Before the Covid-19 crisis, I — like most physicians — thought that in person, face-to-face encounters afforded me the greatest level of connection and intimacy with my patients. Yet many of us have been pleasantly surprised to discover the perks of telehealth during the unprecedented coronavirus crisis.
Centuries of doctor-patient relations have centered on in-person communication and physical examination. We have been conditioned to view that as the norm, causing us to see telehealth as disembodied and impersonal, making us reluctant to embrace it.
Then came the Covid-19 ambush. With mandated social distancing policies in place to counter the rapid spread of a highly infective virus, health care providers have been forced into an overnight arranged marriage with telemedicine. For some of us, there is the potential for true love.
Telehealth has many advantages, including keeping patients safe from possible exposure to the coronavirus that causes Covid-19, improving access to care, cutting health care costs, and contributing toward a greener earth by cutting down on car trips to see doctors in their offices. It also offers its own type of personal and lighthearted or even heart-warming connections.
Over the past few weeks, I have had conversations with several colleagues about this new wrinkle in our professional lives. Here are some of the things we enjoy about telemedicine in the time of Covid-19:
- Seeing our patients in their pajamas.
- We can work in pajamas, too.
- Finally “meeting” the dogs and cats they talk so much about.
- Gently reminding them about social distancing as their grandkids play on their laps.
- Feeling amazed after a successful FaceTime visit with an 89-year-old.
- Getting magnified views of chin hair, moles, nostrils, and other facial features of patients who aren’t fully familiar with the cameras on their phones or computers.
- Conversing about their home décor and choice of wall color.
- Realizing that it’s now acceptable to enjoy a cup of coffee with our patients.
- Actually seeing ourselves as we chat, and fixing our hair or smiles in response to the image in the video window.
- iPads are now a legitimate business expense.
- Having far fewer test results to review since patients aren’t coming to the lab for tests.
If laughter is indeed the best medicine, and if this sampling of anecdotes is any indication, my colleagues doing telehealth are quite healthy:
“I just spent an entire televisit looking at a patient’s ear canal.” — an oncologist in New Jersey.
“I find it rather difficult to do pelvic exams with virtual visits.” — a gynecologist in Atlanta.
“I thought virtual visits were going well until my patient decided to show me his hemorrhoids.” — a gastroenterologist in New Jersey.
To be fair, this optimistic view of telemedicine must be balanced against its downsides, including the inability to do physical examinations, which can affect patient care; the inability to obtain essential blood work; the inability to console patients when giving bad news; and more. To get through the time of Covid-19 with as little PTSD as possible, physicians need to keep their rose-colored glasses on, at least now and then.
During virtual visits with patients, when I hear their children crying or see their dogs on their laps, a certain friendship develops that otherwise wouldn’t have incubated in an office setting. As a colleague, Dr. Bonnie Guerin, told me, “It’s just a different vibe.”
For some of us, our arranged marriages to telemedicine might morph into love. If Gabriel García Márquez were still alive, he might have called these silver linings “Love in the time of corona.”
Rujuta Saksena, M.D., is a hematology and oncology specialist in Summit, New Jersey.