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July 13, 2020

Baby and Bathwater—A Telehealth Tale

Author Affiliations
  • 1Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington
JAMA Pediatr. 2021;175(1):11-12. doi:10.1001/jamapediatrics.2020.2205

A fictional scenario: a recently retired general academic pediatrician (called Dr 20th), who came of age as a clinician in the last quarter of the 20th century, has read a perceptive, strongly positive JAMA Pediatrics Viewpoint on telehealth. This pediatrician is on a video call with a good friend and former trainee, a primary care pediatrician who is experienced, forward-looking, and trained in the 21st century (called Dr 21st), when the conversation turns to telehealth.

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1 Comment for this article
How to Get the Best of the Two?!
Arvind Joshi, MBBS MD FCGP FAMS FICP | Founder Convener and President Our Own Discussion Group Mumbai PIN 400028 & Ruchi Diagnostic Center, Ruchi Clinical Laboratory, Kharghar PIN 410210, Maharashtra State INDIA
Of course, every one, till an year ago, faced people actually.
For very peculiar reasons, I also had to help people who were NOT in front of me.
I worked in a village. In my childhood, even the telephone landline also was scarce. Fortunately, when I entered my personal Medical Practice, after a waiting of six months, I got a landline telephone. In the era when villagers who thought of a doctor, in the words of my father, who was the only qualified doctor in area of 40 kilometres' radius, to the villagers, any one with a tube(Stethoscope) around the
neck, a tube (Thermometer) in the pocket, and a tube (Syringe) in the hand was a Doctor.
As a Consultant Physician, I did wield the first two. But often the third was missing, unless the medication had to be an injection only, either because medication is only available as in injection like benzathin penicillin comes only as an injection, or due to the situation being an emergency. So some people from very remote moffusil places thought I am only a half doctor. The idea was more strengthened because I did not dispense but Prescribed Medicine. Once a person asked me why I am charging fees, was I MBBS at all?
Humor aside, if I was not dispensing or injecting medicines, people felt why they should come for a follow up and why can I not prescribe Medicine on telephone, instead of in person follow-up. Some time, when certain advice had to be given at odd hours and it would be impossible for people to see me in person, improvisation had to be done by giving advice on telephone. Right or wrong, Tele-consultation of sorts could not be escaped.
When the Lockdown came into force, I did not find the Tele-consultation a jarring change. Yet one can not get all the perceptions of in person Examination and Consultation. At the same time, for the people convince and comfort and saving time and hardships of travel by Tele-consultation is Icing on the Cake!
But of late again, people have become keen to see their Physician in the person!
Let us see how the things evolve as the future unfolds!
- Arvind Joshi.