Clinician Corner: Meet Dr. Jaskirit Gill, MD

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This month, we’re sitting down to talk with Dr. Jaskirit Gill.

Q. How did you find Iris and decide you wanted to be an Iris provider?

A: I was referred to Iris by a colleague. Before I worked at Iris, I was doing locums work and looking for a more permanent fit. I talked to several colleagues at other telehealth companies and one at Iris. I did my due diligence. I spoke to other telehealth companies, along with Iris. However, there were a few things that made me choose Iris.

One of them was that they had a benefits package. It was a few years ago, and many telehealth companies were doing 1099s. Another unique thing was the fact that they did the match process. I felt like there was a lot of thoughtfulness. They thought about what would be a good long-term fit. When looking for a permanent job, you’re really thinking about what will be sustainable. I felt out of the options available at the time, Iris was the most sustainable option for my career and my family. My family is growing, so it was important for me to think about what would work three or two and a half years ago and what would work now.

Q. What does a typical day as an Iris Telehealth provider look like for you?

A: I start in the morning reviewing the huddle. I’m lucky that my clinic gives me a huddle. We have the patients scheduled, so I know who I’m going to see every day. I get some notes from the primary service provider and the nurses. I start the day very prepared. I know exactly what to expect, which is a huge positive, especially in psychiatry which can be unpredictable. This workload is very predictable, and I really appreciate that.

After I do the huddle, I see my morning patients. I have time to catch up on my notes, have lunch, and then see my afternoon patients. Then, I wrap up, and I’m usually done by five, which is really nice. I think one of the biggest things I like is that it’s really done at 5. I’m not being called afterward. For me, I think that it’s really important that there really is a clear end to the workday. That provides a lot of help not only for my family but for my peace of mind.

Q. What do you love about being a telepsychiatry provider?

A: I love providing patient care to people who may not have had access to a psychiatrist before. The clinic that I’m at is more in a rural area. I think they only have one psychiatrist in the county. I know many patients I see were on a long waiting list, or their family doctor was doing their best to manage the condition. Telepsychiatry really helps to reach those areas. A lot of people may not want to live in a rural area but would still like to help service those areas. I felt Iris provided a really unique opportunity to live in a region that I want to live in, but still be able to provide services to people who may not have access to care.

Q. How do you foster connection with patients virtually?

A: I think it’s really the same as in person. You make eye contact, listen, and meet them where they’re at. I feel, maybe since I grew up with technology, and especially in the pandemic, talking with my friends on Zoom felt no different. It’s as if they were sitting in front of me. I would say it’s identical to how you connect in real life. You listen, and you really try to put yourself in the other person’s shoes. Then you use the tools and resources you may have to help that person with whatever situation they’re dealing with.

Q. As a healthcare professional, how do you manage work-life balance?

A: I think I’m really lucky in that regard. Telehealth makes it much easier to manage work-life balance. Before, when I was doing locums, it was very disruptive to my family life because I would be moving or need to be in a certain place; maybe that was not close to my family. And with telepsychiatry, one thing I thought about that’s unique is even if I move, my family, or my husband, if his job moves to Chicago, that doesn’t mean I have to find a new job. I think before you move out of state, you may move 45 minutes away because that’s where affordable housing is, that means finding a new job. But I don’t think that’s the case anymore. With my role, I can live anywhere and still keep my job, which is unique.

I think the key with telehealth is that it’s not only sustainable, but it’s also really stable. I do not have to go to a locums assignment here or there. I can stay with my family for the most part. And still have benefits, pay my bills, and be around if grandma needs anything. That’s huge for me.

Q. What are your biggest learnings from your time at Iris?

A: I learned, especially during the pandemic, the power of people. I’m just one person, and Iris is a big company with lots of people who do lots of things. There are lots of patients and clinics. I was amazed at how well people worked together and their resilience. It really touched me to realize that healthcare providers are doing so much, but there are also so many people behind the scenes who make that happen. That keeps the lights on and makes sure I have internet. In really challenging and uncertain times, people persevered, and I think I played a small part in that if any. It was the collective people and the power of that.

Q. What’s the most rewarding part of your job?

A: The most rewarding part is my team. I’m privileged to have a role where I provide care and service to others and try my best to help people. The fact that I have such great support with Iris and such great support with my clinic – all of that is really unique. A lot of doctors who were discouraging me from telehealth said I may not know who I’m working with or what I’m getting into. However, Iris did a good job of helping me really understand my clinic.

When I did my interview, I wasn’t interviewing with just one person at the clinic. I met the whole team. They told me what to expect. I went through a week-long orientation with the Iris team, and they helped me get situated with the clinic. They didn’t just drop me off and leave me. They’ve been with me for the last two and half years, making sure I’m doing okay. Making sure the clinic is happy.

All that collaboration made a difference and every person at Iris really cares. They are all about the patient and helping the clinic solve their problems, and also helping me – if I have a small camera issue or something, somebody cares. I heard telemedicine is like a one-person island; you’re by yourself and left to figure it out on your own. I haven’t felt that way at all.

