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Telehealth Best Practices: Stephen Offenburger of Airrosti Remote Recovery On How to Best Care for Your Patients When They Are Not Physically in Front of You

An Interview with Dave Philistin

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 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 Stephen Offenburger, DC, Director of Teleservices and Digital Solutions for Airrosti.

Dr. Stephen Offenburger is Director of Teleservices and Digital Solutions for Airrosti and a telehealth provider with Airrosti Remote Recovery. Before joining Airrosti in 2009, Dr. Offenburger earned his Doctor of Chiropractic from Texas Chiropractic College in Pasadena, Texas. He earned his undergraduate degree from San Jacinto College in his hometown of Houston, Texas.

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?

I grew up working in my father’s construction business, doing pretty much anything anyone needed — mainly the most undesirable jobs. I learned a lot about work and the importance of having the mindset that just because something is new, doesn’t mean it is impossible. In undergrad and graduate school, I worked full time in the bar and night club industry. I worked all night, slept in the parking lot, and went to class all day. I became a manager by the time I turned 19 years old. I did a master’s in neuroscience while I was earning my graduate degree in chiropractic. That knowledge has helped me a lot through the years. I graduated in 2006 with all three degrees and took a year off to travel the world before starting my clinical career.

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

I loved practicing in the clinic, and gathered many great stories along the way, but I think my favorite story is that I took a sabbatical to create what has now become Airrosti Remote Recovery, Airrosti’s digital musculoskeletal health solution. I always wanted to help a ton of people in the world and make an impact. I feel like that can happen now.

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

My favorite quote from Ray Dalio: “It’s just another one of those.” Essentially it means the first time you encounter something difficult or scary it can be overwhelming — first love, first heartbreak, first failure, loss of loved one, etc. Over time, the older you get, and he more of these experiences you have, the less challenging it feels. When something hard comes your way, put yourself in your future self-perspective and realize this will happen many more times and, “it’s just another one of those.”

None of us can 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 have been so blessed to have had an endless list of people that believed in me or helped me grow throughout my life. Probably the person closest to me is my wife. We have known each other since we were 16 years old. We have had many struggles throughout the years, but through it all she has helped me grow both as a husband and as a person. It is not easy being married to an entrepreneur, but through her adventurous spirit and openness to change, she has allowed me to have the freedom to take chances, which has ultimately led to my success. She has also now given me a set of twin boys, Jake and Elwood (yes, the names of the “Blues Brothers”). That gift alone drives me more every day.

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?

There are many benefits of having a patient in front of you, the biggest one being that there are no technology glitches in person. Overall, seeing a patient in three dimensions is helpful when reading body language. However, providers can mimic this skill on screen to still be effective. It is also easier for most doctors to make a connection with patients in person. We have been communicating face to face for thousands of years and our brains are just wired that way. Making connections over a screen is a skill that must be learned, since the timing of conversation and nonverbal communication is very different.

When it comes to diagnosis and treatment, in-person appointments tend to be easier because having a patient in the clinic allows providers the opportunity to palpate and observe the body. During virtual appointments, computer camera angles can make it difficult for providers to see the patient’s entire body and how all the joints move. Rehab wise, telehealth appointments are limited because providers can only watch and give verbal feedback, not tactical.

For example, we cannot set up exercises over Zoom, ensure proper body position, or foam roll the exact right spot.

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?

Because we use all our senses including intuition, sometimes providers will skip an exam, history taking, or detailed questions to get to a derived conclusion. In the digital musculoskeletal world, because we must use technology to do an exam, we use pre-determined orthopedic exams and take a more in-depth history, so we don’t miss anything.

The pace of in-person appointments can be hectic and a provider might skip over explanations. This can lead to a lack of detailed communication and decreased patient attention and buy in. Patients who come into the clinic sometimes suffer from white coat syndrome where they feel nervous to see a doctor. Telehealth is a good option for patients who feel more comfortable at home and need providers who can use the virtual platform to slow down and take time to make a connection.

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. Listen and pry for details
  2. Over communicate
  3. Keep communication flowing
  4. Design care knowing the limitations of telehealth
  5. Empower, educate, and provide guidance

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?

Telehealth can create several opportunities and benefits that traditional in-office visits cannot. One of the biggest benefits is scale and geo-flexibility. In testing Airrosti’s digital product for effectiveness while I was overseas, we found that people all over the world have pain and other musculoskeletal problems. During this time, I was seeing patients on four to five continents.

When you do musculoskeletal telehealth, it is all about the patient and empathy is key. Providers must focus on teaching, guiding, and empowering. When you can’t physically do something for your patients, you get better at realizing how powerful, long-lasting, and truly life-changing your knowledge can be to others. So many patients along the way have thanked me. They thought things would just get worse or they would have to stop doing what they love. Now they have a way to treat themselves and feel in control of their lives.

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 think it’s a combination of things. Convenient and fast internet service, easy user experience onboarding for video calls (no downloading app), self-treatment tools that can be easily shipped to the patient (think Amazon shipping speeds = immediate use and treatment), text messaging for constant feedback of what is and is not working without waiting for the next visit.

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

I wish the adoption curve was more advanced and that patients knew how many things can be treated effectively in the telehealth world. There is still a lot of hesitancy among the general population to feel comfortable in this space. All of this will come in time, but I every day I see people get better who had no idea that something like this was possible prior to giving it a try.

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 think we are a few years away from general population adopting of any of these, but I am excited about all of them. AR probably has the most immediate use case in the healthcare field, but I believe MR is catching up very fast.

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

Only the hesitancy of adoption by providers and organizations. Inherently people don’t like change and sometimes are affected negatively by the constantly shifting landscape. There are so many great doctors and clinicians in the world. However, I am always concerned that if doctors and clinicians do not continue to adapt and be a part of advances in healthcare, patients will not have knowledge and access they need to take advantage of them.

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. :-)

Question what is “known” and have hope that anything is possible. Take the onus of responsibility for your health on yourself. Find guides, education, and other things that will help you. Even if it is not 100% it is a step in the right direction. Too often we have been taught to take what we are told is wrong with us and just live with it. We are learning every day, and more conditions are being treated in unique and creative ways. I hope everyone seeks the latest knowledge and guidance to lead a more fulfilling life.

How can our readers further follow your work online?

https://www.linkedin.com/in/doffenburger/

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

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Dave Philistin, CEO of Candor

Dave Philistin Played Professional Football in the NFL for 3 years. Dave is currently the CEO of the cloud solutions provider Candor