It’s one of the biggest questions of the COVID-19 era: How to you connect with people when you’re so physically disconnected?
When bedside manner turns to ‘webside’ manner, there are some important things for physicians to keep in mind for virtual care. As the Canadian Medical Association’s Virtual Care Playbook discusses, it is easy in the virtual care environment to overlook the things missing from the conventional physician office.
The visible cues that normally assure patients of their safety and comfort in a professional setting are missing from the encounter. The visual limitations created by the tunnel vision of a monitor or smartphone screen restrict the patient from taking everything in and feeling naturally engaged in the exchange – seeing everything the physician is focusing on when not looking directly at them.
Trust is harder to gain in the virtual environment; yet it’s a critical part of a physician/patient relationship. That’s especially true for first-time visits. Trust is everything in the medical profession – as we discussed in Parts 1-3, relying on trusted services like a reliable online medical transcription service for doctor dictation or virtual visiting technology gives you the confidence that you’re in compliance with regulations and your patients information is kept private. Patients need that same level of trust in their physicians.
In spite of some of the virtual service challenges, early research – including a patient survey and observational study from Canada Health Infoway in BC – found virtual visits to be overwhelmingly positive when it comes to confidence in security and privacy, and 91 per cent of people in the study felt their health issue was addressed appropriately during the visit.
A half-dozen keys to ensuring your clinic is addressing the needs of the patient throughout virtual visits include privacy, professionalism, positioning, attention and mannerisms.
This one is about location, location, location. Your workspace for virtual visits should protect the patient exchange. Make sure the monitor can’t be seen and that the conversation can’t be overheard or interrupted – even if that sight line is through a window. Set it up so that you’re not just a giant head on a screen on the other side of your conversation. Patients don’t want to hear other people talking in the background, or see someone walking in the background while you’re doing a virtual visit.
Chatting with a patient over a computer screen can instantly seem a bit informal because at least one of you is in the comfortable surroundings of home, so it’s important to remind them that they’re interacting with a professional in a specialized environment. Use a neutral backdrop and good lighting to make sure the focus is on you and what you’re saying as opposed to items in the background. Wear your white coat; research has shown patients of all ages prefer their doctors to wear white lab coats, reinforcing their position as a health professional.
Positioning is all about eye contact in this context. Make sure you put your camera in a place that encourages eye contact through the lens. This isn’t an option with a laptop or a desktop computer without a separate web cam, in which case you’ll have to make a mental note to look up to the top of your screen once in a while to give the appearance of eye contact (which can be difficult on a laptop because when you’re actually looking a patient in the eye, your own eyes are slanted downward).
If you do have a separate web cam, align it as close as possible to the image you’ll be looking at.
Remember, the patient can’t see anything outside of your web cam’s scope, so take away distractions from your computer, your workstation, and your entire surroundings. This means shut off any and all notifications on your computer or phone that could buzz, beep, chime or rock during an appointment to cause a distraction and interrupt yours or your patient’s train of thought.
Another way to get the patient to properly engage with you without the in-person cues is overemphasizing them in front of the camera. Use body language (hand gestures, leaning into the frame) to communicate, reinforcing certain words and thoughts, and showing that they have your undivided attention.
As a bonus, you may want to collect or create educational texts and web links to share with patients after the virtual visit, replacing what you might have been showing them in your office or online during your regular visit.
The CMA’s Virtual Care Playbook also offers an overview/checklist to take you from setup to wrap, but the bottom line is that integration of this new delivery for some types of health care should help your practice and patients.
To read the other articles in this series, go to Part 1: Virtual Care and Your Practice – Finding the Right Fit ; Part 2: Virtual Care and Your Practice – Virtually All the Technology You’ll Need; Part 3: Virtual Care and Your Practice – Your Virtual Waiting Room
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