Doctors today can help more people, and prevent the spread of disease more effectively through communication, than we ever could by seeing patients one-at-a-time in person. I have realized that instant human connection through technology makes us more powerful and faster than a virus. I began my career as a physician in the pre-iPhone era. The only way for the sick to seek medical advice was to crowd into places where doctors were kept behind many closed doors. This was true during Swine Flu. As a young doctor, I managed throngs of mildly ill, and asymptomatic-worried mixing in the lobbies of urgent care and emergency facilities seeking tests, treatment, and reassurance. I was sure that many who walked in without the flu, probably walked out with it. Now a mid-career physician in another global pandemic, I can provide reassurance, fulfillment, and ongoing care without a medical facility involved at all, keeping both the sick and the worried from what ten years ago was a necessary and dangerous social mixing in the only place they could possibly see me. In the month of March, I logged 134 chat-first telehealth hours. On one eight-hour shift, I helped 55 patients who were either worried that they had symptoms of coronavirus, knew they had COVID-19, or were concerned about risking exposure if they sought in-person medical care for an unrelated matter. To put that into perspective, during a typical eight-hour shift in the ER, I am able to see only 16 to 20 patients. Epidemics and pandemics existed in previous centuries, but back then, viruses spread far faster than the rate of information or the capacity of physicians to help people. Not today. Telemedicine is allowing patients to seek medical advice without risking exposure to themselves or others. While traditional telemedicine, which typically relies on scheduled video visits, is being stretched beyond capacity, it remains a safer option for people who don’t require hospitalization. Meanwhile, chat-first telehealth has hummed frictionless through this pandemic. “Using chat services is comfortable for me,” one patient writes. “I am delighted this service is available.” An “always open” service model, with no fee or triage barrier to re-entry has allowed physicians like me to be “here” for people, something that not only patients feel reassured by, but as a care provider I appreciate because it means I know that patients I treat at home can get back to us directly. The most professionally satisfying experiences these last several weeks involved reassuring people that – despite the absence of testing and the order to shelter in place – “the doctor is only a thumb-type away.” My colleagues and I have been able to tell people that we are not leaving them, that they are not alone. I constantly invite people to consider us their direct resource during this time. Closure of clinics for routine medical issues such as high blood pressure, asthma or diabetes means those issues aren’t being taken care of unless patients are able to somehow break through on the phone to their doctors who are now just as hard to “see” as their schedule of calls and video visits backlog just like a busy clinic would. What this epidemic has brought to the fore is how chat-first, communications-based telehealth is a physician multiplier. By breaking apart the notion of a 15-minute visit, technology supports ongoing conversational experiences that are fully human, highly empathetic, and truly satisfying at a time when medical resources have never been harder to access – or more needed. Never have people been so informed, so quick to mobilize, so united in a global battle. Coronavirus is fast. Hitting “send” on your smartphone is faster. The worst might be yet to come, but we are armed with the technology, the compassion, and the will to get through this. The scarcity of personal protective equipment (PPE) is a real and growing concern. We need the right gear to protect ourselves as we protect others. But one “weapon” I know we have in abundance is the ability to communicate and disseminate information – and for that, I feel incredibly grateful. Technology has created a more connected world than ever. In this time of social distancing, of fear and uncertainty, I believe that our tech-enabled human connections will prove to be our greatest strength. Blake McKinney is an emergency physician and co-founder and chief medical officer, CirrusMD. Source
