As we have heard many times by now, the COVID-19 pandemic is bringing about a plethora of unforeseen changes to our world. The healthcare field especially has been dramatically affected by the disease, one notable development being the surge of telemedicine in primary care settings in the U.S. Telemedicine has proved to be a valuable tool during this time in many ways. However, despite the advantages of telemedicine, we should strongly consider returning to predominately in-person medical care following a potential end to the pandemic.
Telemedicine refers to electronically-delivered remote medical care. Although already in existence for over 50 years, telemedicine has been increasingly employed in this era of limited contact in an attempt to reduce potential exposure to the coronavirus disease.
Telemedicine appears to be effective for COVID-19 screening. Methods have been developed for physicians to virtually assess respiratory symptoms and collect necessary information from the patient. Patients may undergo remote testing and those in need of care can be transferred directly to the hospital; this reduces contact between a potentially infected patient under self-quarantine and those present in the healthcare setting.
Telemedicine is also being used for routine physical exams on patients who are not experiencing any symptoms of COVID-19. This is an attempt to decrease the amount of people in healthcare facilities and preserve social distancing practices. While not all aspects of the physical exam can be replicated virtually, telemedicine still allows for the assessment of many factors such as breathing rate and external physical appearance, given proper cooperation and assistance by the patient. Patients are guided to direct the camera to different areas of the body such as the eyes, throat and limbs. They may also be instructed to perform such activities as palpating their abdomens to evaluate tenderness, demonstrating specific movements and recording their own pulse and temperature.
As with almost every adjustment brought on by the pandemic, the rising utilization of telemedicine has potential advantages and disadvantages. Some argue that telemedicine increases patient involvement and thus understanding of their health, and can give a physician a better look into the patient’s lifestyle by observing them outside of the office setting. Telemedicine may also conveniently cut down on costs, travel and time spent for both the physician and the patient; however, convenience should not overrule quality, which can be lessened during telemedical visits.
Not all patients may have access to the proper technology to allow for a private, secure and steady connection during an online visit. Poor video quality can hinder proper examination and a limited view of the patient can quite literally prevent the physician from seeing the whole picture. Computers and video services cannot fully replicate the same interactions provided by a face-to-face visit. When listening to a patient’s heart rate and breathing, feeling for abnormalities and observing a patient’s demeanor and body language, physicians and nurses may catch what a patient might intentionally or unintentionally withhold. Furthermore, the physical presence of the physician with the patient helps to establish a connection that can allow for more comfort and trust between the two parties and therefore better care.
Telemedical physical exams may have been a necessary precaution in corralling the spread of the coronavirus disease, but they should not permanently replace their in-person counterparts and become the standard in healthcare. If a COVID-19 vaccine is developed, leading to adequate containment and an end to the pandemic, then in-person physical examinations should once again become the norm. In our increasingly technology-driven world, we should make an effort to preserve human interaction and interconnectedness when possible.