We live in an era now when workers have leverage over their employers. Nearly every establishment is struggling to hire employees. It’s mysterious not only why so many folks have chosen not to return to work but also how they are paying their living expenses. Remote work, particularly for younger workers, has become a non-negotiable red line. If you are an employer who expects full-time in-person presence, then good luck finding willing candidates.

Telemedicine has also permeated the medical profession. Ten years ago, physicians would have howled that there could never be a replacement for the in-person visit when doctors could read body language and engage in the age-old hands-on physical examination. That was then. Now, many physicians prefer to offer virtual care, and many patients demand it.

I’ve given up virtual visits, but not for the reasons that you may think.

During the early months of the pandemic, when I first entered the virtual visit arena, I found the experience to be novel. I could practice medicine from my own couch wearing sweatpants. It was refreshing to use a different platform after practicing gastroenterology the same way for 30 years. It was all new, and I felt, in a very small way, that I was standing up to the pandemic by still providing care to my patients.

But obstacles soon presented themselves. Many of them were technical. The audio was absent. The connectivity was spotty. The functionality of my laptop at home was much more limited than my office desktop models. And, as a consequence of having practiced for decades, many of my patients are now in their 80s, and the cyber universe is not their natural habitat.

I powered through the technical roadblocks as best I could. But another obstacle was taking shape that I was not willing to accommodate or work through. The virtual visits were not fun. There was no handshake. There was no real banter or even a joke or two, which is so characteristic of my style. The visit became literally framed by two faces staring out of computer monitors. There was no way to duplicate the rapport that patients and I enjoy during our personal visits. Telemedicine, at least in my experience, was a transactional process that was largely stripped of the aspects of medical practice that I enjoy so much.

Perhaps data will show that the medical quality of virtual medicine is equivalent to the office. But I maintain that the quality of the experience is quite different.

Michael Kirsch is a gastroenterologist.