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Improving telemedicine and in-person management of rheumatic and autoimmune diseases,during and after COVID-19 pandemic outbreak. Definite need for more Rheumatologists. Response to: ‘Can telerheumatology improve rheumatic and musculoskeletal disease service delivery in sub-Saharan Africa?’ by Akpabio et al
  1. Francesco Caso1,
  2. Antonio del Puente1,
  3. Nicolò Girolimetto2,
  4. Marco Tasso1,
  5. Corrado Caso3,
  6. Raffaele Scarpa1,
  7. Luisa Costa1
  1. 1Department of Clinical Medicine and Surgery, University of Naples Federico II, School of Medicine and Surgery, Napoli, Campania, Italy
  2. 2Department of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia Romagna, Italy
  3. 3Italian Federation of General Practitioners, FIMMG, Salerno, Italy
  1. Correspondence to Professor Raffaele Scarpa, Department of Clinical Medicine and Surgery, University of Naples Federico II School of Medicine and Surgery, 80138 Napoli, Italy; rscarpa{at}

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The letter by Akpabio and colleagues1 raises an important question and describes an interesting scenario related to their geographical area. However, this scenario can easily be applied to several other experiences. In fact, the situation described by Akpabio and colleagues1 with regard to rheumatological centres being located in great urban areas as compared with the shortage of these specialists within their periphery is quite frequent.

The impact of the COVID-19 pandemic on everyday practice gives us an opportunity to speed up the development of the process already known as telemedicine, which may be an attempt to correct some of these disparities.

The authors of the letter indicate many and relevant suggestions which we find very adequate and deserve immediate consideration. In particular, during this phase, we feel that it is necessary to manage this development. What can this mean? First of all, it should be outlined that telemedicine does not mean reduced need for specialists. Each one of us has experienced the burden of this approach. Telemedicine, as compared with the traditional inperson medical consultation, means greater effort in terms of more complex visit planning, of time spent, of organisation (detailed patient charts …

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