Teleconferences and Teleconsults

By Dr. Michaela Ann Gonzales-Montalbo

My husband closed his laptop late that night. He had just finished one of the on-demand PCP videos from the last annual convention. On the adjacent table was my laptop streaming an international conference on food allergy.  

"Do you think things will go back to face-to-face conferences?" he asked.  

"Yeah," I absent-mindedly nodded, as I took a screenshot of a diagram.  

"No, like 100% face to face? Without any virtual event?" He was getting ready for bed.  

"No," I shook my head. I'm happy about how virtual conferences became a thing. I looked at him. "Guest speakers can just record their lectures, instead of chasing planes and adjusting their schedules for a face-to-face."  

On my screen, an esteemed doctor admitted that he recorded his lecture while isolating in some resort, before he presented his disclosures.  

"We can listen to multiple conferences at the same time," I said. I reminded him that we were both watching two different lectures a while ago. "And we can watch the videos again. Pause the video when we need to go to the bathroom, or when we need to write notes."  

He agreed with me. "Things will be a hybrid then." 

Virtual conference are convenient.  On the other hand, I really miss lining up in booths and filling my big bag with free ballpoint pens and notebooks. 

Technology has been keeping pace, even in quarantine. While in isolation, we found a way to adapt to the lack of personal communication with our families, friends and colleagues.  The conferences pushed through. In the medical field, virtual consultation immediately became a thing.  

When I started fellowship in Allergology and Immunology, my seniors told me that they saw most of their patients through teleconsults. Face-to-face consult, though, is starting to make a come back, little by little.

It’s amazing how it can be convenient for our patients, especially the elderly, and the immunocompromised, to be seen by a doctor immediately. They do not have to queue for a long time in the outpatient department. Instead, the patients can just wait for their teleconsult schedule in the comforts of their homes, shielded from the virus lingering outside their doorsteps.

But what makes teleconsult extra-challenging is the physical examination. I ask my patients to send pictures of their lesions, if they have any. But even so, not every photo is good and clear and contains all the needed details. Sometimes, I ask them to send their pictures multiple times. I also miss using my stethoscope. I want to hear the patients’ breath sounds or rhythmic lub-dub of their hearts.

There is also the rapport between a physician and his/her patient that may sometimes be lost when talking in front of screens. For instance, because I can’t see the patient fully, I can’t observe the walk, the hand gestures, the fidgeting, certain mannerisms. Those tiny details that give a clue about the patient I’m treating.

A glass barrier exists. It is cold and calculating, with its pixels and audio. And oh, sometimes, the internet has its own problems too. The words can come out like gibberish on another end. There are choppy stories, and so I have to ask the patient to repeat many sentences again and again.

The art of medicine can sometimes be lost in screens. Although teleconsult is a real convenience, nothing beats seeing patients face-to-face, shaking their hands, examining them personally. My medical diagnosis is not clouded by technical difficulties.

Looking back from the pre-pandemic and during the lockdown days, we have really evolved in our ways. The future of medicine is inevitably interwoven with the progress of technology. While it’s good to push further, it is also important to always look back to where we have been, and to never forget the basics.

Michaela Ann Gonzales-Montalbo, M.D. is an internist who graduated from Batangas Medical Center and is currently on her first year of fellowship of Allergology, Asthma and Immunology at Fe del Mundo Medical Center. She juggles her time between her fellowship duties, her mommy duties, and her passion in creating literary pieces.

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