Physicians Are Hesitant About Virtual Visits

Physicians reluctant to use telemedicine for fear it might sabotage relationships with patients.Are physicians ready for virtual visits with their patients? This issue was examined recently in the New York Times by Pauline W. Chen, M.D., a liver transplant and liver cancer surgeon and the author of “Final Exam: A Surgeon’s Reflections on Mortality”.  Virtual physician visits would allow clinicians in a “control center” to remotely monitor, consult and even care for and perform procedures.  A rural primary-care physician, for example, whose patient has a rare skin lesion could get expert consultation from a dermatologist who might be hundreds of miles away.

According to Dr. Chen, “Despite its promise, telemedicine has failed to take hold in the same way that other, newer, technologies have.  Not because of technical challenges, expense or insufficient need.  On the contrary, the most daunting obstacle to date has been a deeply entrenched resistance on the part of providers.”  Although most physicians believe that technology can strengthen their bonds with their patients, Dr. Chen says this is not the case in telemedicine.  “Indeed, for many doctors, telemedicine seems to depersonalize the relationship and sabotage trust.”

Dr. Chen references a recent study performed at the University of Texas Medical School in Houston that examined the impact of telemedicine on patients in I.C.U.s.  “Every I.C.U. patient in the study received the usual on-site care, as well as all the additional audiovisual and vital signs monitoring offered by a remote critical care specialist 24 hours a day.  In addition, each patient’s physician could choose the degree to which the remote specialists would be involved in delivering direct care – that is, giving orders and intervening from afar.”

The majority of doctors in the study elected to limit remote involvement for their patients, fearing telemedicine might adversely affect their relationship with the patient.  “Certainly some of the doctors were just skeptical,” said Dr. Eric J. Thomas, one of the study’s authors and director of the University of Texas – Memorial Hermann Center for Health Care Quality and Safety.  “Others were hesitant because of how they felt about their relationship with their patients.

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