Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Telemedicine exhaustion is real

Ni-Cheng Liang, MD
Physician
January 22, 2022
Share
Tweet
Share

I’m angry. The sound cut out again, for the fifth time in the last hour. “Why can’t I get through one telemedicine visit without some technical problem?” I ask myself. I can feel the chest discomfort, my shoulders tense, I start to flush, tell-tale signs of frustration and anger bubbling up. I did not go to medical school to become tech support. After 12 patients, it’s finally time for lunch. I get up from my chair and notice that my low back is sore, as are my shoulders, and my eyes are very dry—all occupational hazards of telemedicine, sitting in one location for much of the workday.

Having lost track of how many surges we have and will continue to encounter with COVID-19, telemedicine is undeniably here to stay, more fully integrated into our health care system than ever. Overall, I believe this is a positive, as it improves access for many of my geriatric patients who have high-risk co-morbid conditions, putting them at risk for having severe COVID-19 infections and complications, already limited in their mobility, or do not drive anymore. With how contagious Omicron is, pivoting to seeing more telemedicine patients also helps protect us, the health care professionals, and support staff.

Let’s be real, there have been patients who have arrived in clinic who you sent for COVID testing, and ended up being positive shortly after the visit, or brought a visitor that turned up to be positive. Exposures almost two years into the pandemic era have become countless, even in outpatient settings. When possible, pivoting to more telemedicine during Omicron helps keep the healthy health care professionals doing what they do best. However, there is a cost: I sometimes struggle to get a sense of how my patient is doing by only looking at their face. I miss hearing lung sounds, having true eye contact, and firm handshakes of connection before and after the clinic visit.

After a day of telemedicine patients, I find myself more physically and emotionally exhausted than had I seen them in person. Part of this is due to the ergonomics of the telemedicine setup: feeling stuck in the same place in mostly the same position, looking at the same screens, and repeating, over and over again the same words of, “Can you hear me? How about now? Can you hear me now?” I’m worried about her “what ifs …” – our expert catastrophizing for our patients has become more prevalent for me, worried I am missing a key physical exam finding that could mean the difference between life and death because some of my patients are not great historians. Telemedicine requires us to rely even more on the accurate recounting of a patient’s subjective experience, as we try to distill it down into some semblance of objectivity, but with less objective data, namely the lack of the physical exam. And when our patients are not capable of being historians, we rely on their loved ones or caretakers to provide a third-person history, but without the physical exam to help us assimilate valuable, sometimes nuanced information about our patients that a clinician is trained to detect.

Telemedicine exhaustion is real, and it is yet another ongoing potential source of burnout that health care professionals face. May I offer some tools that have helped me?

1. Ergonomics. Ensure that your workspace is set up to provide you with maximum physical comfort: screen at eye level, chair height that enables you to place both feet flat on the ground, key-board, mouse, speaker/microphone located where you do not have to strain to reach, keeping your elbow as much as possible at a right angle while you are typing. If you do notice any tension or pain, take a moment and think about what you could do to help bring more physical comfort to you, and do it; it might be as easy as doing a few shoulder and neck rolls. Work standing if you have that option.

2. Breaks. I go outside for a walk during lunch, looking at the sky and the trees around me. This is an intentional mini-mindfulness practice. It helps reset me and refreshes me for the next 12 patients. Can the “start” button on the telemedicine window become a reminder for you to take an intentional deep breath as a moment of reorienting to the present moment before the visit?

3. Intentional social curiosity. Part of the exhaustion is the loss of physical and emotional connection we have with our patients over the contrived atmosphere of telemedicine — can you broaden your curiosity about your patient to include something in their environment that you might not have known about your patient? I’ve met more pets than I can remember now and meaningful artwork hanging in my patient’s homes with fascinating stories behind them, a social connection that otherwise would not have been forged had it not been for this unique opportunity to have a view inside our patient’s homes and be authentically curious about some new facets of their life.

4. Blue light protection. We know that the blue light emitted from monitors and the screens on our phones decreases melatonin secretion, adversely affecting our circadian rhythms and increasing irritability, amongst other detrimental effects to our well-being. Being mindful about not looking at screens 2 to 3 hours before bedtime and protecting eyes can be extremely helpful in reducing dry eye and optimizing sleep hygiene.

As Steve Hickman, PsyD so eloquently suggests, “Let’s be present to absence, without becoming absent to presence.” We are doing the best we can. Despite disagreements in some of my patients’ thoughts or actions about COVID-19, I believe that our patients are doing the best they can. We are in this unprecedented time of what seems like constant adjusting to our new normal together. Let this time be a much-needed reminder that we cannot care for others unless we care for ourselves.

Ni-Cheng Liang is a pulmonary physician and founder, the Mindful Healthcare Collective.

Image credit: Shutterstock.com

Prev

Is home hospital care the way forward?

January 22, 2022 Kevin 0
…
Next

Please don't stop fighting for what brought you to medicine: a tale of 2 physicians

January 22, 2022 Kevin 1
…

ADVERTISEMENT

Tagged as: COVID, Primary Care

Post navigation

< Previous Post
Is home hospital care the way forward?
Next Post >
Please don't stop fighting for what brought you to medicine: a tale of 2 physicians

ADVERTISEMENT

More by Ni-Cheng Liang, MD

  • Reflections from a former intern

    Ni-Cheng Liang, MD
  • Anti-Asian racism magnified during COVID-19

    Ni-Cheng Liang, MD
  • A physician waits in uncertainty

    Ni-Cheng Liang, MD

Related Posts

  • Why social media may be causing real emotional harm

    Edwin Leap, MD
  • A real-life example of irrational health care spending

    Taylor J. Christensen, MD
  • The real value of high-value care

    Julia Canick and Walter Lee, MD, MHS
  • Got real rights? Not when seeking health care.              

    John T. James, PhD and Michael F. Mascia, MD, MPH
  • Why health care replaced physician care

    Michael Weiss, MD
  • Telemedicine should be easy. Here’s why it’s not.

    Dennis Wichern

More in Physician

  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • How New Mexico became a malpractice lawsuit hotspot

    Patrick Hudson, MD
  • Why compassion—not credentials—defines great doctors

    Dr. Saad S. Alshohaib
  • Why Canada is losing its skilled immigrant doctors

    Olumuyiwa Bamgbade, MD
  • Why doctors are reclaiming control from burnout culture

    Maureen Gibbons, MD
  • Why screening for diseases you might have can backfire

    Andy Lazris, MD and Alan Roth, DO
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Who will train the next generation of primary care clinicians without physician mentorship? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • The CDC’s restructuring: Where is the voice of health care in the room?

      Tarek Khrisat, MD | Policy
    • Choosing between care and country: a dual citizen’s Independence Day reflection

      Kathleen Muldoon, PhD | Policy
    • What Elon Musk and Diddy reveal about the price of power

      Osmund Agbo, MD | Conditions
    • 3 tips for using AI medical scribes to save time charting

      Erica Dorn, FNP | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Who will train the next generation of primary care clinicians without physician mentorship? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • The CDC’s restructuring: Where is the voice of health care in the room?

      Tarek Khrisat, MD | Policy
    • Choosing between care and country: a dual citizen’s Independence Day reflection

      Kathleen Muldoon, PhD | Policy
    • What Elon Musk and Diddy reveal about the price of power

      Osmund Agbo, MD | Conditions
    • 3 tips for using AI medical scribes to save time charting

      Erica Dorn, FNP | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...