The majority of our cases are referred by frontline health workers, yet we do receive a number of cases each month from physicians who need second opinions from physician volunteers. Providers who operate in large hospitals or outpatient clinics have constant access to professional colleagues with whom to share ideas, discuss patients and collaborate on treatment plans, but this is not the case for our partner physicians. They are usually the only doctor at a rural hospital with hours of travel between them and another colleague, so they rely on The Addis Clinic teleconsultations for virtual professional discussions.
A 5-day-old infant was brought by his parents to a rural hospital in East Africa because he seemed quite sick. The physician on duty immediately completed a full assessment, noting that the baby was having difficulty breathing, was grunting, and irritable. His heart rate was elevated, and upon examination of his lungs, the physician heard crackling sounds. He initially suspected severe pneumonia, and started the patient on two different antibiotics, a nebulizer and a pain and fever reducer. However, after 3 days of this treatment the patient was not improving. This East African physician transcribed the details of the case into our telemedicine platform and sent us the case, asking for pediatrician input. A pediatrician volunteer with significant global health experience immediately responded that the baby seemed very sick with neonatal sepsis and pneumonia. She recommended changing one of the antibiotics to one more appropriate for a newborn and asked some additional questions about the baby’s heart sounds, recommending referral to a larger hospital if the referring doctor heard a murmur. Our volunteer pediatrician also recommended starting the baby on some IV fluids with dextrose until he was able to nurse or take a bottle.
While this case was just referred, and we do not yet know the outcome for this patient, we do know that the referring physician learned something new and now has the expertise of a pediatrician at his fingertips thanks to our telemedicine system and volunteers.