A good communication strategy that considers what’s important to patients before, during, and after their office visit can help providers deliver more personalized engagement tactics that motivate patients to take active roles in their care. From appointment reminders to post-visit follow-up, patients appreciate when they are regularly in touch with their providers and not just a name on their office or virtual visit schedule.
4. Patients want access to digital tools to schedule appointments, look at medical records or lab results and more. Providers need to offer a patient portal or mobile app for patients to easily access their medical records 24/7 to look up information on their own.
5. Providers need to collaborate with their patients about their care. While patients want and value their doctor’s recommendation, they want to feel like they have a say in choosing which option is best for them. Engaged patients want to understand why they need to do certain things to improve their health.

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?

With telehealth as a part of their chronic disease management strategy, patients connect more with their care providers, reducing the chance of a relapse in treatment and lowering hospital readmission rates. Telehealth helps patients with medication adherence and clinical and dietary outcomes.

Telehealth can extend the reach of physicians to a greater number of patients, providing virtual visits, remote monitoring and digital patient engagement tools to enhance their experiences with a broad health care team.

This care is less costly than traditional settings, improves recovery and well-being and eliminates the need to travel for appropriate services.

Telehealth is playing a major role in providing access to mental/behavioral care since it provides more options for convenience, privacy and safety than face-to-face meetings. In many cases, virtual consults have also been shown to be as effective as in-person visits.

Behavioral telehealth connects patients and providers to a wider network no matter where they live. It also provides more opportunity for patients and providers to connect with others who share the same language and culture.

With significant investments in behavioral health, there is a variety of services, including teletherapy and telehealth for substance use disorder.

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?

The modern smartphone, complimented access to broadband, Wi-Fi, 4G and 5G have helped evolve telehealth from a simple communication modality to a broader, functional engagement strategy, ultimately supporting omnichannel engagement strategy.

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

The optimal digital health solution uses a digital medical home TM strategy with an integrated, interoperable platform designed to house the tools, resources and support needed to manage a variety of health care issues and conditions in one place.

The best digital health solution is tailored so employers, payers and providers can build their own digital health platform with targeted solutions for certain populations. It needs to be fully integrated and customized with existing solutions and works with features and capabilities, including virtual care/behavioral telehealth, at-home lab and onsite testing, genomics and much more.

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?

Virtual and in-person care should be the same. The standard of care should be the same regardless of the communication modality or site of care. To paraphrase a mentor, Dr. Jay Sanders: the exam room isn’t where the doctor practices, it is where the patient is.

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?

We are excited that the broader medical communities and patients are embracing virtual care. What excites me is that the technology has caught up with its promise and vision and the ubiquity of informative data is powering better outcomes.

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

The government must make telehealth reimbursement permanent. Telehealth adoption is currently tied to the surge in COVID-19. There is sentiment that as soon as the public health crisis abates then we can return to normal, in-person care but the value of telehealth is so great: the future vision is that telehealth is health.

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 application of telehealth or digital health that scales and ensures that everyone gets the right care in the right setting at the right time.

How can our readers further follow your work online?

They can look at our website, www.recurohealth.com and follow me on my LinkedIn page where I talk about all my involvement in the companies I have either started or continue to help grow.

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