– I felt the real power of telemedicine during the first weekend of the lockdown – explains Dr. Tomasz Grzelewski, MD, a pediatrician and allergist. – I had a night shift and patients were registered every 5-10 minutes. Everyone terrified, with requests for information, help, prescription of drugs, referrals. Shocking experience for the doctor. I remember falling asleep between 5 and 6 am for an hour of exhaustion, then finished the conversation. I was shocked – for the first time in my life I helped so many nervous, confused people!
Karolina Świdrak, MedTvoiLokony: Many people in Poland heard about e-visits for the first time (and used them for the first time) during the COVID-19 pandemic, when they did not have access to traditional visits. Telemedicine in Poland is new or not necessarily?
Tomasz Grzelewski, MD, PhD: Telemedicine in Poland is not a novelty. This is the area of patient-doctor contact that has always been known! Ever since there is a regular telephone or e-mail. But real, fully functional telemedicine has been operating in our country for several years. Specifically, since our government and the minister of health considered the e-visit almost equivalent to a doctor’s visit to the office. The concept of telemedicine is wide – from a visit for advice, issuing a referral and prescription, through consulting the results of all tests, to remote management of surgical robots by surgeons!
What is the attitude of Poles to broadly understood telemedicine? Are we rather afraid of it or on the contrary? What have the recent pandemic months changed in this approach?
At the beginning of the pandemic – I remember that day well, the first weekend of the lockdown in Poland – I was asked if I could take the night shift from 22pm on Sunday to 7am on Monday. Then I understood what telemedicine has to offer. These few years of work were not in vain! As if we are the only ones ready to provide such a huge initial help to terrified patients! It was amazing – like cathartic, cleansing for me! Patients called and were enrolled every 5- 10 minutes! Everyone terrified with requests for information, help, prescription of drugs, referrals. It’s shocking for the doctor. I remember falling asleep between 5 and 6 am for an hour from exhaustion. But I finished my conversation at 8am. I was shocked – for the first time in my life I helped so many nervous, confused people!
Patients appreciate telemedicine. They see its advantages – easy access, high reliability of the operating system, commitment of doctors to whom they can tell more about their problems, which really increases the detection of diseases and targeted diagnostics, personalized treatment.
- How has telemedicine developed in Poland?
But there is also the other side of the coin. Unfortunately, many patients treat such doctors with reserve, sometimes with unnecessary aggression, with mockery. During the conversation, sometimes numerous frustrations emerge, and their addressee, sometimes also insults, are the doctor. I’ve had many of these conversations. It is sad because we try really hard, the patients do not see that we make 40-60 calls a day and we are also only people who have their endurance and resilience. But that’s why I especially like this job, because it requires me to constantly focus on the patient’s problem, it’s a constant challenge. Empathy, listening, non-stopping, humility – I’m still learning this. I’m not perfect and I know it!
Are there any medical specialties or any medical conditions that are more or less suitable for telemedicine advice?
Each disease entity is suitable for telemedicine initial consultation, some emergencies, even for a short conversation and help in calling an ambulance!
What does a telemedicine consultation look like from the doctor’s perspective? How is it different from a classic patient visit to the office?
From my perspective, the interview looks similar, but it is more honest, because the situation of tele-conversation makes patients less embarrassing and opens up more. But I cannot see the patient, unless it is a video consultation, where I can observe his behavior. Let me put it this way: sometimes it is also light magic. You need to have experience, and a lot of it, in various disease entities and keep learning, sometimes hearing something between sentences or seeing more than the video shows.
What are the biggest advantages of an e-visit to the doctor? What are their disadvantages?
The advantages include ease of contact, quick connection, the possibility of sending a prescription for chronic or acute diseases, easy-to-cure diseases, referrals to numerous examinations, assistance in calling an ambulance. Possible reaction to drug side effects.
The disadvantages are the lack of a physical, personal medical examination (but maybe our Polish Higo Sense will help soon!). This limits our possibilities. Still, 90 percent of patients are satisfied with our services!
What surprised you the most in your career?
There were many surprises. Positive surprises are primarily a very honest interview with the patient with unexpected, surprising news. The tendency of patients to speak very honestly, greater openness, which really makes the diagnosis easier!
Negative surprises are the failure of your computer, phone or tablet – very frustrating if you are really focused on this form of helping patients!
How can a patient prepare for a television visit in order to benefit from it? What does he need to know, what to remember?
The patient must be aware that sometimes we will not solve his problem, he should be asked not to be irritated by this, it is very important to say it right away. It must have access to a smartphone, tablet, computer with high-speed internet. Older people should be supported by younger family members in a conversation with a doctor and they should have easier access to the system, try to learn how to use it, because telemedicine is not a trend for a moment, it is needed only in exceptional situations, such as the coronavirus pandemic. This is the future of patient-doctor contact.
Read also:
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