OPINION

OPINION | KAREN MARTIN: Doing telehealth the right way

Karen Martin
Karen Martin

A recent telemedicine appointment turned out to be better, yet worse, than expected.

These medical confabs, which have been around for decades and have gained popularity and prominence since the arrival of covid-19, allow doctors and other health-care professionals to conduct virtual appointments with patients via video.

The benefits are plentiful; the most obvious is the ability to limit exposure for patients and medical workers to the coronavirus, along with other infectious diseases.

Along with that, there's no need to take off work. No sitting in waiting rooms with sick people (just as well; all the magazines are gone now anyway). No childcare or eldercare problems. Transportation arrangements and expenses aren't required. Patients who don't feel well (which, duh, is why they're going to the doctor) can stay at home, which helps reduce the spread of illness and the anxiety of those who have to be in the office.

And access to specialists, even those far away, is available.

My experience with this practice was unplanned. I had called my longtime physician's office to get a prescription refill--a simple enough procedure--and was surprised to be told that my request could be--would be--handled via a telehealth appointment on the afternoon of the next day. I didn't think an appointment was necessary, but what the heck.

So, after I spent part of the next morning drinking too much coffee, wondering what to wear, and fretting about how this was going to work (I don't bother learning how to handle technology I don't use much, like video conferencing), a representative of my doctor texted me a link to a secure video connection at more or less the time that had been designated the day before.

Turns out my fretting wasn't needed; a click on the link connected me instantly. And there was my doc in a little window on my phone's little screen, asking me if I'd gotten in my usual bike ride that morning. And I was there too, in an even smaller window.

Watching yourself in this way is disconcerting, so I tried to keep my eyes on my doctor as we discussed the effectiveness of the medication under consideration. Although we are totally comfortable with each other, I felt rushed--through no fault of his--and that I was babbling about a minor concern I had while discounting its importance.

It wasn't at all typical of the way we usually interact during our in-person appointments, which usually last about 10 minutes but feel relaxed and complete when they're over.

It wasn't him. It was me. When it ended, there were questions that went unanswered. And I resolve to do better in the future.

There are lots of ways for a patient to be a more competent communicator with a health-care provider during a telemedicine session (that's what the Internet is for).

Among them: Since physical examinations are impossible, think ahead about how best to describe a problem or concern in graphic, concise terms. It's not necessary to fill in dead time with chatter. Just state your case and stop talking. The doctor can, and will, ask if clarification is needed.

Write down your questions before the session starts. You think you'll remember everything, but you won't.

Don't let the health-care professional dominate the discussion and make all the decisions. Don't be passive; this is your time (you, or your insurance, will be paying for it; the charge for my outpatient visit was $101), so speak up if you don't agree with a proposed treatment or outcome, or if you've had a prior experience that indicates a diagnosis or treatment may not be the right way to go.

Make sure your doctor is listening to you. If you get interrupted, stay on track and continue where you left off. Don't leave out details because you think you've already mentioned them or brought them up in a previous visit. Not everything makes it into your permanent record.

Make sure you understand your diagnosis, treatment options and care instructions. If you don't, ask for the information to be repeated.

Collect a pen and paper beforehand in order to take detailed notes during the appointment. Don't scribble illegible words in the margins of a grocery list you dug out of your pocket at the last minute. Your memory will likely fail you if you wait until the videoconference ends. To make sure you've got the gist of the discussion, repeat what you heard.

Don't tell yourself that you'll check out confusing/conflicting information or medical terminology later. If something doesn't seem right, say so. If you sound stupid, so what?

The prescription I needed was efficiently called into my pharmacy, and although I called my doc's office a day later to clear up some confusion, no further drama occurred.

But next time, I'll be prepared to make this situation much more productive--for me and for my doctor.

Karen Martin is senior editor of Perspective.

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