The Value of Physical Examination in the Era of Telemedicine

Abstract

Telemedicine use has expanded rapidly to cope with increasing demand on services by delivering remote clinical review and monitoring of long-term conditions. Triaging individual patients to determine their suitability for telephone, video or face-to-face consultations is necessary. This is crucial in the context of COVID-19 to ensure doctor-patient safety. Telemedicine was shown to be safe and feasible in managing certain chronic diseases and providing patient education. When reviewing newly referred or long-term patients, different specialty clinics have different requirements for physical examination. Clinicians prefer face-to-face consultations at the initial visit to establish a doctor-patient relationship; telephone or video consultations are reasonable options for long-term patients where physical examination may not be needed. Video consultations, often aided by sophisticated devices and apps or medical assistants, are useful to facilitate remote physical examination. Most patients prefer telemedicine as it saves time and travel cost and provides better access to appointments.

Telehealth for gynaecology outpatients during the COVID‐19 pandemic: Patient and clinician experiences

“…While modern medicine is increasingly reliant upon investigation, the inability to examine the patient will continue to be a barrier to telehealth acceptance. 22 The value of clinical examination is threefold; firstly, it adds objective assessment to the subjective patient experience of an illness, guiding judicious use of investigation and treatment; secondly, human touch in itself may have therapeutic value in improving the doctor–patient relationship and alleviating patient and clinician anxiety about possibility of misdiagnosis; and thirdly, examination allows opportunistic screening for other health conditions. Although virtual patient‐assisted examination is expanding in response to the uptake of telehealth, 23 there are obvious logistic and privacy limitations with regard to examination of the pelvis and genitalia.…”

“…While modern medicine is increasingly reliant upon investigation, the inability to examine the patient will continue to be a barrier to telehealth acceptance. 22 The value of clinical examination is threefold; firstly, it adds objective assessment to the subjective patient experience of an illness, guiding judicious use of a pandemic, resulting in a low recruitment and response rate. This may have been improved if we had dedicated research staff to engage participants.…”

Physician Perspectives on Telemedicine in Radiation Oncology

“…There is an increasing body of literature that describes a physical examination as an examination performed remotely with the aid of patient or caretaker assistance or adjunctive devices, such as wearables and monitors. 18 It is possible that with increased familiarity with remote physical examination skills or greater proliferation of technology supporting remote examinations, the need for an in-person examination will become less important.…”

The Logistics of Medication and Patient Flow in Video-Based Virtual Clinics During a Sudden COVID-19 Outbreak in Taiwan: Observational Study

“…Novel technologies such as an electronic stethoscope, pulse oximeter, or wearable electrocardiography can only be used in certain conditions. This barrier may preclude the use of virtual clinic visits for the initial visit of a new patient [ 26 ].…”