Last week i had a thought leader within the Physio profession present a controversial question for my thoughts: Is telehealth destroying the health profession? This was my response:
I completely understand the hesitation that Physiotherapists feel when faced with the treat of digitised consultations, bereft from physical touch. I felt the same way when i was considering the development of a telehealth service. It is crucial to remember, however, that my primary driver was NOT to replace face to face care, but rather to grant access to quality injury management to those who simply had no opportunity to access such a service in person. In my case, these were expatriate workers in a third world country.
As Physiotherapists, we are the best placed profession to advise injured people in remote areas. The three main options they would otherwise have available to them pale in comparison:
1) They could travel long distances to seek healthcare, which is time consuming and costly
2) They could google generic health information online, which can be inaccurate and even unsafe
3) They could leave their injury and do nothing about it, but we know that this leads to poorer outcomes and greater recurrences.
As teleconsultations have started gaining popularity, we are now seeing a shift whereby people in urban areas choose an online consultation, even when an in person one may be readily available to them. I realise that this is a very confronting situation for traditionally minded Physiotherapists, and i think it prompts a need to look to the future of our profession, and to learn lessons from other industries that have faced a similar crossroad.
Traditional bookshops that were reticent to look past the beautiful ‘touch and feel’ of a physical book have gone out of business due to the rise of book businesses that chose to develop an electronic book strategy. Now in reality, physical books will ALWAYS continue to exist, due to the joy of physical touch. So like the book world, can we not find a way for both physical and online consultations to co-exist, without one having to reign supreme over the other?
Online dating used to be considered strange. Now it is a billion dollar industry with more couples than ever before getting together due to digital dating platforms. At the same time, meeting a partner the ‘traditional’ way through friends, family or at the pub still concurrently occurs, and always will. Both online and in person dating worlds happily coexist. And so it should be with Physiotherapy.
In terms of the touch being ‘the essence of Physio’, i have a few thoughts around this.
Firstly, the Physios throughout my career that i have admired the most have been impressive due to their sharp clinical reasoning, warm interpersonal skills, and their ability to explain complex conditions in understandable terms, obtaining ‘buy in’ and compliance from their patient. None of these skills involve physical touch.
Second, the more we feel that our role is to execute complex physical movements on our patients, the more we may be disempowering them. What i have learned through telehealth is that our patients actually have a massive capacity to learn strategies and techniques to assess and manage their own injuries. As Physios, is the push to protect our own ‘touch ego’ stripping our patients of the independence that they so deserve?
As Physios, we have always been taught to be open to many different strategies and techniques to help our patients to get better. Telehealth consultations are simply another tool we can choose to have in our artillery. There is no question in my mind that both in person and online consultations can happily exist within the Physiotherapy profession.
What do you think?