Q. What do you love about working with Iris?

A: Working here has been a big blessing on my life. When you go into psychiatry, and especially doing locums before, I saw many different ways of providing care. And then I joined Iris and felt from the beginning I was so lucky. I’m so lucky to be working with the clinic I’m at. I was so lucky to have Ted as my Clinical Operations Manager. And then to have Martha now, and then the IT people, every day, it was like, “I’m so lucky.” This is such an amazing role that I have.

As my family needs changed, my scheduling availability changed, and I was relieved that the clinic and Iris could work with me and make a new schedule as my family grows. I thought that was really special. I’ve heard about places where they tell you, “This is the assignment. This is what we expect from you.” And working at Iris was the reverse. I came to them saying, “I love the clinic. I want to stay here, but I’m only going to be available these days of the week.” And then they worked with me to make that happen.

Q. Why do you think telepsychiatry is important to the future of mental healthcare?

A: It is the future. I don’t think we have a choice about it. It’s where a lot of patients are. I see a large age group, especially the younger patients, who prefer it. It’s more convenient for them. I think as people give it a chance, they’ll realize many benefits. They can see a doctor where they may not have been able to before. There’s a lot of flexibility in terms of scheduling too. We’re just at the beginning of what telehealth can do, and Iris is really at the forefront of that.

There are so many things that are still yet to come. The fact that we have all this health data. The fact that we can use that in a way that’s meaningful to patients. There are so many places for telehealth to go. I’m excited that I’m a part of it. It’s been nice to see how it’s evolved through the pandemic and where it will go even after that.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be more proud to say, “thank you” to our very own Dr. Jaskirit Gill. If you’d like to learn more about working for Iris Telehealth, contact us today.

Telehealth Update on Centers for Medicare & Medicaid Services (CMS) Rules

There are many barriers that can keep people from getting the mental health care they need. One of these key barriers is access. Thankfully, organizations like the Centers for Medicare and Medicaid Services (CMS) continue to drive new initiatives to mitigate this barrier and help more people get the care they need. In November 2022, CMS finalized new rules to expand access to behavioral health.

Key initiatives include flexibility in billing and supervision as well as permanently covering certain telehealth services. These new flexibilities improve access to substance use and mental health services for patients all across the country.

These new telehealth rules are an optimistic next step in expanding behavioral health care to those who need it most. That’s why we’ve condensed everything you and your providers need to know about the newly expanded rules.

Overview of new CMS rules

At a high level, these new changes by CMS include flexibility in supervision denoting that a supervising clinician does not need to be on-site for certain behavioral health services. In addition, Medicare will pay opioid treatment programs to start MAT (medication assisted treatment) with buprenorphine for care delivered via telehealth or by a mobile unit.

Let’s take a closer look at these two final rules:

1. Physician fee schedule final rule: This new rule helps ensure patients needing behavioral health care can access the care they need. By no longer requiring clinicians to be on-site for billable behavioral health services, it opens up greater opportunity for those enrolled in Medicare to see their providers.

This rule states that certain behavioral health clinicians can provide care without their supervisor on-site. CMS permits clinicians like licensed professional counselors (LPCs) and licensed marriage and family therapists (LMFTs) to bill under the general supervision of a physician or non-physician practitioner rather than direct supervision for any mental health or substance use disorder (SUD) treatment.

Additionally, the final physician fee schedule rule also clarifies that any mental health or substance use disorder (SUD) treatment service is billed under general supervision.

2. Hospital outpatient prospective payment system final rule: The hospital outpatient prospective payment system final rule allows hospital outpatient departments to bill for certain in-home telebehavioral health services when patients cannot go in person for a visit but need to be seen. This expanded access is crucial for reaching those in rural communities who need care.

This final rule requires patients to have an in-person visit within 6 months before and every 12 months after the telehealth visit. However, if the patient and provider agree that the risk and burden of an in-person visit outweighs the benefits, they can forgo the in-person visit.

Additionally, the final rule allows audio-only visits when video technology isn’t available.

Core benefits of the new CMS rules

These new rules provide benefits for providers, patients, and organizations overall. Here are a few core benefits for each person in the healthcare ecosystem:

  • For patients: Access is everything in mental health care and these new rules from CMS help patients secure continuity of care. Additionally, as this access improves, there are more opportunities for patients to find the right care.
  • For providers: Making the public health emergency telehealth flexibilities permanent means there is no longer a worry about a disruption of workflow and care – should this line of service no longer be a billable option. The new rules create flexibility in delivery of care; via telehealth and a more flexible supervision model allowing clinicians to reach more patients.Additionally, the CMS rules provide new codes for psychologists and LCSWs for behavioral integration, allowing services to be delivered in a primary care setting which ultimately improves patient access to substance use and mental health services.If you’re a provider looking to learn more about navigating these new changes, check out this article by CMS.
  • For organizations: As the new rules permanently cover certain telehealth services, organizations who are delivering care via telehealth are able to maintain this model that has ensured continuity of care during the pandemic and improved the number of patients served.

