This feature is part of Amwell's Meet Our Providers series. Read on to learn more about the doctors you can visit on Amwell for online care.
Cynthia Horner, MD, is a family physician with over 25 years of experience in women's health, pediatrics, and health program development. She is the mother of two daughters with a large extended family, and has traveled and worked in the U.S. and Africa. At her core Dr. Horner believes that people everywhere share a common right to kindness, dignity, and respect.
When did you first decide that you wanted to pursue medicine?
When I was a sophomore in high school, I had a fantastic chemistry teacher who made science come alive. He was a bit crazy — jumping on lab tables to illustrate a point — but he helped me realize that science and medicine are really about solving puzzles in ways that help people. I knew that was something I wanted to do.
Why do you think Amwell has been a good fit for you?
I love our mission of helping people gain access to more affordable, high quality care. I have served in a few different communities over my career — from a relatively affluent suburban community to relief work in sub-saharan Africa, and I’ve found that no matter where a person lives, we all want— and I believe deserve — excellent care from a compassionate and available doctor. I have two daughters who are trying to figure out their careers right now and my one piece of advice for them is to follow their passion and work hard to make a difference in the world.
We’re so happy you chose this path! What’s your favorite part about practicing online, in comparison to traditional in-person care?
Even though online visits are often shorter, I have more time to explain the why behind treatments to patients.
When I worked at a traditional in-person practice, I took care of everything from urgent care visits to well baby check-ups. I often didn’t have enough time to educate my patients on the little, but important things like why a woman’s period might be irregular, or why you don’t need antibiotics for a viral infection.
Traditional practices don’t leave a lot of time to focus on education, especially when it comes to more complicated care, like women’s health. With online care, I can do a deeper dive into women’s symptoms and talk about a broader spectrum of treatment rationales. I love the education aspect. An extra few minutes make all the difference!
Do you have a specific case where using online care was more beneficial than going in person?
Last week I saw a patient online who wasn’t going to see a doctor because she thought it was only a sore throat. She opened her mouth, uploaded a picture, and I took one look and told her, “You need to go to the ER right now.” She had a tonsillar abscess.
A quick triage visit from her home with a doctor helped her know not to wait until the next morning, and probably saved her a stay in the hospital.
Also, there was a woman who spent her summers far away from her primary care provider (PCP). She was going through menopause, and a month into her summer was experiencing significant hot flashes. She couldn’t get back to her primary care provider for another three months. She wanted to know if there was anything she could do. Online care was convenient for her and we were able to talk through all of her options. I prescribed a low-risk medication to relieve her symptoms for a short while until she was able to get back to her PCP.
What are the conditions for women’s health that you most often see?
We see a lot of urinary tract infections and get questions about periods, menopause, painful sex, and family planning. Even with the occasional conditions for which we refer women to in-person care, we can help them understand what might be going on and what to look for in the next steps of their care.
What’s your favorite feature of the app?
The image upload feature and, of course, video visits!
How has practicing online helped your schedule?
The amount of paperwork is significantly lower than what I had in traditional in-person care. Also, the lack of a commute helps. I can do activities up until my shift and then five minutes later, I can transition to work. I am able to see more patients each day because I’m not wasting time on a commute.
What are some common misconceptions you see online?
I think the biggest misconception that I hear is people who think online medical care is just a dial-a-prescription service. We’re board-certified, highly-experienced medical professionals that use the same diagnostic evaluations and decision-making processes as with in-person care. People are often happily surprised to see that we actually provide holistic care for their condition, not just a prescription transaction.
How often should women get a health checkup?
It varies depending on her age and individual health. She should speak to her primary care provider (PCP) first, but generally women 21 and over should see a PCP every one to three years (more frequently for ongoing conditions or medicine follow-ups). She should have:
- An annual breast exam (opinions sometimes vary on this)
- A blood pressure check, especially if she’s on medication like birth control
- A Pap smear every two to three years if she’s sexually active, and more often if she’s had a recent abnormal Pap smear
Women in menopause or ages 50 and over should get a women’s health checkup every year.
How can online care fill the gaps on how women have some of these visits?
I honestly think that we can help a lot. An online — or virtual — care first mindset can help you get treatment from home or help you determine whether in-person care is necessary.
We provide a lot of care in between routine visits such as addressing urgent care issues which come up, provide health education, or refills. We can review routine screening recommendations in detail and take the time to talk about any personal concerns or specific health risk factors.
For example, if a woman has gained 30 pounds, we could spend time talking about a diet that might work, how to find a nutritionist (even online!), and I’d probably recommend she get her cholesterol and maybe a thyroid level checked. Labs would require partnering with a primary care provider or a women’s health provider.
Since the start of the COVID-19 pandemic, we’ve seen online healthcare rapidly expand beyond one-time urgent care visits. We are increasingly working together with primary care and specialty care clinicians to provide care which frees them up for care that requires a hands-on visit.
What do you want more women to know?
In the United States, people are educated on the need to exercise more and eat right. But there’s a lot of misinformation out there on what a healthy lifestyle looks like in different phases of life. What a 55-year-old woman needs is different from what she did when she was 25.
The needs of our bodies change throughout life. Helping women know what to do, and motivating them to follow a healthy lifestyle, is so important. If clinicians get really good at it people will need doctors less. That, to me, is a victory.
What are your favorite tools for patients to use to manage their health?
- For smoking cessation there’s a free website called smokefree.gov. It has practical and effective steps to help people quit for good.
- For general health, Familydoctor.org and health.gov are great resources.
- For breastfeeding moms, I recommend the app called Lactmed. It helps them know if a certain medicine or over-the-counter supplement is safe while nursing.
For a final question, what animal would you say best describes you and why?
An otter because they’re so full of energy and happiness. They’re very busy creatures who seem to be constantly taking care of their families, and they have a reputation for being chatty and a little bossy, but very affectionate. I hate to say it, but that’s me!
Thank you, Dr. Cynthia Horner. We’re so happy you’re on Amwell helping women get care each day.