The Doctor Diplomat is in
Advice for proper e-health etiquette
Dear Doctor Diplomat,
My GP gave me a virtual appointment to look at a rash. They said I could send a photo for a better look, but the rash is in a sensitive area, and I’m not comfortable even taking such a photo, let alone having it in the cloud forever. What do I do?
—itching for answers, Little Italy
It’s your doctor’s job to be medically interested in every last inch of you—even the parts you’d rather keep private. And I promise that whatever it is, they’ve seen worse. Privacy is paramount in the new e-health universe, and chances are your doctor is using software that’s as secure as it gets. Most clinics switched to these specialized online patient portals years ago, allowing patients to schedule appointments and send emails (and pics!) fully encrypted and worry free. So my advice is to go ahead and send the photo. However, if you’re still uncomfortable with the very existence of a digital recording of your less photogenic bits, you can also request an in-person appointment. You’ll avoid the unflattering pic—even if it means a few awkward minutes on the exam table.
Dear Doctor Diplomat,
I’ve been recording my Zoom therapy sessions for the past year, because sometimes, in my more fragile moments, I like to replay what my shrink said. I mentioned it to her the other week, and she’s not happy. She says I should’ve asked for her consent before recording. How is this any different than her taking notes the whole time?
—candid camera, Parkdale
Therapy is a trust exercise. She trusts you to be open and honest, you trust her to be professional and discreet. Those notes she scribbles while peering into your soul are part of her medical practice, just as your GP’s notes are a record of your physical health. The real question is why you want that video in the first place. If there’s a good reason—you need the pep talk, say, or there was a complicated conversation about important next steps— your therapist might be happy for you to have a record of your session. Just ask her first.
Dear Doctor Diplomat,
My husband and I live in a small condo. I have virtual therapy once a week, and unless he leaves the apartment he can hear my conversation. I ask him to leave and go for a walk during that time, but he says it’s inconvenient and resents the break in his workday. How should I handle the situation?
—private practice, the Distillery
If your partner is unwilling to get out of the way, you can always request a phone call with your therapist instead of a video chat and take your appointment somewhere you won’t be overheard—in the car, say, or out on the balcony, if you have one. Even better, go for a walk on your own. You’ll get some steps in and feel freer to hash out the whole uncooperative husband thing.
Dear Doctor Diplomat,
I’m a single mom, and my five-year-old always wants to stay close by. I’ve been having a series of tests for a persistent heart issue that, frankly, makes me nervous. When I’m on a video call with my doctor, I usually just get my kid to stay out of frame. But on the last one, she popped up to ask for a snack—and my doctor was rattled. Why was he so put out?
—staying mum, Willowdale
While it’s true that you’re the one who should be concerned about privacy during virtual appointments, your doctor should be aware of who he’s talking to—and who’s listening just out of frame. Knowing a fiveyear-old is lurking within earshot probably won’t change the substance of the call, but it might change how certain information is delivered. Plus, it’s just common courtesy. You’d probably tell your boss if your kid was sitting there with you, so why not your doctor? Next time, I’d suggest arranging some kind of childcare—a relative? A neighbour? A really engrossing set of Lego in the next room?—for the length of the call.
Dear Doctor Diplomat,
My cottage is a perfect refuge except for one tiny detail: the Wi-Fi is occasionally— okay, regularly—spotty. I’ve had to reschedule a virtual doctor’s appointment three times now because of a bad connection. I just need a re-up on my asthma inhaler, and it could easily be done over email, but the doc insists on seeing me. What’s the deal?
Your doc isn’t going to write you an email for two reasons. One is a matter of best practice: whenever you ask for a prescription, she’ll want to see you to make sure everything’s working the way it should be. The other reason is slightly more annoying, but no less important: your doctor can’t bill OHIP for an email. If you don’t show up in her office—or on Zoom or over the phone— she doesn’t get paid. Yes, it’s annoying, but that’s the price of free health care.