Telemedicine is a good idea early in a pandemic when a vaccine doesn’t exist. This saves the lives of both healthcare staff and patients.
Telemedicine is a good idea for a patient stationed in Antarctica where the next available face-to-face visit is six months away.
Telemedicine can be a good idea when there is an a priori relationship between physician and patient—one in which there is an established deep sense of trust and one in which there is a system for rapid face-to-face backup.
Outside of these three scenarios, telemedicine is a race to mediocrity.
It often comes with deep downside risk to both physician and patient, particularly in reference to misdiagnosis and mismanagement. It’s also often dehumanizing. The over-dependence on algorithms and the lack of nuanced, face-to-face communication makes the evolution of a high-volume telemedicine system into a pill factory likely.
With this in mind, telemedicine should be a tool only used at the discretion and judgment of the treating physician — not the Chief Medical Officer, not the Chief Operating Officer, not the Chief Executive Officer, and not the patient. And that’s not going to happen.
Mediocrity, here we come.