We are in the middle of a pandemic that will likely be with us for another year. When Covid-19 largely shut down the country in March, most of the in-person interactions we took for granted had to move online. In many cases, that included non-emergency appointments with healthcare providers.
The good news is that telemedicine has been a slowly growing practice for the past several years. Therefore, it was relatively easy for many of us to be comfortable with the idea of chatting with our doctor on a video call or over the phone. The bad news, however, is that telemedicine is limited in scope and effectiveness, and cannot replace the important experience of having a patient and a doctor in the same room. In some cases, overreliance on this technology could lead to misdiagnosis or failure to diagnose serious medical conditions.
What isn’t being said or seen?
Every in-person visit includes a conversation between doctor and patient. But it also includes a hands-on physical examination and the chance for the doctor to react to symptoms observed but not reported. In other words, the doctor may notice a problem that the patient wasn’t aware of.
With telemedicine, the topics of discussion are often limited to what the patient has self-reported on medical history forms and in the discussion during the appointment. Webcams may be able to pick up some visual clues, but not nearly as much as one would expect from an in-person visit. The question then becomes: What are doctors likely to miss without close contact?
How telemedicine could lead to missed diagnoses
In a recent news article, one doctor discussed a hypothetical scenario that could arise due to the limits of telemedicine. Let’s say that a patient is suffering from heart problems that were not part of the patient’s history. During an in-person visit, the doctor may notice signs of a fluid buildup in the body, warranting further inspection.
This symptom can be difficult to see on a video call. And even if the doctor did notice something, he wouldn’t be able to react as he normally would in person: By listening to the patient’s heart, checking blood pressure, touching the patient in areas of fluid buildup, examining the legs and the veins in the neck.
Without noticing fluid buildup, the doctor would have no reason to request an in-person visit or ask about symptoms. And if the patient had no history of heart problems, he might not broach the subject, either.
Doctors need to be especially vigilant right now
We’re all going through a difficult ordeal with the coronavirus pandemic, and there are no perfect replacements for in-person interactions. But even if we are primarily limited to telemedicine for non-emergency interactions with medical professionals, we deserve to speak to a doctor who is as engaged as possible in our care. Failing to diagnose a serious medical condition due to inattention is simply unacceptable – regardless of the venue for diagnosis.