I started out intending to write a fairly negative article about telemedicine and then got hijacked by the TV show that was playing in the background.  First and foremost, I think face to face encounters are necessary at least 80% of the time in the medical field.  There are multitude of reasons why an in person medical encounter is essential and the number one reason is developing that “caring” relationship I discussed many times in the past.

Second on my list is obtaining an adequate physical exam.  While telemedicine is in its early stages, home diagnostic equipment already can provide the phone doc with BP, pulse rate, temp, weight; and my bet is that, in the not too distant future, a telemed doc will be able to see inside your throat, ears, nose and listen to your chest and abdomen.  Of course, a Facetime rectal (I’ve got to come up with some other term) is going to be a little more uncomfortable; and a pap, well, I’ll leave that to your imagination. Treatments will be defined by protocol.

In the future world of telemedicine using the home diagnostic equipment described above, will you really need a doctor, or will a computer program suffice?  When I think about it, and I do, a computer could do just about everything I did with the exception of caring for you, as an individual.

It’s my core belief that the true art of medicine is in the ability to develop multiple, caring/trusting, relationships. 

Now back to that TV show playing in the background.  I must confess, I’m a Judge Judy junkie.  There’s just something about watching an authority figure put aside political correctness and call an idiot “an idiot and a stupid one to boot.” I love the fact that she doesn’t take shit from anyone and her judgements are final.  She’s also quite humorous!  You rock, Judge Judy!

So, what’s Judge Judy got to do with telemedicine?  Well, the case she was hearing pertained to a internet scam based on developing a trusting/ caring internet relationship.  As I watched this woman make a complete fool of herself, I thought about a patient who sent hundreds of thousands of dollars to a Nigerian address because of a similar scam.  Researching this scam made it apparent that caring/trusting relationships can be made over the internet and maybe, just maybe, telemedicine can replace the conventional doctor patient relationship I hold so dear.

NAH!  That’s bullshit.  Telemedicine may be good for small things and routine follow-ups, but, for the stuff that really counts, in-person care will always be preferable and, in most cases, necessary.

Here’s your music for the day and a joke. The Judge said to the defendant, “I thought I told you I never wanted to see you in here again?” 

“Your Honor,” the criminal said, “that’s what I tried to tell the police but they wouldn’t listen.”

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