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The Current View of Telemedicine
"Any physician worth his weight will be able to plan his next 4 moves after he performs his patient interview and physical exam." These wise words for our instructor during our Cardiology rounds depict the classical state of health care where medical decisions are made after a patient comes for a visit, answers some questions, and then is examined by the doctor before a course of action in his management is charted. Since the emergence of the Internet, healthcare has undergone a gradual shift from the classical approach where patients no longer have to travel to the local doctor's office to receive medical advice. Enter Telemedicine, a new-aged standard of care where patients can log onto their computers from home, call a physician from a regional hub, and then receive a diagnosis and the proper therapy for his condition. This is very radical shift from the standard of care and obvious questions into the merit of this style of Medicine have begun to surface.
I had the unique opportunity to take a course in Telemedicine during my Medical School Training. I was skeptical at first, like most of my colleagues, based on the absurdity of the concept. How could you possibility treat a patient effectively through a Skype call? In the medical world, it is common to have relatives or family members call for medical advice for the 2-day head-cold or the upset stomach and expect a detailed diagnosis and therapy because "you're a doctor" while giving very nonspecific clues. The phone calls often resolve in laughably incomplete medical histories and no form of medical evaluation whatsoever just so you don't have to spend another painful minute dealing with your mother-in-law. At least with family, however, it is possible to have a vague idea of the general medical condition of your own "flesh and blood" after meeting up during any holiday gathering. In Telemedicine scenarios, this is essentially the same concept but the medical conditions are often more serious and patients are complete strangers.
During this course, we were presented with several unique scenarios that demonstrated the benefits of Telemedicine and this ultimately shifted my perspective of this growing field. Our instructors pointed out several scenarios where this video-call could be a valuable resource for patients in rural communities who had limited access to healthcare. I completed my medical schooling in a large city in Europe and often had patients come to the University clinic with stage IV cancers or gangrenous ulcers from surrounding villages. Patients would typically either ignore their symptoms or reveal that they hadn't been to a doctor's office in over 10 years. More difficult still, elderly patients often have a negative perspective of hospitals already because many of their friends and family did not survive their inpatient stay making them less likely to seek treatment themselves. This negative stereotype pushes these patients to neglect their symptoms and often level physicians with end-stage diseases and no feasible medical therapy. Had Telemedicine been an available avenue, patients would have been more comfortable discussing some of their symptoms with physicians earlier on in the disease course and would have undoubtedly had a more positive outcome.