In the early days of COVID-19, I often found myself frustrated. While everyone else had the luxury of working from home, I still had to go in. In some medical specialties, telemedicine was a perfect substitute for office visits—psychiatry, internal medicine, and even bariatric surgery, where visits mostly revolved around discussing lab values or imaging results, with little need for a physical exam. I recalled times during my training when attendings would review a CT scan of appendicitis in the middle of the night and casually say, “Book for OR,” trusting that the residents had conducted a thorough physical exam without needing to touch the patient themselves.
Navigating the Age of Telemedicine: When Technology Can’t Replace Physical Exams
However, I found myself in a subspecialty where the accuracy of a diagnosis is crucial, and there’s no one-size-fits-all treatment. In my field as a colorectal surgeon, a physical exam is essential. While I can formulate educated hypotheses, the only way to truly understand a patient’s condition—whether it’s a hemorrhoid or something more complex—is to examine the anorectal area directly. And sometimes, this requires not just visual inspection, but the application of an experienced touch. Though telemedicine serves its purpose for certain cases—such as when patients are out of state or when imaging is more critical than a physical exam, like in cancer—it’s no substitute for the hands-on approach that surgery and patient care demand. Despite our reliance on technology and imaging, our foundation as physicians lies in the thorough history-taking and physical examination we’ve been trained in.
The Limitations of Telemedicine in the Age of Telemedicine: Why We Need Human Connection
In the current healthcare environment, many providers are forced to travel between various offices and juggle ever-changing schedules to maximize their productivity. However, in the age of telemedicine, I have more control over my time as a private practice owner and appreciate being a steady presence in my community. My patients know that, every week, they’ll find me in the same place, at the same time. They can expect a warm welcome from my staff and thoughtful care from me. Even though external factors like insurance requirements, hospital administration, and electronic health records (EMRs) complicate matters, my ultimate goal remains to heal the patient-physician relationship through genuine human connection, one interaction at a time.
Embracing In-Person Care: The Power of Face-to-Face Encounters
I recently had a patient who was moving out of state. A few hours before the moving truck arrived, he made the effort to come in and express his gratitude. “I wanted to thank you,” he said. Those simple words underscored the lasting impact of in-person care. The human touch—both figuratively and literally—makes a difference that technology alone can’t replicate.
As I reflect on the increasing reliance on technology in healthcare, it’s clear to me that while telemedicine has advanced us, we cannot forget why we became physicians in the first place: to help people. This article began as a reflection on the value of reassurance, but it’s ultimately a tribute to the importance of being present—for our patients, in person.
As Susan leaves the office, she smiles and says, “I’m glad you’re here on Fridays.”
I offer a small wave, replying, “You know where to find me.”
Carmen Fong is a colorectal surgeon.
For more on the evolving role of healthcare providers and how to maintain a human connection in a digital world, visit Stanford Physician Advocate.