From cold robot to lifeline: How perception of the virtual physician has shifted during the pandemic 

The COVID-19 pandemic has transformed the perception of telehealth in palliative care from being a cold and crass method of communication between the physician and patient to an act of compassion, according to Jessica Nutik Zitter, MD. 

In a Dec. 1 op-ed for the New York Times, Dr. Nutik Zitter recalled a March 2019 interaction between a Kaiser Permanente Medical Center physician and a 79-year-old patient and his granddaughter. A nurse had told them that a physician would make rounds, but instead a physician called in and communicated over video that the patient's lungs were failing and that he was dying. 

"This experience, posted to the granddaughter’s Facebook page, was treated as a scandal," Dr. Nutik Zitter wrote. "Newscasters questioned the humanity of a healthcare system that would do such a thing. Words like callous, heartless and cold were used to describe this apparent lack of compassion and care." 

Just one year later, COVID-19 flipped this notion; with hospital visitations limited due to the pandemic, telehealth has become almost a lifeline to connect patients with their loved ones and families with care teams. Dr. Nutik Zitter, who serves as an attending physician at a public hospital in Oakland, Calif., wrote about her and her team's first Zoom call with a COVID-19 patient's family at the start of the pandemic. The care team worried about families grieving at home alone or experiencing technical difficulties during the call but soon found these issues to be less challenging than anticipated. 

"Any initial doubts I had about this medium were erased by the relief of families connecting in this desolate time. True, they didn’t have much of a choice, having been shut out of the hospitals, Dr. Nutik Zitter wrote. "But their heartfelt appreciation of a physician’s presence was a striking contrast to the national sentiment expressed just 12 months earlier, where an iPad on a stick was seen as a cold robot. Now, it was perceived as a lifeline. One patient said to me as I hovered from home in one of the Zoom squares, 'I don’t know who you are, but thank you for bringing my family here to be with me.'" 

Dr. Nutik Zitter's experience with virtual care during the pandemic has shifted her outlook on telehealth as being more than a substitute for in-person care to instead a plausible alternative. It even offers distinct advantages, such as allowing patients to connect with their loved ones from all over the world, limiting the risk of exposure to hospital-borne infections and saving personal protective equipment for the care teams who need it, she wrote. 

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