It’s not always necessary to get close to a patient to make a general diagnosis, or to counsel on good medical care. In dermatology in particular, as long as a medical practitioner can see a presenting skin condition, a long-distance data link with some good pictures can often be enough. ‘Teledermatology’, in fact, because it’s so visual, is one of the really fast-growing offerings in the healthcare field these days.
It’s not actually a very new idea, surprisingly. Two-way video consultations in other specialties have been around since the 1960’s.
Why haven’t they replaced in-person consultations altogether? Because that was never the intention.
Telemedicine isn’t a complete replacement for face-to-face care. It’s an enhancement. Target patients are the ones who already have diagnoses, but need follow-up. Or they’re the ones who, for reasons of distance or mobility, have trouble getting in, physically. They can also be people who don’t feel they have anything frightening, that needs attention right now, but who would like some competent counsel on something that’s bothering them, or some coaching on reasonable care. It’s for people who want to talk to a doctor.
It’s a strategy for healthcare that has been shown to work terrifically well in the developing world.1 In developed countries too, studies are demonstrating that doctors and patients do find teledermatology effective and satisfying across a range of skin complaints.2
In recent months, for pretty obvious reasons, the telemedicine option in patient care has exploded. It’s actually the case in some localities that video is almost the only option for consulting. Business analysts, as one would expect, are pointing to record use of online clinics now, and suggesting that healthcare going forward will never look the same again – we will use video consultations as an adjunct to face-to-face visits forevermore.3 It may be, in fact, that remote monitoring technology will soon be so good that things like home-based virtual intensive care will be possible, a capability far beyond, say, controlling acne or simple eczema. There is also talk of teletherapy currently, a virtual model that focuses on mental health. Outbreaks of anxiety and depression, no surprise, are turning out to be big features of pandemic lockdowns.
Patients like telemedicine because it’s quick and easy, and also because it doesn’t cost much, as a rule. Major insurance companies are happy to pay for the service, because it runs efficiently. Some practices partner with online pharmacies and big drugstore chains to make prescribing medication cheap and simple. Doctors like it because they avoid infection. Faced with the choice of trying to source quantities of protective gear that may not be available and setting up a video link instead, practice managers are scrambling to go online.
It’s hard to think of anything good that can come out of a pandemic. But the present one at least has helped accelerate what was a good thing already. We used to speak of teledermatology as the coming event, the way of future medicine. Actually, much to the benefit of patients and their healthcare providers, it’s here now.
1 Burg, G. JEADV 2020, 34, 670–671.
2 Frühauf, J, et al. JEADV 2015, 29, 919–924.
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