Skip to main content

Why I Gave Up Telemedicine

We live in an era now when workers have leverage over their employers.  Nearly every establishment is struggling to hire employees.  It’s mysterious, not only why so many folks have chosen not to return to work, but also how they are paying their living expenses.   Remote work, particularly for younger workers, has become a non-negotiable red line.  If you are an employer who expects full time in person presence, then good luck finding willing candidates. 

Telemedicine has also permeated the medical profession.  Ten years ago, physicians would have howled that there could never be a replacement to the in person visit when doctors could read body language and engage in the age-old hands-on physical examination.  That was then.  Now, many physicians prefer to offer virtual care and many patients demand it.

I’ve given up virtual visits, but not for the reasons that you may think.

During the early months of the pandemic, when I first entered the virtual visit arena, I found the experience to be novel.  I could practice medicine from my own couch wearing sweat pants.  It was refreshing to use a different platform after practicing gastroenterology the same way for 30 years.  It was all new.  And I felt in a very small way that I was standing up to the pandemic by still providing care to my patients.

But obstacles soon presented themselves. Many of them were technical.  The audio was absent. The connectivity was spotty.  The functionality of my laptop at home was much more limited than my office desk top models.  And, as a consequence of having practiced for decades, many of my patients are now in their 80’s and the cyber universe is not their natural habitat. 

I powered through the technical roadblocks as best I could.  But another obstacle was taking shape that I was not willing to accommodate or work through.  The virtual visits were not fun.  There was no handshake.  There was no real banter or even a joke or two which is so characteristic of my style. The visit became literally framed by two faces staring out of computer monitors. There was no way to duplicate the rapport that patients and I enjoy during our personal visits.  Telemedicine, at least in my experience, was a transactional process which was largely stripped of the aspects of medical practice that I enjoy so much.

Perhaps, data will show that the medical quality of virtual medicine is equivalent to the office.  But I maintain that the quality of the experience is quite different.

 

Comments

Popular posts from this blog

Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so.  The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals.  In addition, the alternatives to direct employment are scarce, although they do exist.  Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings.  Another practice model is gaining ground rapidly on the medical landscape.   Private equity (PE) firms have   been purchasing medical practices who are in need of capital and management oversight.   PE can provide services efficiently as they may be serving multiple practices and have economies of scale.   While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Should Doctors Wear White Coats?

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier.  There must be a reason why so many professions require a uniform.  Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele.  It certainly doesn’t enhance professional performance.  For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings?  If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?  The medical profession for most of its existence has had its own uniform.   Male doctors donned a shirt and tie and all doctors wore the iconic white coat.   The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families.   Indeed, even today

Electronic Medical Records vs Physicians: Not a Fair Fight!

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary