window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'UA-97641742-42');

2023 LMS Essay Contest: Medical Student 3rd Place

“The Rise of Telehealth and the Floating Head Phenomenon”
By Hannah Cleary

With origins in Louisville, Kentucky, Hannah Cleary obtained a Bachelor of Science in Agricultural and Medical Biotechnology from the University of Kentucky in May of 2022. Hannah is currently a first-year medical student at the University of Kentucky College of Medicine where she serves as a Medicine Student Ambassador in addition to being a member of the Medical Student Curriculum Committee. Hannah conducts research in the department of surgery and volunteers her time as an assistant track and field coach at Frederick Douglass High School in Lexington, Kentucky.   

“Hello, you have reached the office of Doctor X. If this is a medical emergency, please hang up and dial 911.”

A telephone is a system for transmitting voices over a distance using wire or radio, by converting acoustic vibrations to electrical signals. The first patent for the telephone was granted in 1876. In 2023, nearly a century and a half later, telephones seem to control, or at least attempt to control, every aspect of human life. The reach of the telephone knows no bounds. There is next to nothing, neither age nor gender nor race nor ethnicity, limiting who is in possession of a telephone. Similarly, there is next to nothing the telephone seems to lack. There is an “app” for nearly everything. Why? “To aid the user in doing specified tasks.” If you can text them instead, why email? If you can provide a status update to the world, why call? If you can stay at home and watch, why attend? If you can renew your prescription with a short, simple message, why meet your doctor at the office? If you can get a diagnosis with a quick video chat, why bother your doctor in their element? The ease with which “healthcare” can be delivered via a simple device is utterly amazing and entirely alarming. Yet, this is the current practice of medicine: telehealth.

Telehealth is the provision of healthcare remotely by means of telecommunications technology. In short, telehealth is the phenomenon of the floating head. The patient sees the physician from the neck upwards, and, if the physician is lucky, they see the same of their patient. In a rare turn of events, an upper torso may enter the picture, but, for the most part, there are only floating heads. If the only way you interacted with your spouse was via a screen and an image of their head, would that be enough to feel and genuinely express the love you have for them? If the only way you interacted with your closest friend was via a screen and an image of their head, would that be enough to relieve any building tension and maintain rapport with them? If the only way you interacted with your mentor was via a screen and an image of their head, would that be enough to establish a trusted relationship built on encouragement and support from them? If this miniscule screen and this incomplete image is not enough, then how can they be enough for a physician seeking to foster a relationship with their patient?

The relationship between a physician and their patient is not one of a mere spouse, close friend, or mentor, though. The physician-patient relationship is a conglomeration. The patient is meant to feel genuinely cared for by their physician as in a spousal relationship. The physician is meant to empathetically connect with their patient despite any conflicting ideologies as in a close friendship. The physician is meant to advocate for and embolden their patient to take control of their health as in a mentorship. Without a doubt, this combination of qualities has the potential to result in an advantageous physician-patient relationship. However, if each of these qualities cannot be independently fostered with a screen, then it is insensible to argue that the totality of these qualities could be simultaneously fostered with a screen, specifically regarding the relationship between a physician and their patient. The screen is convenient. The screen saves time and money. The screen cannot, however, serve and heal which is the calling of a physician.  

Serve is the performance of duties or services for another person or an organization. Heal is to cause a wound, injury, or person to become sound or healthy again. A patient very rarely visits their physician with the intent to merely chat about their life. Yet, those visits where the patient is not only allowed, but is admittedly encouraged to share more than their list of symptoms are arguably the most comforting and confirming visits for patients. These are the visits from which patients walk away feeling truly served or truly healed. In these visits, the patient observes how their physician faces them with their body, notes how they maintain eye contact, and remarks how they move their body in agreement and not as if they are hasty to escape. In other words, the connection is not unstable, the camera is not unsteady, and the patient sees more than a mere head. Telehealth is a powerful tool, but, if allowed to grow unchecked, will result in the utter downfall of the physician-patient relationship. The telephone is a considerable convenience and yet, is not always the necessity such a device is made out to be in this year of 2023. 

“We appreciate your call to the office of Doctor X, and we look forward to seeing you at your next appointment!”