DO listen carefully
Do’s & Don’ts of virtual care There’s a lot to like about virtual care – for patients and providers. For minor conditions, patients can check in with their physician without having to leave home. No more headaches trying to find a parking spot, no need to find a babysitter for the kids. And during the pandemic, it has enabled patients, physicians, and clinic staff to stay safe. But there are challenges to delivering high-quality care over the phone or by video chat. Dr. Susan Hayton, former Director of Physician Advocacy & Leadership for the Saskatchewan Medical Association, offered a handful of tips that can help physicians make the most of their virtual visits.
There are a lot of cues that physicians – particularly family doctors – can pick up on just by looking at a patient. Do they seem upset? Are they behaving in the way they normally do? Do they look thinner? Are they pale? You can’t do that same visual assessment over the phone. “You need to be listening carefully, to ensure that what you’re hearing is not something that needs to be seen in person,” says Dr. Hayton. Patients may not realize that a symptom they’re experiencing is significant. “I do think it takes a bit of practice and heightened acuity or heightened cautiousness to be very sure that you’re not missing something when you talk to people (over the phone).” It’s better, she says, to err on the side of caution by having a patient come in for an inperson appointment if you have any doubts about what you’re hearing.
DON’T rush virtual visits
While many people thought virtual care would be faster than in-person visits, many doctors have found the opposite. That’s probably a good thing, says Dr. Hayton. “Maybe it’s partly because some of the cues you would get in an in-person visit you might not be picking up on, so you need to ask a few more questions.” And during the pandemic, some people have been lonely and just need to talk.
DO adjust your approach to chronic disease management
Chronic disease management has suffered due to COVID. For example, some physicians may have delayed regular appointments with their patients with diabetes, assuming that the pandemic would be over by now. Dr. Hayton says physicians need to think about how best to use virtual visits to ensure they are continuing to deliver optimal care. “Maybe I need to see them a little less frequently. Maybe I still schedule them for the same amount of blood tests, but we can discuss the results on the phone.” Be sure to communicate these changes to your patients as well. “Patients need to know what your plan is and why and how you are going to manage their care.”
DON’T assume all patients prefer virtual
If you’re trying to replace some of your routine visits with virtual care, be sure that’s what the patient wants and that it’s meeting their physical – and emotional – needs. “Offer people the option, particularly once it’s safer to do so after the pandemic is over,” says Dr. Hayton. “Despite the potential convenience of virtual care, some people will still want to see you in person because they feel that they get more from that.” Based on her own clinical experience, Dr. Hayton says many elderly people like getting out -- even if it is to visit the doctor. “It’s a social outing for them.” Similarly, patients struggling with depression or anxiety may not get the same benefits over the phone as they would from being with you face to face. “You have to figure out what the best type of visit is for the individual and the particular type of problem they have.”
Virtual care is a mechanism of ongoing care, says Dr. Hayton, but not a replacement for in-person care. “I think it’s becoming more and more clear that it’s a modality, but it shouldn’t replace other things that you do. There are some real benefits, but it just needs to be advanced cautiously.” ◆
SMA DIGEST | FALL 2020
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