As the COVID pandemic ranges, physicians and patients have adapted to the new telemedicine world. Telemedicine has proven to be a good resource for continuing the patient/physician relationship and allowing patients to continue receiving care during a difficult period.
✅ Telemedicine works best for appointments that involve lab and imaging reviews or discussions, medication refills or changes to existing medication regimens, simple follow up visits for patients with stable disease, or new patients with very mild or non-emergent complaints. People with simple cough, respiratory illness, or mild joint complaints are examples. Some visits during pregnancy are being performed virtually if it is a regular follow up of symptoms and the visit does not require an ultrasound to be performed or blood pressure or glucose monitoring.
🚫 A virtual visit is not ideal if the patient has a rash that needs to be visualized or swelling in a particular joint or a condition like Hypertension or Diabetes that is uncontrolled. Any orthopedic complaint or trauma like a fall or possible broken bone should be evaluated in the office or health care facility.
🚫 Other types of scenarios not suited for telemedicine can include individuals experiencing symptoms of moderate to severe cardiac, respiratory, or pulmonary symptoms like chest pain, palpitations, cough, abdominal pain, or bleeding.
🚫 Any person with a prolonged fever not relieved with medications should come in for an in-person visit.
🚫 A regular annual physical exam or gynecological visit requiring a breast and pelvic exam should be performed in person.
🚫 If the patient has a sore throat or eye symptoms like discharge, eye pain, or changes in vision, they should come in.
🚫 Any individual who needs a comprehensive neurological exam ( for muscle weakness or acute neurological decline) should be evaluated in the office.
🚫 If there is significant swelling or redness in one joint, an infection may need to be ruled out so a doctor may need to be seen for joint fluid withdrawal (arthrocentesis).
Although telemedicine does offer a beneficial alternative for so many people and can help save time for both patient and physician, there are still so many indications to continue with the traditional patient-physician relationship in the office.
It will be interesting to see in the future if telemedicine will be utilized more to enhance preventative care for many minority populations or patients who normally may not have access to preventative services. Telemedicine may also be beneficial for those who may have been lost to follow up due to socioeconomic reasons, inability to have time off from their employment, or may have mistrust in the healthcare system.