It seems that in recent years, the practice of medicine has become less and less personal. While patients once enjoyed routine and adequately long visits with their primary care physician, these visits have increasingly become shorter and more cursory in nature. In many cases, doctors feel compelled to tick boxes on a computer screen and finish appointments quickly in order to see as many patients as possible.
Not only does this approach fray the important human connections that are essential in medical care, it also increases the risks that doctors will miss important diagnostic clues. As a result, patients can be misdiagnosed or left undiagnosed for potentially life-threatening conditions. Now, as medicine moves primarily online in response to Covid-19, the problem is likely to get even worse.
Telemedicine is the new reality for most people who aren’t seeking emergency care or things like surgical procedures. While video conferences with one’s doctor can be both effective and mutually convenient for certain patients and certain conditions, they make it harder to pick up diagnostic clues that might be noticed during an in-person visit.
In a recent interview, a primary care physician gave the example of a patient with a poorly functioning heart. One symptom of certain types of heart trouble is fluid buildup in the body. On a video call or phone call, the doctor may not be able to notice signs of fluid buildup. Doing so might require listening to a patient’s heart, taking blood pressure readings, touching them, examining their legs and observing other visual indicators. If the patient didn’t previously have a history of heart problems, neither the patient nor the doctor may think to ask for further examination based on the results of the e-visit. The problem could go undiagnosed and untreated.
During a pandemic, there will not be a perfect way to give patients the best possible care while also reducing the risk of spreading Covid-19. But in times like these, doctors need to be even more vigilant about asking questions, and patients need to strongly advocate for their own concerns. Otherwise, it is only a matter of time before telemedicine leads to serious medical errors and medical malpractice litigation.
