GPVILLANUEVA’S MAR [15-06]: Telemedicine, an Emerging Trend

Indexing Title: GPVILLANUEVA’S MAR [15-06]
MAR Title: Telemedicine, an Emerging Trend
Date of Medical Observation: June 2015
Tag: Telemedicine, although an emerging trend precludes physician-patient relationship  
Category: Professional/ Ethical – Reinforcement


My wife and I were preparing our dinner at home when my cellphone rang. It was a call from Cebu of a son of a patient asking about his father’s possible operation. The caller greeted good evening and introduced himself.  He sounded like a typical Cebuano who avoids talking in Tagalog due to a strong accent but fluent in English.

Curious as I was, I asked him where he got my cellphone number. He said that he called the hospital but there was no doctor to attend to his call so they gave him mine. I didn’t know how I will feel, because it is not appropriate to give information to strangers.  I just thought that the person who received the call from the hospital trusted me that much that I’m the first person in his or her mind regarding the matter.

I ended my inquiry and started asking about the purpose of the call. He was asking about his father, a 60-year-old male diagnosed with hernia in the province and was asking about how would be the cost of his operation here in our hospital.

During our conversation I remembered a Medical Anecdotal Report (MAR) presented by my co-resident last year regarding phone etiquette. Although it was about revealing the condition of a patient thru phone, but the message of that MAR remained in my mind. It is to limit disclosure of a patient thru phone and to do it in person on the clinic.

“Doctor, how much will I prepare for my father’s operation in your hospital?” he said.

I replied, “Sir, we don’t actually have consultations thru phone and I still have to see your patient to confirm the diagnosis of hernia. With regards to the expense, we are a government hospital so technically, we don’t have physician fee and there are several aspects to be considered.  It will depend if you want your father to be admitted as private patient of a consultant or not. Your father will also be evaluated for the risk of complication to the operation. All of these must be discussed in person in our Outpatient Department clinic”

“Doctor, I really need to know how much would be the cost because I will still tell my other relatives for them to provide for the operation.”

“I’m sorry sir I cannot do that here in the phone, but you can have your consult from Monday to Friday in surgery Outpatient Department and then I will explain to you further”

He was still insisting but I was still denying him of the disclosure. I repeatedly told him the importance of his consult and of seeing the patient in person.

(Physical, Psychosocial, Professional/ Ethical)
(Discovery, Stimulus, Reinforcement)

Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities.

Of its several advantages there is a drawback that is also one of the most important aspects of being a physician, the decrease in human interaction. Physician-patient relationship is established through personal interaction.

ROJoson’s Notes (17jan20):

There are advantages and disadvantages of telemedicine.  One has just to control the disadavantages and utilize the advantages.  An example of an outstanding disadvantage is that physical examination is limited.  This is oftentimes important in contributing to an accurate diagnosis.  An example of outstanding advantage is efficiency in time and efforts in diagnosing and advising treatment.

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