I saw and examined a patient this afternoon while she was sitting 50 miles away from me. All through the wonders of technology. And I love it! It was my first telemedicine patient.
I was in my clinic in greater Des Moines, in front of a TV screen, and my patient was in another clinic somewhere in southern Iowa, also in front of another TV screen. While I can speak directly to the patient via videoconferencing to get her history, the physical examination was skillfully performed with the aid of a nurse who was in the patient’s room.
The nurse, under my direction, placed the otoscope into the patient’s ears, and I could see her ear canal so clearly in my monitor. Then the nurse placed a scope in the patients mouth and I could visualize her throat (without smelling what the patient ate for lunch). Then the nurse placed the special stethoscope to the patient’s chest and back and I could hear her heart sounds and lung sounds crisply through my headphones.
What I could not do though, is palpate (touch) the patient to examine for swelling and bumps. Nor could I do percussion (tapping) on patient chest while listening for the evoked sounds. You could detect fluid in the chest if the percussed sound is dull, or just air if it is resonant. This is akin to thumping a watermelon to determine if it is ripe or not.
Telemedicine though takes away the “physician touch” as a part of the exam but maybe not for long. I told the Telemedicine technician who was in the room with me that maybe someday they can develop a glove with sensors that an examiner can put on and palpate the patient, while the doctor who is far away have another gloves that he puts on and can feel the sensation. I was surprised when he said that this kind of gloves is already being developed. I’m telling you, technology will take over the world!
I am happy to be a part of this cutting edge technology. It means that I could see patients from anywhere in the world, including the Philippines, as long as there is computer and internet connection. Though it really require a fast internet connection to possibly make it interactive.
Or the other way around, I could have my clinic in Boracay, in front of lapping ocean waves and under the swaying coconut trees, and see patients anywhere in the world, including the US. I think I like that better.