Proper distance in the age of social distancing: Hepatitis C treatment, telehealth and questions of care and responsibility

Abstract

During the COVID‐19 pandemic, telehealth has played a prominent role in the treatment of hepatitis C. As part of a qualitative study on the accessibility and effectiveness of telehealth for hepatitis C treatment during this period in Australia, this article considers how health‐care practitioners and patients experience and manage their proximity to each other in telehealth encounters of care. Comparisons between telehealth and in‐person health‐care tend to focus on measures of patient satisfaction rather than qualitative changes in treatment relationships. Media scholar Silverstone (Digital media revisited: Theoretical and conceptual innovations in digital domains, MIT Press, 2003) uses the term ‘proper distance’ to theorise how ethical relationships are mediated by technology. Drawing on this concept, we explore how patients and health‐care practitioners understand telehealth as affecting distance and proximity. We find that both groups express some ambivalence about the impact of telehealth on relationships, on the one hand expecting and privileging simple, transactional relationships, and on the other hand, expressing concerns about the loss of more intimate relationships in health care and about ‘missing something’ while providing health care. Given that proximity is important to the development of ethical relationships in health care, we conclude with some considerations for establishing and sustaining attentive and responsive relationships in telehealth.

Telemedicine in specialist outpatient care during COVID‐19: a qualitative study

“…40,41 Furthermore, the absence of a physical examination might impact clinicians' comfort with meeting their duty of care to patients or cause patients to question whether practitioners can adequately understand their conditions during telehealth consultations. 42 Some clinicians in our study voiced similar concerns, and it appears important for policymakers to consider these dynamics when implementing hybrid models of care in order to meet clinicians' professional and personal expectations of care and achieve optimal clinical outcomes. Our findings also highlight the importance of considering patient safety in the implementation of new telemedicine models to prevent mishaps or accidents.…”

“…However, most clinicians largely favoured in‐person consultations for many clinical problems, citing the value of physical cues 40,41 . Furthermore, the absence of a physical examination might impact clinicians' comfort with meeting their duty of care to patients or cause patients to question whether practitioners can adequately understand their conditions during telehealth consultations 42 . Some clinicians in our study voiced similar concerns, and it appears important for policymakers to consider these dynamics when implementing hybrid models of care in order to meet clinicians' professional and personal expectations of care and achieve optimal clinical outcomes.…”