Physician viewpoint: During time of rapid telemedicine transformation, we must 'anchor ourselves' in personal interactions

While it has emerged as a lifeline for patient care across the U.S. during the pandemic, telemedicine cannot capture the patient-physician interactions and personal contact in-person visits deliver, according to Marcin Chwistek, MD.

Dr. Chwistek, an oncologist at Philadelphia-based Fox Chase Cancer Center, penned a June 25 viewpoint article in the Journal of the American Medical Association about practicing telemedicine during the COVID-19 pandemic. Despite the benefits of virtual care, such as quick contact with patients, connecting with patients who live far away and preventing exposure to the COVID-19 virus, telemedicine lacks opportunities for personal contact.

Here are seven quotes from Dr. Chiwstek about his telemedicine experience during the pandemic:

1.  On his shift to telemedicine. "During more than 20 years of practicing medicine, I have worked on 2 different continents and in a variety of medical systems and settings. But one thing has always remained constant: the practice of medicine as an in-person endeavor."

2. On the benefits of telemedicine: "The potential benefits of telemedicine are many and easy to appreciate during normal times; in the times of the pandemic they are priceless… The video encounters also offer a direct glimpse into the lives of patients, an updated version of the traditional home visit, when patients can be now seen in their home environment—their bedrooms, living rooms, and kitchens."

3. On telemedicine visits not being for everyone and his thoughts on a patient saying he liked to have his vitals taken in person: "I missed the ritual too. An imposed order commands the in-person visit, and it travels beyond the verbal: body language, rush of emotions, physical proximity, and touch. If it goes well, there can be a sense of peace for the patient that they are cared for, and satisfaction as meaning emerges for the clinician."

4. On the lack of personal interactions: "Compared with the face-to-face interactions, the virtual interactions seem barren, devoid of the richness the personal contact brings. In a specialty like mine, where a lot depends on emotional connection with the patient and their caregivers, the virtual visits demanded more of me and yet felt a lot less fulfilling."

5. On tech issues with telemedicine visits: "And they all seemed to be plagued by annoying technical issues: a weak Wi-Fi signal, dropped connections, wrong phone numbers in the chart, malfunctioning headphones, or a broken phone camera. And what to do about the omnipresent background noise of a lawn mower?"

6. On his prediction for telemedicine permanence: "Telemedicine has proven to be incredibly useful, and it is here to stay. Over time, supporting technology and systems will make virtual visits more efficient, better coordinated, and hopefully, more patient-friendly."

7. On the need for personal interactions in virtual care: "There is no doubt that the virtual visit is a fundamental alteration to the patient-physician encounter. … And as news, discoveries, ideas, and policies spin around in a flurry, now more than ever we must anchor ourselves in and cherish the wisdom of personal interactions. The place where it all starts."

More articles on telehealth:
67% of patients say telemedicine is better than in-person visits, survey finds 
How Cleveland Clinic created a telehealth team and new documentation to tackle coding, billing changes
10 payers extend telehealth coverage in Oregon through 2020

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