lisa machado: the humanness that patients need is being lost
virtual appointments and phone check-ups come at an emotional cost for patients.
5 minute read
virtual and phone appointments miss the human aspect of in-person appointments. stock/getty
the list of the many ways that covid-19 stinks is growing every day. besides the toll it has taken on countless lives, the pandemic has also hit healthcare systems hard, not only pushing them to the brink of collapse, but also forcing hospital and clinic administrators to rethink the ways they have traditionally delivered care. with the arrival of the virus, family care teams have felt distant as they close physical spaces and move to virtual or phone appointments. for some offices, coronavirus was the nudge they needed to implement the telemedicine strategies they had been planning for years.
while i like seeing my gp in person, i am also okay with the concept of having an appointment by phone, especially during a global pandemic. after all, why take on risk when you don’t have to? plus, telemedicine means that i can be working one minute and getting medical advice the next, all in the comfort of my kitchen office. so when my daughter needed guidance on a painful rash — beyond some technical glitches, like a bad connection and an emailed photo that wasn’t getting through — i barely batted an eye describing over the phone the strange-looking redness that was creeping across her leg. in five minutes we had a diagnosis and a prescription waiting at the local pharmacy. awesome.
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but then it was my turn.
every six months, i make my way to princess margaret cancer centre for a blood test, wait for a couple of hours, and then see my oncologist who relays the results. on days that i feel nervous, i find comfort in knowing that the span of time my stomach churns will be a mere few hours. plus, if anything is wrong, he is right in front of me to answer my questions, tell me about the next steps, and give me a hug should i need it. and, as anyone who has ever received scary 世界杯决赛2022 would know, it can be weirdly cathartic to search your specialist’s face for clues that you are, in fact, going to be okay.
i guess i have taken the comfort of this process for granted over the last twelve years because this week, when i had blood taken on monday and then, because of covid-19 restrictions, had to wait until tuesday for a call to discuss the results, well, i wasn’t feeling so jazzed about the short commute. in fact, the wait strangely reminded me of how i felt in the early days of my diagnosis, when test results were indications of living or dying. it was like the added hours made room for a little bit of anxiety mixed with that nauseating ‘what if’ feeling. there’s always a chance that something is not right — and as it turns out, it’s hard to wait to find out.
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what’s strange about this reaction is that while i may have to wait to speak to my specialist, i don’t have to wait for results. through the university health network’s patient portal, myuhn, i can look up test results old and new. i can see graphs that show the trends over the years. so within hours of monday’s test, my email inbox was flooded with the various blood reports, sent one by one until the early evening.
but here’s the thing, i mostly only give them a skim.
i realize how crazy that might sound. after all, i work with people who live with cancer and their families, helping them get the right care, educating them on drug access and their disease. i support patient portals. i believe that patients should have the option to access their reports. i also support the notion that access to personal records improves outcomes, allows patients to become experts in their own care and empowers them to monitor their health like their life depended on it. sometimes they catch little things that have been missed, like a forgotten referral. other times, the oversight is bigger and life-changing, like a misdiagnosis. there’s no question that online access to personal health information shifts power to the patient — where it should be, of course. this is our life, after all.
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at the same time, it’s important not to lose sight of the value of a face-to-face sit down with a doctor. especially if they — and this sounds dramatic, but it’s true — hold your life in their hands. virtual and phone visits not only gloss over the human touch of the doctor-patient relationship, but also potentially miss critical indicators of well-being, such as a person’s posture — are they slouching in despair or with fatigue, for example — and emotional state — do they seem despondent, or sad?
i wrote a story a few years ago about patient portals, whether or not access to health information was beneficial and how technology was changing the way patients interacted with their healthcare team. the idea for the piece came after my brother got a stage four liver cancer diagnosis through his patient portal on a friday night, and then had to wait until tuesday to hear a live voice explain not so much what the results meant, but what happened next. days later, a colleague learned she had metastatic cancer by reading her scan results online, only to be told by the oncologist who saw her three days — three days! — later, “well, you already know the details, so what do you want to do about it?”
there’s no question that technology plays a critical role in empowering patients, and though it took a deadly virus to fully embrace virtual care, that we have seen successful connections between patients and their families to their healthcare teams during a crisis shows an ability to adapt and evolve when it matters most.
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at the same time, we are missing out on one of the critical things that make a difference in patient care and outcomes: the human side.
hopefully, as we figure covid-19 out and learn about ways to get back to some sort of “normal,” we can also reunite the patient experience with valuable in-person dialogues with healthcare teams.
lisa machado is the executive producer of healthing.ca.
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