The first thing I heard from my team after starting full time telehealth was the exhaustion that seemed to set in at the end of the day. I have noticed this myself. After 8 hours of back-to-back virtual engagement with parents I found myself with a kind of telemedicine fatigue that’s hard to describe.
Then I started hearing the same sentiment from doctors on Twitter. Here and there I hear the the same thing: constant virtual engagement was taxing in its own way.
Of course, there was the expected social media posturing from those who find that virtual medicine is nothing but rainbows and unicorns. Or better, I ‘had to be doing it all wrong.’
There are a few potential explanations for this almost consistent report among my colleagues who had transitioned to a full telehealth practice. I’m going to continue to dig deeper into this but I suspect that it represents a couple of things.
Often there are inconsistencies in connection, lighting, front-facing lens hygiene, and video quality that require a kind of on-the-fly compensation. And there are the parents who want to hold their phone at arms length during a 30 minute consult creating a simulated earthquake experience.
The most obvious potential contributor to this fatigue is the simple stress of transition. Adjusting to a completely different workflow is impossibly challenging, especially for health professionals who have been conducting analog care for most of their career. And on both ends of the encounter is the new ‘literacy’ of engagement by live video connection. For example, the basic error of watching the screen display rather than the seeing-eye camera leads to a classic disconjugate virtual gaze that is subtly jarring and strangely distracting.
But the source of telemedicine fatigue goes beyond professional adjustment and correction of technical glitches.
I’ve identified that the emotional stress of subtly strained connection is a huge contributor to the exhaustion I feel. A video connection negates the subtleties of connection that are critical to my assessment of a parent and child. Identifying and exploring these subtleties is central to the care of chronically ill children and their families. It feels like I’m working hard to pick up on non-verbal cues that may be difficult to identify or simply out of the frame of view. The simultaneous observation of a mother and child in the same frame presents its own challenges in a home environment. I call this the ‘drive by’ telemedicine assessment as the child zips in and out of the field of view grabbing toys, running for snacks, etc.
I’ll unpack this more as think about it. And I would love your ideas on what’s behind this observation of telemedicine fatigue.
Update: Here are how the brains at Google explain the jarring disconnect of online connection.
If you liked Telemedicine Fatigue you might like the 33 charts Telemedicine Archives. Have a peek.