Is Telemedicine Our Future?

The COVID-19 pandemic has unleashed a huge push for telemedicine, a means by which patients can "visit" their doctor without risking exposure to illness in waiting rooms and health care facilities.  Social engineers in our government view this as being a large part of our health care delivery in the future.  They have convinced many doctors that this as a good thing, effusively praising this new iteration of the doctor-patient experience as necessary and laudable.

But common sense has to tell you that this trend is not in anyone's best interest.

 There is a reason doctors are taught how to perform a physical examination.  The best physicians among us listen to the patient tell them what is wrong, ask the right questions to guide them to a diagnosis, confirm the diagnosis on physical exam, and know what to prescribe based on the most effective treatment.  Telemedicine has limitations, often removing the confirmatory part of this equation.

The most obvious problem with telemedicine is that not every symptom is from the same disease process.  Some complaints are notoriously vague and have an astonishingly broad number of possible etiologies.  A physical exam is an absolute necessity in these patients.  (Truth be told, even when a patient has already visited a health care professional, the resulting diagnosis can be incorrect, the physical signs of the problem missed, and the treatment ineffective.  Medicine is not always easy.)

 

Medical specialists not only are tuned in to the specialized parts of the physical examination, but have additional equipment available to them in their offices that helps to confirm a diagnosis.  These tools are often expensive, but not using them can lead to a missed diagnosis and the resulting incorrect management.  Thinking a telemedicine visit is adequate for specialty care is ludicrous.  And keep in mind that there are costs and risks associated with being misdiagnosed.

As anyone but a politician could surmise, there are countless examples of how the physical exam would change a presumed diagnosis and alter the treatment plan.  In my own practice in just the past month, there have been innumerable times telemedicine totally missed the underlying problem.  Here are just a couple of examples.

– An adult male complained of left ear pain.  The cause of the ear pain was an ulcer on the side of the voice box, a classic example of what is called referred pain.  The ulcer resulted from stomach acids coming up and spilling over the area when he slept on his left side.  He snored and had apnea from having large tonsils and a weak chin that could not hold his tongue off the back of the throat, the airway collapsing when he tried to breathe in while sleeping.  His nasal septum was deviated off to the left, making him sleep preferentially on his left side.  This is why acids would suck up from the stomach into the left side of the throat while he slept.  He had no heartburn, he complained of "post-nasal drip," and he was skinnier than most apnea patients, so his telemedicine doctor prescribed him the antibiotic Amoxicillin, thinking he might have an infection.  Proper treatment will instead revolve around apnea and reflux management.

– A child had an infection with nasty nasal discharge.  The cause of the problem was a small piece of chicken that had been pushed up into the nasal passage, where it stuck.  Telemedicine prescriptions of antibiotics had failed.  Treatment was pulling out the nasal foreign body.

– A teenage girl got light-headed and "almost passed out."  The cause of the problem turned out to be an unusual issue with the autonomic nervous system called Postural Orthostatic Tachycardia Syndrome.  When she would stand, her pulse skyrocketed.  In layman's terms, most of the blood in her circulatory system would stay in her "butt" and not make it to her head when she stood up.  Telemedicine interviewing a light-headed teenage girl correctly worried most about eating habits and low blood sugars, heavy periods and anemia, and dehydration.  Preaching good eating habits, iron supplements, exercise, and drinking more water didn't work.  Making the correct diagnosis in this case answered her legitimate and frightening concerns over what was wrong, even though the treatment of this problem is not predictably effective.

– Woman with a plugged up right ear.  The diagnosis was acute hearing loss caused by the COVID-19 virus.  A hearing test and normal physical examination of the ear confirmed the problem.  Telemedicine recommendations of flushing out the presumed ear wax and a subsequent trial of the antibiotic Amoxicillin for a possible ear infection were ineffective.  Just as losing your sense of smell can happen from a virus, so can issues like this.  Complete resolution of hearing loss is not always possible and may not happen at all.  Early steroid treatment helps more than anything else.

Nearly every patient seen at an office is getting a diagnosis as much from the physical examination and in-office testing as from the history available through telemedicine.  (Even before telemedicine, specialists like me would wonder about other health professionals' physical diagnostic acumen, especially since they don't have a specialist's in-office equipment.)  When the physical exam is just completely avoided, missed diagnoses will be the rule rather than the exception.  Antibiotics will be "thrown" at nearly everything, and we will be relying instead on people's natural abilities to survive illness in spite of our care.

The political left, with the help of the virus, is actively working to lower our expectations for the future.  Leftists tell us to hide from our friends and loved ones, asking us to accept a diminished life as a result.  They scream at us to wear a mask even if we have had the virus (with Biden naïvely predicting that if we all just did this for a week, this COVID-19 nightmare could have been avoided) and attack us if we don't.  They assume that we will give up our freedom to worship "to be safe" and hope we are fulfilled by them attempting  to supplant God in our life with a secular, benevolent government.

Telemedicine is another example of "Big Brother" forcing a diminished product on us using fear as an excuse.  Leftists hope we will be good lemmings and accept our fate.  It is scary realizing how much Americans are willing to sacrifice under the thumb of our politicians, personal freedoms be damned.  Scarier than that is how a complicit mainstream media will exaggerate and even outright lie to us to help the left in their quest for control.

When this all works itself out, I sincerely hope Amoxicillin turns out to actually benefit you when you get sick, because it may be the only approved medicine available through the government-issued app on your phone.  Actual trained doctors will be the next casualty of progress, all having succumbed to legal malpractice issues from delayed diagnoses.