Virtual care has some benefits, but it’s not a panacea
Many have endorsed virtual care for its economic and accessibility advantages. This helps our most vulnerable populations. But virtual care cannot come at the cost of strong patient-physician relationships.
In an era when technology increasingly caters to our needs, we must not approach medicine as we would ordering toiletries online. Some may wish it to be so, but health is not something that can be commodified. Medicine is fundamentally personal, and that means the therapeutic relationship can impact our health.
Unfortunately, some elements of virtual care encourage consumerism. This can create a split between the patient and the person.
A perennial complaint of patients is that they feel unheard by their physicians. At times, this is justified. But sometimes it is because of a relational disconnect. We are unlikely to feel heard if we think our physician dismisses us as a person. Yet that level of care is difficult to communicate with a stranger over video. Many patients feel uncared for unless their physician listens to their heart, even when clinically irrelevant.
Conversely, from the physician’s perspective, if you feel your patients respect your time and expertise as a person, you are less likely to feel like a medication vending machine. This in turn can mitigate the major issue of burnout.
Shifting to a system that further relies on quick dispensations exacerbates the impersonal and bureaucratic state of medicine. But we are not patrons and customer service agents. A strong physician-patient relationship shapes how we perceive our interactions.
Within their exchanges, physicians share heartbreaking news and patients divulge their deepest anxieties. Compassionate body language and a physical presence can make all the difference. But an emphasis on efficiency and cutting costs may tempt us to do this virtually.
Human health cannot be reduced to biochemistry, where medications can simply titrate various blood levels. This narrow stance toward medicine turns patients into machines and physicians into mechanics.
While robots do not suffer, we do. We grieve and we wonder about how illness will affect us and our families. Our existential concerns cannot be measured in terms of efficiency. We must be wary of a personal encounter becoming a mechanical transaction.
The virtual check-in is sensible for minor issues. Encumbered systems benefit from streamlining. We have seen advantages of walk-in clinics and their accessibility. But walk-in medicine suffers from difficult follow-up and the lack of an ongoing history with the patient to contextualize new concerns.
Similar worries exist for virtual care. But some physical contact and a prior relationship make online interactions healthier.
In promoting virtual care, we must recognize how technology shapes our perception of medicine. Expanding our use of innovative technology is critical. But we cannot lose the personal touch in medicine. Lester Liao is a pediatric rheumatology fellow at Sick Kids and director of Common Pursuits, an organization fostering local communities through technology and culture.
Joel Gamble studies medicine at the University of Toronto. He is a researcher in the philosophy of medicine.