How Iris Can Help

At Iris, we’re always here to clarify and help your organization understand new rules and regulations in the evolving telehealth landscape. If you have any questions about the new CMS rules, we can help guide you and your team through these new changes. To talk to one of our team members, contact us today.

How Telepsychiatry Can Decrease Clinician Burnout

According to a study done before the pandemic, over one-half of physicians and one-third of nurses experience symptoms of burnout. Following the pandemic, we’ve seen an unprecedented rise in the prevalence of burnout among clinicians due to demanding hours, lack of work-life balance, and higher demand for providers.

Burnout generally refers to physical and emotional exhaustion coming from chronic stressors. For many providers, it can feel like they can’t provide their highest quality of care or that they’re not functioning in a high-quality system.

The state of clinician burnout

In 2020, the clinician burnout rate was reported to be around 25%. Over the past couple of years, that number has only increased. It can be challenging when providers balance raising a family, longer work hours, personal life, and their mental and physical health.

Many behavioral health providers are on the front lines of the mental health crisis. Providers across the country are having a hard time handling many patients, especially when there are few resources to provide quality care to patients.

And, due to the provider shortage, there is enormous pressure and insufficient providers to combat the mental health crisis.

What providers can do to identify burnout

Burnout can be hard to identify, but physical exhaustion and the need to recharge and self-care can be early signs. Sometimes burnout can show itself in emotional exhaustion as well. Pay attention if you feel you cannot emotionally engage in your relationships with your family and friends or are having difficulty enjoying your hobbies. These can be early red flags that you are suffering from acute burnout.

It can be hard to take time for yourself as a provider, especially when you want to meet the needs of your patients. Taking time out for yourself and engaging in self-care can help mitigate and alleviate burnout.

Ways telepsychiatry can alleviate provider burnout

When implemented properly, telepsychiatry can help address the challenge of provider burnout. According to Physician’s Weekly, 20% of providers said greater flexibility in their work schedules could help avoid burnout. Here are just a few of the ways telepsychiatry can help decrease burnout:

  1. Telepsychiatry can help clinicians to have a better work-life balance, decreasing burnout. Through telepsychiatry, providers can have a sense of control and autonomy over their schedules. Providers can have the ability to spend more time with their family, engage in self-care, and take appointments from the comfort of their own home.
  2. No more long commutes. Providers can skip the commute and conduct remote visits with the help of telepsychiatry. When providers can work from home, they no longer need to worry about wasted time or the expense of a commute. This is especially true in rural areas where they might have to travel further to see patients.
  3. Practicing from a setting where you are more comfortable improves patient quality of care. With telepsychiatry, providers can provide optimal care from the comfort of their own homes.

How can organizations help their providers?

As an organization, you should make sure your providers aren’t isolated during difficult times. Here are a few ways you can help your providers:

  1. Remind them about employee assistance programs and other places to get mental health help. Ensure they know who is on their team and who they can talk to, especially when they are virtual. With a culture of open communication, encourage your providers to talk about their concerns.
  2. Monitor your provider’s mental wellbeing. Check in with your providers about their mental health. Sometimes, when taking care of their patients and their loved ones, it can be challenging for providers to take a step back and think about themselves. Burnout can be mitigated by creating an environment where a provider’s mental health is a priority.
  3. Give your clinicians ample time for their personal lives by not overscheduling them. Make sure you’re giving your providers as much flexibility as you can. Reinforce safety practices, monitor their stress, and provide support for your providers. And, remember to encourage your providers to take their PTO.

Resources to support providers and looking towards the future

According to a study on physician suicide before the pandemic, an estimated 300 physicians die by suicide every year, and that rate has continued to increase. It’s becoming more important to keep an eye on depression and anxiety for physicians during this difficult time. Many providers are leaving the profession or retiring early, which is also contributing to the provider shortage. By ensuring our providers are feel mentally and emotionally well, we can keep more people in the profession and provide the best quality possible.

There are a few resources that can help you manage clinician burnout from an individual level and organizational level. These toolkits, TEDTalks, and guides can help you prevent burnout for yourself and advocate for a healthier workplace culture. Here are a few resources:

  1. TEDTalks: TED has a list of TEDTalks that can help you mitigate burnout. They share great information on how to bounce back and get you back in the groove of everyday life through various tips and tricks.
  2. The American Psychiatrist Association Toolkit for Well-Being Ambassadors: This slide deck can help you support, advocate, and spread awareness about burnout in your organization. The APA also has a toolkit, manual, and flyer to help you address the burnout needs in your workplace.
  3. The Agency for Healthcare Research and Quality (AHRQ): AHRQ’s guide on physician burnout shows the causes of burnout and lists research-backed interventions for clinician burnout.

Where Iris Telehealth can help

At Iris Telehealth, we strive to make implementing a telepsychiatry solution for your organization as easy as possible. We take care of the paperwork, credentialing, and licensing for providers. Iris can work alongside you every step of the way to help take the burden off of providers and your organization. Contact us today to see if our telepsychiatry services can help your providers and organization provide high-quality care for your patients.