Telemedicine: Where Telemedicine Falls Short. Perspective from a primary care physician

There has been a rash of write ups on Telemedicine and I did share some thoughts with a well known researcher. Of course, the blog offers a “raw material” for the “world-view” and each idea layers on to others to make it possible. That’s the reason why I consider writing a sacrosanct.

However, it is important to get differing perspectives and this one from a primary care physician.

I also know that well-trained clinicians use all their senses — not just hearing and vision. They appraise the whole patient: Is there a new limp, a shift in posture, a new pallor? Often, it’s what patients don’t notice or complain about that is essential. And there is no diagnostic test more cost-effective than the laying on of hands. I have found treatable cancers multiple times in routine exams that would be impossible to replicate in the virtual world. Could a Zoom visit detect a lymph node too firm, a spleen or liver too large, or an unexpected prostate nodule (with a normal PSA)?

Where Telemedicine Falls Short

Should we push for Telemedicine? I think it would make perfect sense for remote “monitoring” but of course, I have other ideas. We don’t use it for quantitative estimation of effects of therapeutic interventions. That’s the problem which Apple is trying to solve under the garb of consumer electronics.

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