In this time of COVID, many people are using some form of Telehealth options. In my jurisdiction we can use phone calls, or video calls to talk to our family doctor, as visits to clinics and the Doctors office are not yet back to normal. If people want in person care they can go to the emergency room. More and more people are doing this as we settle into our new normal. In an online Journal from Jama Internal Medicine there was an interesting article on Telehealth from a Doctors Perspective, which I thought was interesting. Here is some of what the Doctor said. For the complete link to the PDF article see the end of this post.
Many
physicians would say that some diagnoses cannot be made without examining a
patient in person. I am not sure how I am supposed to distinguish central vs
peripheral vertigo, diagnose otitis media, or determine if someone has
orthostatic hypotension without examining a person in front of me. In addition,
many of us have cases where an unanticipated finding on examination feels as
though it saved a patient’s life. A discovery of an irregular mole, a soft
tissue mass, or a new murmur—I do not forget these cases, and I do not think
the patients do either.
Finally,
the physical examination is one of my routines, 15 years in the making, that
has been taken away with the emergence of the pandemic. Starting with the
principles of active listening, gathering data, and creating a broad
differential, I had developed a way of practicing medicine that I felt worked often.
While I continued to revaluate this process, I did not question each day
whether a patient needed a physical examination. But the pandemic has forced me
to deconstruct my routine, including the physical examination, in a way that
leaves me on uncertain ground. This has been emotionally exhausting and
unsettling.
Not all
is lost with the emergence of telehealth. At least in these early phases,
virtual visits seem to allow me to connect more frequently and easily with
patients. With telehealth, I can see patients in their home environments, which
often provides me with new information on factors that influence their health
behaviors. Virtual visits respect a patient’s time. And, of course, in this
pandemic when social distancing is so important, telehealth keeps patients
safe. As the months go by, I will adapt and undoubtedly learn new ways to
gather physical examination data. Wearable technology or guiding patients
through self-examinations will offer some creative approaches to obtain tele-examination
findings.
Source: http://click.alerts.jamanetwork.com/click/axac-2ah3q4-qerbuh-8n20dk39/
