Telemedicine and our moment of transition

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In 2020, with the overnight adoption of telemedicine, we experienced a variant that twentieth-century theorist Marshall McLuhan called moment of transition. It basically suggests that when we are faced with a new media, we tend to use it in a way that reiterates the old media. Early use of YouTube, for example, mimicked television. Years passed before users could truly harness the power of YouTube as their own creative medium and platform.

Doctors are no different. When we adopt a new technology, we usually see it through the lens the way we have always done things. The adoption of telemedicine is a good example.

See new technology through a 20th century goal

Although McLuhan’s iconic quote referred to the media, the transitional moment applies to our response to telemedicine. In our telemedicine encounters, we tend to frame this new type of connection in the context of a real-life encounter. We find it hard to imagine a different structure or paradigm for connecting with patients. Therefore, we seek comfort in old constructs and shape telemedicine visits that evoke images of our clinical spaces.

The telemedicine platforms used today make skeptical doctors comfortable with a remote doctor-patient connection. Developers bake into skeuomorphic elements that evoke images of the square and UV-lit exam room. Waiting rooms and reassuring pop-ups that suggest this the doctor will see you soon it makes us see the remote video connection as a virtual iteration of a convenient analog process. Some doctors even appear on the screen as if they were physically in a 20th century exam room with a stethoscope in the neck.

The next wave of telemedicine

The next wave of remote care will involve taking the telemedicine meeting to a new level. Your own level. Instead of working to mimic a visit to the IRL office, the evolution of remote care will involve shaping a patient experience that builds on the defining strengths of a virtual connection. Monitoring the patient through a point of care will make the encounter with telemedicine look very different. More importantly, provider and patient expectations will evolve so that emotional comfort zones in examination rooms and reception areas become part of the pre-digital health history.

Telemedicine at this time will again be medicine.

The next phase of 21st century medicine will also recognize that the continuous connection between physician and patient will range from an asynchronous text exchange to the actual laying on of hands. Despite the convenience and excitement of remote video attention, we will return to the reality that there are some things that require human touch. And as new forms of virtual, defining connection appear what kind of doctor-patient connection it serves better what kind of problem our professional discussions will occupy.

Care as a continuum rather than a series of episodes

Just as the connection between physician and patient will not be restricted to a single medium, neither will it be restricted to a single moment. The relationship between a patient, their data, and the healthcare system will become something that happens closer to real time than during the annual physical meeting or even one-off telemedicine. Players who can create the technology that supports this permanently connected clinical environment will shape the future of healthcare practice and the future of the able-bodied patient. Our success as health professionals will be defined by our ability to adapt and function in this new connected environment. More importantly, professional success will be ensured by our active participation in the process of imagining and shaping the future of the clinical encounter.

When McLuhan suggested:We look at the present through a rearview mirror. We are moving backwards towards the future“It could also have been describing our awkward first steps towards telemedicine. This is the moment of transition in medicine. We can take advantage of this moment or continue to see our relationships, encounters and even our technology through the comfort of the rearview mirror.


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