Season 1 • Episode 103

Telehealth Isn't Enough for Rural Patients. Northwell's Dr. Chethan Sathya on Remote Monitoring, Home-Based Care, and Who Will Pay for It

How I Doctor with Dr. Graham WalkerNov 12 · 28 min

Episode Description

Dr. Chethan Sathya is a pediatric trauma surgeon at Cohen Children's Medical Center and Vice President of Strategic Initiatives at Northwell Health. In his first week as an attending, he operated on a six-month-old with a gunshot wound. The baby survived, and the case launched a second career: Chethan founded Northwell's Center for Gun Violence Prevention, built the We Ask Everyone firearm risk screening protocol that is now available nationally through Epic, and worked on All the Empty Rooms, this year's Oscar winner for Best Documentary Short.

In this episode of How I Doctor, Dr. Graham Walker sits down with Chethan to ask whether the public health playbook that moved gun violence into the clinical workflow can work on a different problem: why a patient in rural Iowa or Kansas can't see a specialist. Chethan helped launch the National Specialty Care Access Coalition, a health system led group of more than 20 systems, and he argues the answer isn't more video visits. It's tech-enabled care that reaches patients where they live, through remote monitoring, home-based care, and upskilled primary care, paired with payment models that keep local hospitals open.

Along the way they dig into why nuance matters in gun policy, how to screen more than 400,000 patients without judgment, why virtual care outside of stroke still lacks reimbursement, the licensure barriers that keep specialists from crossing state lines, and the tension between hospitals as businesses and as community lifelines.

The technology to reach rural patients largely exists. The harder question is who will pay for it.

What You'll Learn in This Episode

Why Chethan treats firearm risk like a vital sign, and how a harm reduction approach has made gun owners the program's biggest supporters
Why mass shootings, suicides, accidental injuries, and urban violence need different policy responses
Why tech-enabled care is more than telehealth, from remote patient monitoring to specialists taking quick referral touchpoints
Why reimbursement is the real barrier to rural specialty access, and how to incentivize local hospitals to survive
How state licensure and credentialing barriers limit physicians who want to see patients across state lines

Resources and Where to Find Chethan and Offcall

Find Chethan on LinkedIn: https://www.linkedin.com/in/dr-chethan-sathya-md-00707441/

Find Chethan's Northwell profile: northwell.edu/chethan-sathya-md

Northwell Health Center for Gun Violence Prevention: northwell.edu/center-for-gun-violence-prevention

Find Chethan on Instagram: https://www.instagram.com/drchethansathya/

Find Graham on LinkedIn: linkedin.com/in/graham-walker-md

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