The practice of medicine is to the life sciences what finance and economics are to the mathematical disciplines. Both are wedged between STEM subjects and the humanities requiring skills emanating from both the right and left brain.
Read any student’s application to medical school or residency program as they explain why medicine’s intersection of science and humanity is most appealing to them. They quote our medical luminaries including Hippocrates (“Wherever the art of medicine is loved, there is a love of humanity”) and William Osler (“To serve the art of medicine as it should be served, one must love his fellow man”) who ground us in the need to balance our science with a strong human bond.
Over the past decades, multiple forces have threatened to erode the doctor-patient relationship and its foundational basis — trust. From the healthcare perspective these forces include the “corporatization” of medicine that monitors physicians’ “relative value units,” compresses visit times, and incentivizes “more” care, thereby commoditizing physicians. From the patient perspective these forces include cumbersome medical and insurance bureaucracies, inefficient processes, and systems of care that limit “face time” with their doctor.
For better or worse, the COVID-19 pandemic ushered in an era of telemedicine rapidly, stressing the doctor-patient relationship even further, particularly for the elderly and disadvantaged.
While technology is often a force multiplier for progress, it also has the potential to complicate and dehumanize the essential aspects of a physician-patient relationship. A virtual visit today is not only challenged by time constraints but also by imperfect technology. Delivering the news of adverse test results or counseling on an escalating care plan with significant risks (eg, surgery or chemotherapy), all while battling connectivity where you cannot read each other’s body language or provide reassurance, diminishes understanding, trust, commitment, and even outcomes.
Psychologists say that the art of the touch is essential to healing. The tradeoff for the logistical benefits of telemedicine is a diminished personal connection. In some cases, the benefits predominate. In others, “Zoom Medicine” is just another force that widens the relationship gap between doctor and patient.
As telehealth evolves, we must not only focus on how it allows “more” care but rather take a holistic view and work to integrate technology to improve care, compliance, and trust. This may sometimes mean less virtual “face time” and more actual “face to face” time.
Robert G. Uzzo, MD, MBA, FACS G. Willing “Wing” Pepper Chair in Cancer Research Professor and Chairman, Department of Surgery Fox Chase Cancer Center, Temple University