Virtual Medicine During the COVID-19 Era
The COVID-19 pandemic has been a whirlwind of activity in medicine. Because of the risk of contracting the coronavirus, doctors had to quickly change the way medicine is typically practiced, pivoting from face-to-face visits to speaking with patients via the telephone or through a computer or smartphone.
The quintessential icon of my profession, a stethoscope, once hung proudly around my neck. It now sits haphazardly in my desk cabinet. My hands, once used to examine a patient or comfort a grieving family member, now speed fervently across a keyboard, trying to keep up with my patients' concerns. During phone appointments, I don't have the same ability to look my patients in the eye, discern their feelings and connect with them as easily as I did face-to-face.
[SEE: How to Prepare for a Virtual Doctor's Visit.]
On the other hand, I do see some subtle, positive changes in the way I interact with patients. I enjoy getting a glimpse of my patient's living quarters when we're on a virtual visit. Sometimes I can see a photograph or picture in the background. It's a great starting point to explore why that object or picture is meaningful to the patient. Also, I can get a sense of the way people live. It's like a modern-day house call.
Sometimes the patient who sits in my office is not the same person sitting at home in their favorite chair. And it's not just the quarantine beard or uncolored hair that makes things different. The concerns that are truly important to the patient tend to come forth more clearly in a virtual setting. I hope this continues when we return to seeing patients in the office.
For the time being, here are some tips to help virtual visits go smoothly.
1. Many offices perform pre-screening phone calls. Be available about 15 to 20 minutes before your appointment to receive calls from your doctor's assistant, who will act as a pre-screener for the physician. They will ask questions like the dosage of your medications, how you're taking them and whether you've had any recent testing or lab work. Be sure to have your medications nearby so you can refer to them. Some offices have gone completely virtual: You answer those same pre-screening questions before being connected to the doctor. Either way, ensuring the doctor has the most up-to-date information is critical to your health.
2. If you have a way to check your blood pressure, weight and pulse, do that before your appointment. It can serve as a substitute for the vital signs we take in the office. If you have diabetes and check your blood sugar levels, make sure to let the assistant or doctor know your results.
[READ: What Role Can Telehealth Play in Senior Care?]
3. Different medical offices use different platforms for virtual visits. Make sure you're familiar with your doctor's platform. Place your phone on a level surface instead of holding it while speaking to the physician. Have it in a stand, tilted so that the doctor can see your face and your upper chest. Unless you're really feeling poorly, try to stay upright and seated during your visit, and don't move from one room to another. This will allow the doctor to evaluate you the same way as in the office.
When you're speaking, the doctor will be examining the way your chest moves or whether your facial muscles are moving synchronously. And similar to taking photos, make sure that the light source is coming from the side or the top, not from behind you. It's difficult to see patients when they're sitting in front of a window with the shades open. Also, be sure that your camera screen is free from dirt for the best possible visual inspection.
4. Be sure to have a pad of paper and a pen with you to take notes during the visit. It's also helpful to have a pen light or a flashlight so that you can spotlight the area on your body where you may have a rash. Or, you can take a picture and ask the assistant how to send it to your medical provider.
[SEE: What to Do About Routine Doctor Visits During Coronavirus.]
5. Try to avoid having a virtual visit in a room with background noise, such as in a kitchen, or with a pet nearby. If possible, have someone else care for young children in another room. Often, sensitive information is discussed during appointments, and it's best not to be within earshot of others. Keep in mind that your audio or your doctor's audio may be delayed, so the flow of conversation may be a bit stilted. Use shorter sentences and allow more pauses in the conversation so that your doctor doesn't miss anything you say.
I look forward to seeing patients in our offices again and pulling out my stethoscope. Until then, I hope these tips can help you make the best of your virtual visit.
Dr. Neha Vyas has been contributing to U.S. News since 2017, writing about health education and general medicine. She has been featured in several media outlets, including Reader's Digest, cnn.com, Good Housekeeping, Men's Health, CBSnews.com, MedPage Today, Real Simple and Health magazine. Dr. Vyas has been practicing family medicine since 2001 and currently resides in Cleveland.
Dr. Vyas is an assistant clinical professor at Case Western Reserve University School of medicine and Cleveland Clinic Lerner College of Medicine, and she is a fellow of the American Academy of Family Medicine. She earned her undergraduate degree in Anthropology from Rice University and her medical degree from Baylor College of Medicine, both in Houston.
Dr. Vyas uses her knowledge in evidence-based medicine to provide high quality health education to empower her patients as well as the community at large, all with the goal of developing healthy families and communities.
