Many of us are now managing outpatients via phone and telecommunication. While the transition has been relatively painless, one can't help but wonder what the future will bring.
Robert Boland, MD
As with many institutions, the Brigham and Women’s Hospital has switched to virtual meetings. In the last two weeks, I have used my computer, phone, and tablet to meet with groups large and small. These online encounters have ranged from one-on-one supervisory meetings that would usually happen in my office to groups of 100 or more that would normally have required an auditorium. We are also conducting our residency didactics this way, using various formats including traditional lectures, interactive workshops, and process groups.
I enjoy technology, and I tend to be an early adopter of high-tech gadgets and software. That said, I have been reluctant to give up in-person meetings, arguing that there is no substitute for sharing physical space with other people. I have always suggested that we cannot overestimate the value of having a person’s full attention, along with the nonverbal cues and food.
In the current crisis, all of that seems quaint. And I am happy to report that, for us, the transition to virtual meetings has been relatively painless. Despite the occasional experience of watching a person talk while they are unaware that no one can hear them, for the most part, the technology has been without glitches.
I do wonder about the future. Once this crisis is past, I expect that many of us will more easily dismiss holdouts like myself, having forced ourselves to brave this new world. I suppose that the faculty at my institution will be more likely to question the need to meet at my office or our conference space. I expect that the many national organizations whose business meetings I attend will reassess the need to fly me to their cities, both from a practical and budgetary standpoint. And, we may see the many large conferences that we so enjoy during the year as unnecessary and even hazardous, a luxury from a bygone era.
And what of patient care?
Many of us are now managing outpatients via phone and telecommunication. Similarly, our consultation-liaison service is doing more curbside and phone interventions to minimize unnecessary exposure. If these patients continue to do well-and I wholeheartedly hope that they do-won’t insurance companies suggest that we move to less frequent in-person appointments and more frequent (and less expensive) virtual check-ins? And won’t other services question the need for traditional consultations?
Like most of us, I don’t have time to worry about this right now. I am too preoccupied with the health and safety of my patients, trainees, and faculty. However, I am hoping that at some more stable point we can reflect on this change. I am hardly the first to suggest that, long after we all receive the coronavirus vaccine, this pandemic may forever change us as a society. Many of the changes would have occurred anyhow, but this may greatly hasten them. Perhaps we should use this opportunity to learn as much as we can from this experience so that, once we are past this, we can intelligently discuss what changes make sense, and in which cases the old ways were the better ways.
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Dr Boland is Vice-Chair for Education at Brigham and Women’s Hospital and Associate Professor at Harvard Medical School. He is also a member of the Psychiatric Times Editorial Board.