In May 2020, I wrote a piece published on this very website titled, “Remembering the art of medicine during virtual visits.” In that article, I wondered how telemedicine could possibly allow us to make the humanistic connection that occurs more organically during in-person office visits. Now, more than three years later, and after hundreds of telehealth visits, my patients have shown me how.
In December 2020, one of the bleakest periods of the pandemic, an elderly patient lamented that she and her husband would have to spend Christmas alone, away from their children and grandchildren. As I tried to console her, I happened to notice and commented on a small knitted stocking hanging from the Christmas tree behind her. She proceeded to pull it off the tree and told me how her great-aunt had knitted it for her and had given it to her for her very first Christmas over 80 years ago. It has hung from her Christmas tree every year since. It brought back a flood of happy childhood memories and Christmases spent with her children and grandchildren, which helped lessen her disappointment.
During another telehealth visit, my 75-year-old patient was speaking to me from her home office, and I noticed several diplomas on the wall behind her. I commented, “I didn’t realize you were so well educated.” She said, “Those are actually the high school and college diplomas of all my grandchildren. Their parents didn’t want to display them, so I asked for them. Now, all my grandchildren give me their diplomas. I’m running out of room on my wall!” She beamed with pride as she pointed to each diploma and told me about each grandchild’s degree and accomplishments.
Another patient had what appeared to be memorabilia from several baseball ballparks displayed on the wall behind him. By now, I knew there had to be a story, and he didn’t disappoint. He and his late father had collected them over several years as they attempted to visit as many parks as possible. “Those trips are some of my fondest memories of my dad. I hadn’t thought about them in a while. Thanks for noticing them and reminding me of him,” he said.
In their book, The Good Life, Drs. Robert Waldinger and Mark Schulz describe the findings of their 84-year (and counting) Harvard study on happiness: “So if you’re going to make that one choice, that single decision that could best ensure your health and happiness, science tells us that your choice should be to cultivate warm relationships. Of all kinds.” These tales my patients tell me during these telehealth visits help them reinforce their relationships with their families and can reestablish their relationships with me.
In the early 1930s, house calls comprised 40 percent of physician visits, but by the 1980s, they declined to less than 1 percent. During its heyday, house calls allowed doctors to deliver care to patients who were either too ill or lacked the resources to travel to the doctor’s office. Now, with Zoom, telehealth visits are a modern-day version of the house call. With the magic of modern technology, physicians can be rapidly transported from their exam rooms to their patients’ homes simply by clicking “new meeting.” Think more Star Trek than Little House on The Prairie. But just because you’ve been immediately transported to your patient’s home doesn’t necessarily mean that you’re “there.”
When I last wrote for this site in May 2020, I mentioned the importance of actively cultivating meaningful physician-patient relationships even over telehealth. So during your next telehealth visit, try noticing something in their Zoom background to be present with your patient. Let it anchor you. Show your patient that you’re really “there” with them. Ask about that knick-knack on their shelf or painting on their wall. You never know what you might learn. You’ll let your patient know they mean more to you than just their diagnosis or medical condition. And just like that old-school doctor who drove and walked miles across country roads to deliver essential care to the sick and needy, you’ll be providing an invaluable service to your patients and yourself.
Joseph Barrera is an endocrinologist.