What Is Telemedicine

Millennial In Medicine: Dr. Robbi B. MD MA CCFP ABFM

As a society, we have envisioned medicine to be one dimensional. If you go to the library and peruse over old medical books, find images from the medical archives or even a simple google search from the mid to late 1900s, what to do you see? Correct me if I am wrong, but usually they are black and white images of a doctor in his white coat sitting at his big mahogany desk writing notes with the patient sitting across him or a female nurse smiling and holding a vaccine or clipboard. Notice how I said “his big mahogany desk” because in these archives all the doctors were men and all the nurses were women, which I guess is why I still get the occasional, “hello nurse” myself, but that’s beside the point. Those mahogany desk visits still happen; however, somewhere along the line a big leap was made into a virtual world.  This shift began over 2 decades ago and has really gained momentum over the last several years within urban and suburban environments.

Virtual care, through the telephone has been around for decades. I am sure you can remember a time when you received a call from your doctor to discuss your blood work or follow up from a previous visit. However, now we have stepped into a more personable virtual reality where you can still see your doctor and feel as though you are sitting right across them.

With remote and rural communities, telemedicine was a great selling point. The patients still felt like they had medical care at their fingertips when they needed it and were too far away to access it in a timely fashion. However, in more suburban and urban environments the focus and emphasis was still on in person visits. I mean after all, the physical examination, immunizations, steroid injections, biopsies, pap smears, etc. still need to be done, right? The virtual world is not an all said and done deal; however, it has opened the doors of convenience for both patients and providers. During this coronavirus pandemic, our clinic which was not virtual at all, did a quick 180 and now we are 50% virtual and 50% in person visits. This has enabled us to put up safety measures and speak to, counsel and treat patients over video visits while attempting to flatten the curve and avoiding hospital and Emergency room congestion.

Virtual Medicine does not negate the fact that you still need to see your doctor in person for various reasons that cannot be addressed over a video visit or a telephone conversation; however, many strides have been made to make it even more user friendly. Now images can be uploaded into telemedicine platforms so rashes, skin lesions, eye disorders can be visualized. If patients have blood pressure monitors or thermometers you can do vitals over the video visit while teaching them how to take a pulse. You can do all of this while the patient is in the comfort of their own home.

The benefits of virtual medicine are further exemplified with the remote communities I was speaking about earlier, with nursing home patients that have specialists who are farther away, with extremely sick patients who cannot make it to the hospital, for lower income families who have no transporation or money to get to the doctors’ offices. Many of the barriers to seeing a provider have been alleviated with the help of telemedicine; however, it is important to bear in mind this isn’t a replacement of the conventional model of medicine.

I was speaking to someone earlier in the week who said, “with virtual, I will never have to see my doctor again” and that had me thinking of a future without in person visits. I don’t see this happening because hands on medicine, in my opinion, is still the best medicine and as I mentioned earlier, many things cannot be done virtually. However, with this impetus of virtual medicine, the hope is that it will be a great complement to conventional medicine. A new revitalized model that strikes a nice balance between hands on visits and mouse click video visits. Both have their merits and we are lucky to be able to live in a world that leaves both at our fingertips.

Hope it was a good read,