What does bedside manner mean in an age of telemedicine?

How do you improve your webside manner for telemedicine?

 

Few patients took advantage of telehealth or virtual visits before the COVID-19 pandemic. But with the convenience it offers patients, a rising interest in telemedicine is here to stay.

 

Before the COVID-19 pandemic, clinicians conducted less than 1% of outpatient visits via telehealth, according to the Peterson-KFF Health System Tracker. Today, telemedicine visits account for about 8% to 17% of U.S. patient visits across all specialties.

 

While patients appreciate the ease of online appointments, practitioners also acknowledge the benefits.

 

Following the pandemic, a survey of physicians on telehealth found:

• 85% indicated that telehealth increased the timeliness of care
• 75% said telehealth allowed them to deliver high-quality care
• More than 70% were motivated to increase telehealth use

 

By now, practitioners have become familiar with virtual visit platforms and the legal guidelines, but conveying a caring bedside manner through a screen can be more challenging to master.

 

Here are some tips to improve your bedside – or “webside” manner.

 

Ensure privacy
With an office visit, patients can see who’s in the room, and they know the visit is confidential. So, ensure your virtual visits also occur behind closed doors in a private setting.

 

To remain HIPAA-compliant, confirm that anyone else in your room is necessary for the visit and approved by the patient. And it’s always a good idea to ask patients to introduce others participating in their virtual appointment.

 

Project professionalism 

Make sure the area visible in your video is simple and professional, not distracting. Try your best to eliminate noise, including kids, music, pets, and whatever may be happening outside the house (such as yard work or machinery). Patients want to feel confident you’re listening and concentrating on them.

 

Preparation is key

Be prepared just as you would during an office visit. First, read the patient’s chart and understand why they made the appointment before you dial in. Then have the materials you need within arm’s length.

 

And be sure your patient is prepared for the appointment as well. Consider having your office get in touch with them to explain how the process works and confirm they know how to log on to a virtual session. Also, remind them to have whatever tools are necessary – blood pressure cuff, thermometer, glucometer or scale. In addition, ask patients to bring a list of active medications.

 

Get ready for your closeup 

 

For some Hollywood tips, be sure your video area is well-lit. Place your camera at eye level. The frame for your shot is from the chest up with some headroom above you.  framing for your shot is from the chest up, with your face filling the frame and just a touch of headroom above you.

 

When selecting your wardrobe, choose solid colors over multicolored patterns. Earth tones, like deep blues, purples and teal green, work well with virtual meetings. If you usually wear scrubs or a lab coat for appointments, you may also want to maintain that wardrobe for telehealth visits.

 

Ease into the conversation

To get things started, introduce yourself at the beginning of the call. Then, make sure your patient can see and hear you well. Next, discuss what you will do if technology glitches interrupt the call. For example, will you reconnect via video? Call them by phone?

 

Since the call may be short, establish a friendly rapport early, so the patient feels comfortable. You may even want to ask them about something you see in the room for a nonmedical connection or icebreaker topic.

 

Ensure patients feel heard and seen  

Patients want providers to listen to and understand their concerns during a virtual visit. Let them finish their train of thought before asking questions or interrupting.

 

Make eye contact with your patient by looking at the camera (not the image on the screen). And explain that you are taking notes or reviewing their chart if you're looking away to do so.

 

Body language and video calls

Body language matters during a video call, perhaps more than in person since cues are hard to read on a video.

 

Nonverbal communication is more important than you may think. In fact, many articles on online meetings refer to the 7-38-55 rule developed by the renowned behavioral psychologist Dr. Albert Mehrabian. He asserted that only 7% of communication is done verbally. Our tone accounts for 38% and body language 55%.

 

 

For example, holding your chin in your hand may be commonplace, but on video, the same position might communicate disinterest. Other suggestions? Make eye contact by looking at the camera. Nod your head, unfold your arms, or use a thumbs-up or reinforcing gestures.

 

Virtual empathy

Many articles about telehealth focus on conveying empathy over a screen. Here are some ways to do that:

• Make a compassionate statement (“I hear your worry”)

• Encourage patient narrative (“Tell me more”)
• Develop a treatment plan together
• Ask them if they have any more questions
• End the call warmly (“Thank you for scheduling with me today”)

 

Practice makes perfect  

As awkward as it may be, you may also want to watch some of your telehealth sessions again to perfect your virtual skills. You may want to practice with a colleague using the online software you use for a patient call.

 

When an office visit might be better   

While a telehealth visit is convenient for both a clinician and patient, sometimes seeing someone in the office is better. For example, you may want to establish your care with a new patient in person before moving to a virtual setting.

 

Be honest and let the patient know if you’ve finished their telehealth appointment and feel it’s inconclusive. Sometimes telehealth isn’t as thorough as an inpatient visit. So, if you sense you’re missing something, ask the patient to schedule an in-office appointment.

 

 Courses on webside manner

With the popularity of telehealth visits, more med schools are integrating lessons into their curriculum. For those already practicing, the AMA offers a Telehealth Immersion Program using webinars, interactive peer-to-peer learning sessions and virtual discussions.

 

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