Telemedicine, or Thoughts on the Less Popular Side of this Issue

In his book, Technopoly, media theorist Neil Postman best describes the love affair tech people have with technology: “They gaze on technology as a lover does on his beloved, seeing it as without blemish and entertaining no apprehension for the future.”

Before I begin I’d like to confess that I’m a late adopter. . .or is it adapter?  Actually, I’m probably both.  In other words, it’s need that drives my actions.  For example, I had a computer just for writing and editing my work.  When it became fashionable for students to e-mail their professors (I’m a professor), I got e-mail connection.  (Most students e-mail me that they won’t be coming to class and/or doing their homework.  I wonder if they’d just come to class and/or do their work if they couldn’t e-mail me?)  I did put a mobile phone in my car when it first became available.  But that’s because I travel fifty miles to get to school and getting stuck isn’t fun. Getting stuck without a phone is even less fun;  I teach on-line, but that’s because we all want to stay “timely” and, as regards the school’s reputation, competitive.  But telemedicine?  I don’t know about that!   

I had heard the term “telemedicine” but never thought much about it.  It didn’t seem to have anything to do with my life.  Still, in recent days, curiosity brought me to a meeting about technological advances.  (As I previously noted, I do like to stay informed!) And that made me realize that telemedicine should be of concern to everyone!  For what really astounded me at that meeting was that most all of the people there were beside themselves with joy over it and I wasn’t!!  Then I looked around the room and noticed the majority of the individuals there were tech “junkies” – and, I’m not.

Put simply, telemedicine makes it possible for an individual to see a doctor without going to all the “trouble” of going to the doctor’s office.  Instead, you can “see” and speak to him or her online.  Thus, you can conveniently “fit in” such a doctor’s “visit” no matter how busy you are.   No more endless sitting in waiting rooms waiting for your appointment. Your MRI’s and other medical tests can be easily “whisked” off to this doctor and just as easily “whisked” off to any other doctor you want for a second opinion.  To calm any fears as regards the privacy of medical records, we are immediately told that privacy here is most definitely “assured.”  As far as money is concerned when it comes to online doctor’s “visits,” there are no travel expenses regardless of where you live and where the doctor practices.  Moreover, online “visits,” we are told, will cost less. Finally, a friend of mine jokingly noted another advantage of not having to actually go to the doctor that I didn’t think of: “You don’t have to get dressed to get undressed!”

In sum, telemedicine will be quick and cheap—the epitome of “efficiency” and “economy”!  But are quick and cheap the criteria that should be used here?  What about the “quality” of the online medical “visit” and, more importantly, the diagnosis a result of it? 

I can’t help wondering if using such technology as a “channel” between doctor and patient won’t erode that delicate relationship.  Will the doctor, seen and heard only on screen, be able to communicate the empathy that encourages the patient to trust the doctor and say all that needs to be said?  Or will the doctor “feel,” to the patient, like some kind of depersonalized, dehumanized on-screen performer?  At the same time, will the doctor listen closely to what the patient says, the verbal, and be attentive to the nonverbal “symptoms” presented by the patient—often more telling than words?  Or will the doctor be so absorbed by the tests and other data on his or her screen—or, more likely, multiple screens—that the patient is no longer the focus of this “visit”?  Indeed, the patient, too, could easily become depersonalized, dehumanized and just another “ailment”— but definitely not a name! 

And speaking of that diagnosed “ailment,” how will that be presented to the online patient?  Will the patient be motivated to follow the instructions of the online doctor?  And what happens if the diagnosis is a serious one?  How will the online doctor handle that?  How will the patient feel hearing it from a “talking head”?

Finally, we have taken for granted that both the doctor and patient have the latest technical equipment and excellent technical skills!  Just imagine the chaos if they don’t! 

I do see where there could be a need for telemedicine.  If the patient can’t physically get to the doctor, telemedicine is great!  I can see its usefulness where the doctor already knows the patient and is monitoring a continuing illness.  I can see its usefulness in garnering a second opinion . . .  The fact that MRI’s and other tests can be quickly e-mailed to doctors is a wonderful thing!  In this “wonderful thing” basket I would also include the use of the computer itself “augmenting” the doctor’s work when an in-office visit is made.  But otherwise as regards telemedicine specifically . . .  I’m not so sure.  And the idea that all this medical information will remain private . . .  Hackers are, surely, already at work!

Of course I do envision 2 big benefits in all this for me:

1)      I could see offering an Acting Course for doctor’s on “Webside Manner or How to Present Yourself as an Empathic Doctor to an Online Patient.” 

2)      If more patients go online to see doctors, it will be easier for me to get an in-person appointment with my doctor!

Yes, in fact, in this last, I can most definitely see that every new idea has its benefits, regardless of its negatives; I suppose that will have to comfort me.      

About Diane Cypkin

Dr. Diane Cypkin, Professor of Media, Communication and Visual Arts at Pace University has had articles published in The Journal of Radio Studies, the Ohio Speech Journal, the Communication and Theatre Association of Minnesota Journal, The New England Journal of History, has a chapter in the anthology Courage of Conviction: Women’s Words, Women’s Wisdom, and regularly reviews books for Martyrdom and Resistance, published by Yad Vashem. She has won awards for teaching and public service including the Jefferson Award, the highest national award for public service.

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