Physician attitudes often hinder remote monitoring

"Are Doctors Ready for Virtual Visits?" read a New York Times headline from last week. It's a question we've been pondering for some time. Now, Dr. Pauline Chen, writing in the Times, ponders for the whole world to see.

Telemedicine has been slow to catch on, Chen says, not because of cost or technological limitations but because of--you guessed it--reluctance to change on the part of healthcare professionals. "But are doctors resisting telemedicine based on truth or on fear? And if we are afraid, how can we address or adjust those fears in a way that might better help patients?" she wonders.

Chen cites a University of Texas Medical School study, published in the Journal of the American Medical Association, that was unable to find a definitive link between remote monitoring of ICU patients and reduced mortality or length of stay. A possible explanation, Chen says, was that most doctors that participated in the study made minimal use of remote monitoring technologies. "Many were worried about telemedicine's effect on their relationships with patients and that it might adversely affect care," she wrote.

"Some physicians felt we were being too intrusive," explains Dr. Bela Patel, executive medical director of critical care at Memorial Hermann Hospital-Texas Medical Center, and lead study author. "We would recommend changing the ventilator settings, for example, but it wouldn't be how they practiced. The doctors would respond, 'It's my patient; leave me alone.' They did not want 20 people looking in on their patient and seeing if anything else could be done." Patel says nurses expressed similar attitudes.

For more:
- see Chen's New York Times column
- read the JAMA study abstract

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