Page 41 - Part 1 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

A particular consideration for non-face-to-face medicine might be

called attenuation. There are collateral signals present in the room
during an in-person visit that may be lost through a video viewing

window. This can make the exchange more transactional and less
interactive. Some positive benefits of transactional communication

are that it may make it easier to:

 Remain focused on specific goals and tasks

 Direct the discussion according to the needs of the provider
(or even shut it off abruptly)

 Cut off threads that aren’t goal directed

 Manage time

Some negative aspects of trading transactions for interactions are

that:

 Tightly managed dialog often gives patients the feeling of

being rushed, not fully heard

 It can sacrifice the high value of silence

 It can preempt the surfacing of ideas that are not yet fully

articulated

 It can lose the opportunity for the well-recognized
phenomenon of the “by-the-way” moment at the doorway

that reveals critical information.

The differences in subliminal and non-verbal communication
between in-person and virtual visits are not completely

understood, and likely depend on technical variables like sound
and video quality and viewing distance. These nuances become

appreciated with experience, and good tele-providers

accommodate for them.

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