Last week, I had my first " #telehealth" (actually, telephone) visit.

It was a long-scheduled annual wellness visit with my primary care doc.

Thread, from my dual vantage point as a doc & a patient:
1. There are so many signifiers of "medicine" that go missing in #telehealth.

No weight check, no BP check, no pulling of the curtain.
2. I know (as a doctor) that much of the physical exam is "for show" - but I& #39;ve come to expect it.

It& #39;s tough to accept that a visit is "thorough" without these physical markers of care.

https://www.webmd.com/a-to-z-guides/annual-physical-examinations">https://www.webmd.com/a-to-z-gu... )
4. To get academic: the semiotics felt .... off-kilter.
5. BUT: I was also surprised by how reassuring it was to hear my long-time doc& #39;s voice. To hear her usual questions. And to have the chance to dive in deep on sticky issues (like: given my mixed heritage and distant family history of cancer, do I *really* need genetic testing?)
6. And to find that maybe it didn& #39;t matter so much that this was on the phone, instead of in person.

I still felt cared for and healthier as a result.
7. A little bit of me wonders about cost: is it FAIR that docs should be paid the same for these visits?

(Quick answer: yes. The cognitive load is the same.)
8. A little bit of me wonders about efficacy: Will Americans& #39; health suffer because of the widespread transition to #telehealth? I talked about cancer, but what about in-person screenings?

(Quick answer: it will probably suffer.) https://www.statnews.com/2020/05/04/cancer-screenings-drop-coronavirus-pandemic-epic/">https://www.statnews.com/2020/05/0...
11. And with newer telehealth modalities that are developing during #COVID19, we may see a new, enhanced experience that keeps patients healthier & happier https://abs.twimg.com/emoji/v2/... draggable="false" alt="💕" title="Two hearts" aria-label="Emoji: Two hearts">https://abs.twimg.com/emoji/v2/... draggable="false" alt="đŸ˜·" title="Face with medical mask" aria-label="Emoji: Face with medical mask">
12. Most of all: we may not have a choice.

/fin
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