Telemedicine - Helpful or Disaster in Waiting
It is long debated sending a healthcare provider, and possibly a trained physician, to a farfetched area of human habitation. In Canada, the most populated areas are the southern regions along the American border where well-advanced tools and access to medical specialists are readily available. Only a few hundred miles north, you enter a drastically different Canadian landscape. Most notably in those areas, specialty care and, on some occasions, primary care is not readily available.
In some regions, without access to primary healthcare in person, Telemedicine and Telehealth are a critical lifeline. In many cases, it saves lots of travel time and a patient gets the appropriate treatment to many common ailments. For the purpose of routine checkups and preventive care, telemedicine works very well.
Telemedicine also has a significant impact in reducing health care cost most notably through decreased travel time and expenses for physicians and healthcare providers. Under the current system, health information is shared electronically. A specialist from an urban center can consult with a patient through video conferencing to potentially remote areas. As a result, there is increased patient compliance in part due to geographical convenience to access care and a reduction in time off work to attend medical appointments. In my view, telemedicine has an overall positive impact on community health. And I am not alone in these views, in fact, there are some insurance companies in the USA that promote Tele-Doc (American equivalent to Telemedicine) consultation over an in-person visit to a physician.
As telemedicine consultation is gaining popularity, there are certain drawbacks to it. Since some of the physical interaction between patient and physician is lost, unspoken concerns may go unnoticed or undiscussed. For example, a patient with low back pain may have altered gait or changes to how their rise from seated. The patient may not bring up the back pain because it is not their most pressing concern but a physician watching them move may take cues to ask about it. With telemedicine, there is a lower chance the healthcare providers will notice these symptoms.
Telemedicine creates a screen and distance barrier for a physician to observe patient as a whole rather than symptom-specific approach and overlooks the purpose of general physical examination in presence of system specific symptoms. In a case of a patient with a cough, it's easy to overlook cardiac examination or review of other systems. This may lead to symptoms specific treatment rather than health as a whole. In certain acute conditions, especially if presenting symptoms are not severe enough, potentially catastrophic conditions are easily missed or misdiagnosed more often than under traditional in-person consultation. It is important to interpret and understand the outcome of ongoing research before implementing telemedicine on a wide spectrum and as a streamlined source of health care.