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I had the opportunity to interview a forward-thinking physician, who saw the benefit of telemedicine as early as 2015.  Dr. Naomi Zilkha has been a practicing pediatrician since 1993 and predicted the telemedicine transition that is now happening.  For the last few years, Dr. Zilkha has been using telemedicine as a platform to engage and connect with her patients. 

1. Why did you choose to become a pediatrician?

I remember knowing, at the age of 4, that I wanted to become a doctor.  I was a ‘sickly child’. By that, I mean that I got sick easily and had bad asthma that gave me significant daily symptoms and affected my daily activities a lot.  I remember at age 4 starting to take theophylline capsules for my asthma, which was a first line asthma treatment at the time. Oddly enough, I remember that the capsules were green and yellow, and my mother told me that they were made for me because they matched the colors of my childhood bedroom!

Since I was often sick, I ended up learning much of elementary school from home and reading a lot to pass the time. Also, from a very young age, I learned to check my pulse and my respiratory rate. I learned how to recognize when the pills weren’t enough and that I needed a visit to the Emergency Room where I was treated with epinephrine injections and oxygen.  I admired my childhood pediatrician, who was both a woman and a mom, became she seemed to always know what to do to make me feel better. She became my role model, and after going through so many medical challenges myself, I decided that I wanted follow in her footsteps and become a pediatrician to help children live their best possible lives, even with asthma. I have never seen it as a job, but instead, my calling.

2. When did you first learn about telemedicine?

In January 2015, while I was at home recuperating from a healthcare-associated pneumonia, I was watching daytime television.  Just by chance, there was a commercial from a health insurance company that was listing their services, and I saw the word “Telemedicine” come across the tv screen.  I called out my husband in the next room and asked him to google the word ‘telemedicine’ – after my husband told me what ‘telemedicine’ was, I decided that Telemedicine was going to be the next chapter in my medical career. I had feared that, after 20 plus years of private practice pediatrics, due to my worsening health issues, I was going to have to give up being a doctor.

3. Why do you mean by “I was going to have to give up being a doctor?”

 Although my asthma improved during my teenage years, it came back with a vengeance in my early 20’s. I did not let it stop me even when it was predicted that I did not have a long life expectancy and might not be able to handle the physically rigorous aspects of medical school, residency and beyond. As a pediatric resident, while my fellow residents and I were sick nearly constantly for the first year of our training, my fellow residents started to build up their immunity and get less sick over time. Unfortunately, the same was not true for me. I was nearly constantly sick, and once I started to work in private practice, often the sickest person I would see in a day was myself. When I did end up getting hospitalized, I was extremely sick because I taught myself to push through even when I felt barely strong enough to get through the day.

 In December 2014, I was admitted to the hospital with pneumonia and sepsis. It’s widely known that doctors often make the worst patients, and I was certainly no exception to that rule. My Infectious Disease doctor gave me a reality check that was very badly needed. I don’t remember verbatim what he said, but the gist was this: My pneumonia and sepsis was life-threatening because (as per usual), I put my patients’ health ahead of mine. He told me to think long and hard about making a change in my career path, or my stubbornness combined with my health issues, would likely kill me. It was after that, when convalescing at home, that I first learned about Telemedicine.

 4. How did you get involved with Telemedicine?

 Although I did recover from that hospitalization, I decided to take my doctor’s words to heart, and planned to retire from in-person pediatrics in July 2015 and start a career in pediatric Telemedicine. So, on January 1, 2015, I sent out CV’s to all the major Telemedicine programs at that time, and none were hiring pediatricians yet. Long story short, when I left in-person pediatrics, I went straight into pediatric Telemedicine, but the volume of patients was very low. I moved around from one Telemedicine platform to another as I learned more and more about Telemedicine and discovered what was a good fit for me. In 2016, I started working for MDLIVE as pediatric Telemedicine provider, and currently work for them as part of their Preferred Providers Network. Soon thereafter, I started working towards a new goal: I wanted to bring Telemedicine to a local pediatric super-group, Allied Physicians Group. Although my initial pitch to them in 2017 was declined, in January 2018, I re-pitched my idea to Allied’s CEO, and was hired to launch their afterhours pediatric Telemedicine Division in March 2018, which I did. I am very proud to have succeeded in taking Telemedicine from just an abstract idea in my mind in 2015 to launching a Telemedicine program with Allied Physicians Group that was able to scale up exponentially in March 2020 when the COVID-19 pandemic hit New York and offer care to 180,00 of New York’s children.

 5. What have you learned about telemedicine so far working in the industry?

I have learned that telemedicine gives me a way to still deliver high quality care to my patients while also enabling me to stay much healthier.  One of my favorite parts of being a pediatrician is the connection between me and my patients, and telemedicine gave me the platform to continue this connection.    

6. What does the future hold for telemedicine?

I think telemedicine is here to stay, even in a post- COVID-19 world.  Telemedicine gave me back the ability to take care of patients and I absolutely see it becoming a normal part of healthcare.   Telemedicine will continue to remove barriers for not only patients, but also for physicians.  I think physicians will be able to connect more with their patients virtually and become cohesive in their ongoing treatment.  Also, I think there will be an integration of Artificial Intelligence technology with telemedicine, just like what is occurring at Simply Speak. 

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