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<\/a>By Diane Batshaw Eisman, M.D. FAAP Doctor Eisman, is in Family Practice in Aventura, Florida with her partner, Dr. Eugene Eisman, an internist\/cardiologist<\/strong><\/p>\nDoctor Curmudgeon\u00ae has been experiencing the joys of Telemedicine for the past few weeks.<\/p>\n
Telemedicine enables her to slouch in her chair, comforted by her favorite pajamas, sipping espresso while dropping chocolate chip crumbs onto her keyboard.<\/p>\n
In bygone years, she had not advocated for this method of communicating with her patients. Without face to face contact in real time \u2013 so much was lost!<\/p>\n
With telemedicine, she might miss the nuances in facial expression. The subtle clues that indicate that the physician must dig a little deeper, explain how important a symptom could be.<\/p>\n
\u201cDo you ever have blood coming from your rectum?\u201d Instead of a brisk “no, \u201cthe patient may glance away for a second, and the \u201cno\u201d might not be quite as brisk.<\/p>\n
With the technology of telemedicine the doctor could conceivably overlook that away glance \u2026might not be aware that the patient was no longer keeping direct eye contact\u2026 could overlook her patient\u2019s quick side glance to view an off camera occurrence or to quiet a furry companion.
\nDoctor Curmudgeon\u00ae, somewhat less cranky than usual, does recognize, that, especially today, there is a place for the occasional video visit.
\nHowever, things may not go exactly as she had planned:<\/p>\n
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\nDOC: \u201cSo\u2026tell my why you wanted to \u2018see\u2019 me.
\nPATIENT: \u201cYou really look different.\u201d
\nDOC: \u201cWhy did you ask for a visit?\u201d
\nPATIENT: \u201cWhat happened to your hair?\u201d
\nDOC: \u201cWhat\u2019s your problem today?\u201d
\nPATIENT: \u201cYou ought to run a comb through it. Or a brush. Or maybe you need to give your hair a good wash.\u201d
\nDOC: \u201cListen to me. You called our office line at 7 AM and asked, no you actually demanded that I call you as soon as I could. It sounded like something urgent, so we set up this call.\u201d
\nPATIENT: \u201cOh, yeah, I did.\u201d
\nDOC: (After an impatient few seconds) \u201cSo, what is going on? Are you in pain? Short of breath? Trouble breathing?\u201d
\nPATIENT: \u201cOh, no doc, none of that.\u201d
\nDOC: \u201cOk, I\u2019ve got another patient to call. Just tell me what it is. Are you running out of a prescription?\u201d
\nPATIENT: \u201cYou hit the nail on the head! I need a prescription\u201d
\nDOC: \u201cFinally. My heartfelt congratulations to you for your brilliance in being able to come to the point. Just tell me which one.\u201d
\nPATIENT: \u201cAw, doc, you don\u2019t have to be nasty.\u201d
\nDOC: (With finger obviously pointing to the disconnect button on the call and now in a loud voice which most people would call \u201cshouting.\u201d) \u201cWhat is the med that you need refilled?\u201d
\nPATIENT: (Getting out of a chair and rummaging around on the desk) \u201cI had the name right here.\u201d
\nDOC: (somewhat calmer) \u201cWhile you\u2019re doing that\u2026you were told to have your blood pressure, pulse, temperature and weight done before the visit\u2026give me those numbers now.\u201d
\nPATIENT: (still rummaging) \u201cAh, that isn\u2019t important\u2026I feel fine so all that has to be good\u2026I don\u2019t need numbers.\u201d
\nAnd before the cranky physician could respond in this losing battle, the patient had a Eureka moment in which the name of the medication was now in his hand.
\nPATIENT: \u201cIt\u2019s called Hydroxychloroquine\u2026wait\u2026I\u2019ll spell it.\u201d
\nDOC: (Now screaming) \u201cFortunately for you, I am NOT an idiot. That drug could cause all kinds of bad things, like problems with your heart\u2026even death!\u201d
\nPATIENT: \u201cWell, the president is taking it.\u201d
\nDOC: \u201cIf he decided to run naked down Pennsylvania Avenue\u2026would you follow? Have you seen evidence of any scientific training\u2026maybe an M, D. a D.O. \u2026a Ph.D. in something?\u201d
\nPATIENT: \u201cYou know, Doc. It\u2019s a good thing I got a needle and syringe. I don\u2019t need you. I\u2019m going to protect myself. I\u2019m going to inject some Lysol.\u201d<\/p>\n
Doctor Curmudgeon\u00ae is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.<\/p>\n