We live in an age where the process of communication always seems to have an intermediary involved. We text rather than call; we gossip on social media; we ask Amazon to send us things by talking to “Alexa”; we receive higher education in the form of online courses, we use AI to select potential romantic partners, and now we’re eliminating another significant human contact point – the physician. We’re moving into the era of telemedicine. While the training for physicians now includes becoming more people conscious and having as much EQ as IQ, we are telling them to be effective and efficient because the future in medicine is going to be delivered remotely. If I sound troubled by this phenomenon, I must confess that I am. Yes, I do believe that telemedicine will be more efficient, but can it deliver the quality interaction that is so essential to an effective diagnosis?
Five years ago Forbes magazine ran an article on telemedicine stating the following:
For one, the technology around virtual consultations has finally matured to the point where doctors can offer a good experience. As Andrew Watson, Chief Medical Director of Telemedicine at University of Pittsburgh Medical Center, puts it, “Telemedicine is moving like lightning. We’re able to do so much more than before”. Faster Internet connections and better software facilitate far smoother video chatting than in days past with ubiquitous mobile devices; people can now access consultations from anywhere… Additionally, telemedicine has expanded to include asynchronous messaging, which patients are increasingly more comfortable using in which truly allows doctors to better utilize their time. A single doctor can now advise many patients on routine issues, freeing up more time to focus in person on trickier cases. …In the last few years, more and more patients have increasingly looked to retail pharmacies in their neighborhoods for routine health care services because it’s more convenient than visiting the doctor. The logical next step is that they won’t have to leave their homes at all.
The software for telemedicine and its accessibility has only increased. OSCAR and Sherpaa, which is now a part of Crossover Health believe that cloud based primary care will make healthcare more affordable and accessible. Nowadays, tele-healthcare is, in one way or another, a part of almost every major medical benefits package offered by employers. The final line in the Forbes quote is its most powerful and explains why people are willing to accept and use telemedicine. In summary, people won’t have to leave their homes at all because technology will provide them with an “acceptable” level of diagnosis for routine healthcare issues. However, none of these “advances” which are being discussed in the world of telemedicine take into account the nuances of a face-to-face diagnosis. There is little evaluation of the psychological impact of the loneliness and depression that can lead to increased health risks (and in the case of our veterans, a frightening suicide rate) in the articles touting telemedicine.
In the case of the current new cycle, the coronavirus also provides an interesting window into healthcare. Without in-person testing, the symptoms for COVID-19 look just like any upper respiratory infection over the phone. In a video conference, it would be difficult to discern the flu from a serious cold. Incidentally, the flu continues to be a great threat to Americans; proving its impact to be greatest for senior citizens and the immuno-compromised. While the danger to those that are actually exposed to COVID-19 is real, there is still a great chance that, you will come in contact with an influenza strain. There have been over 18,000 deaths in the United States during the 2019-2020 flu season as of the end of February, 2020. Neither a flu or Coronavirus diagnosis, however, something that can be done definitively via a phone-call.
Telemedicine is going to continue to play an increasingly important role in the delivery of healthcare, but we cannot allow it to marginalize the unique healthcare experience between a physician, PA, or nurse and their patients. Healthcare is as much an art as a science. You see the art in the interaction between a highly skilled healthcare professional and their patient. As we continue to experience the speed and efficiency of our society with drive-throughs for food, laundry, banks, pharmacies, and now grocery stores, we should have increasing concern if we are about to experience drive-through medicine.
Curus is a counterforce to the speed of the delivery of healthcare. Service with a human touch, utilizing technology to make our human interactions with our members and their doctors meaningful experiences, will assure the highest quality of care available.
