I previously posted about how I prefer to work with patients in-person.
That’s still my preference, even now when meeting with someone in person is always a very carefully measured calculation.
The main concern is that people are much more complex than what is typically captured by their laptop or cell phone cameras.
Most patients, usually in an attempt to be polite, position their cameras to capture their image from the chest up, focusing on their face.
That’s great for board meetings, but for your psychiatrist it can present a real challenge.
People tend to think of psychiatrist as The Talking Doctors, but the truth is we are licensed physicians and a physical exam is often part of the work.
Relying on a camera image from the chest up limits our ability to answer questions like:
-Are your medications affecting your vital signs? -Are there any physical signs that you having side effects to your medication? -Do you have a tremor? If so, how does it change throughout time? -Are their any gait issues? -How do you interact with others? -How are you processing day to day tasks? -Are their signs that while you can hold a conversation, you are struggling with other key functions? -Is there anything indicating you might need a more thorough physical exam? Should I involve other specialties?
It also limits our ability offer services like: -Truly private conversation -Modes of communication that are not as verbally dependent -Tools or trainings that we may have available in our office that just do not translate to videoconferencing
And overall, the truth is that IT issues usually take up a portion of a person’s appointment. This is of course balanced by the need to commute, so sometimes that’s a toss up.
These days, planning for a safe patient visit is a key skill for any physician. But still, my personal opinion is that patients receive a much more thorough evaluation and greater flexibility in what services are offered during in-person visits.
-Leilani M. Sharpe, M.D., Ph.D. #MentalHealth #Psychiatry
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