I am going to start by saying this is part of the evolution of medical care. We have gradually moved toward patient-centered medical treatment. I listen to old radio shows of Dr. Kildare from the 1950s (and yes, there was a TV show by the same name in the 1960s). He and his mentor, Dr. Gillespie, had a very paternalistic approach toward patient care. Doctors “knew best” and it had been that way for a long time. There is no doubt, however, that they had the patient’s best interest in mind.
Fast forward to the 21st century and especially the past decade. We started what we called “Patient-Centered Medical Home” with the patient, not the provider at the center of care. We included “shared decision making” to make sure patients were educated about their illness and treatment options and were active participants in the decision-making process.
There has also been a push toward making medical care more convenient for patients. Years ago, this began with more convenient outpatient testing rather than hospital admission for diagnostic, the Minute clinics. Patient portals have allowed patients to review medical notes, check on lab and test results, communicate with physician offices, and even schedule appointments.
Mass General Brighman (formerly Partners Healthcare) had been dabbling in telemedicine (telephone and video visits) for several at Express Care (our urgent care center). It was a fun experience for both the patient and me. Then came the sentinel event that shook up telemedicine and moved it by leaps and bounds—the Covid-19 pandemic. At Pentucket Medical, we jumped from a few telemedicine visits to 90% of our usual visit volume. We tried different video platforms and now have Zoom integrated into our electronic medical record. It is anticipated that 20-30% of medical visits will be by telemedicine even after the pandemic has passed.
Just like moving to patient-centered medicine, patient education shared decision making, and increased convenience for patient visits, telemedicine has the power to put patient needs at the forefront. Many patient concerns can be handled by a good telemedicine visit. Great for elderly frail patients and maybe Great for elderly frail patients and may be very well suited for behavioral health.
Millennials, being so tech-savvy, will also be happy about the telemedicine options. There is even a term now for bedside manner called “Webside” manner. It is a learning curve for all of us. I view this is as progress that once again puts patients at the center. It seemed to happen in an instant and is here to stay.
Kenneth Adams, MD, FACC
Senior Cardiologist and Medical Director at Pentucket Medical