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Bring the Conversation Back to the Exam Room

By Alan J. Micev, MD

As a hand surgeon, I pride myself on consistency. I am compulsively on time, I almost always listen to the same music in the operating room (bossa nova, for those of you who were wondering), and at the start of a case, I tap my foot the same number of times on the bipolar pedal to confirm whether or not it is functioning properly. The introduction of telehealth completely changed my clinics and my practice. At first, I was hesitant and reluctant to participate because I did not see or appreciate the value. But now, I believe it has the potential to revolutionize modern medicine. As a community, I think we should embrace it and integrate it into our practices. In my opinion, implementation is the biggest hurdle.

The best advice I can give someone trying to overcome that initial hurdle is: bring the conversation back to the exam room. Treat your patients as if they are in the clinic. The idea is simple, but the effect is dramatic.

Initially, at the start of the pandemic, I was seeing telehealth patients from my living room at home. The overall quality of these encounters was mediocre at best. The setting had completely upended my ritual of seeing patients in the office, and consequently I could not get into the right mindset.

I needed to get back to the routine I had become accustomed to over the past several years. I decided to bring the conversation back to the exam room. In our clinic, laptops are placed across the hand table in the exam rooms. My medical assistant begins the encounter by “rooming the patient.” She confirms there is adequate lighting and sound as well as a good connection. I see, evaluate, and treat telehealth patients as if they are in the office. I immediately noticed increased patient as well as personal satisfaction with the visits.  

Nowadays, our practice utilizes telehealth for an array of different reasons. We can evaluate patients acutely in emergency rooms, perform inpatient consultations at multiple hospitals, as well as treat patients who live far away, have a transportation issues, or those who are at high risk. The face-to-face encounter remains the gold standard, however, I believe telehealth will become an invaluable tool for both patients and providers moving forward.

Comment (1)
Charles Carroll
June 12, 2020 12:26 am

Nicely done. Process and setting do combine to optimize the visit and the experience. I agree with your thoughts and comments.


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