I sensed my patient’s hesitation as I looked into my video chat on my lab top screen. After a long pause she said, “ I miss seeing you…” It was our second meeting through telehealth since I had moved from Indiana to New Jersey. I asked her to tell me more. “ I don’t want you to think I’m not thankful for this,” she continued, “ But for some reason it’s just not the same.” I had decided to provide care for the same patients I had seen face- to- face for over three years in an outpatient mental health clinic with a different approach. Telehealth, particularly in psychiatry, has become increasingly popular over the last several years, and with good reason. The world of technology has allowed me to continue a relationship with my patients, a relationship that would not have been possible 20 years ago. It’s something I’m thankful for everyday—the ability to “see” and care for people who are hundreds of miles away allows me to contribute in a way I never imagined when I first entered the world of nursing.
The lack of mental health services across the US along with growing technology has allowed many providers to care for those who may have not received care otherwise due to inability to travel, living in a rural community, or lack of services… the list is endless. Some research argues that telehealth is as good as the typical office visit. Before the transition, I would have agreed. Now, I can appreciate my patient’s perspective…. It’s just not the same.
Telehealth has many benefits in medicine; I’m certainly not arguing its overall value. But, does it have the same possibility for connection or therapeutic value as a face- to- face interaction? I do not offer therapy sessions for my patients, but over the last several years, I have realized to properly treat and diagnose someone, the ‘’whole story’’ is needed. If the potential for empathy and connection are sacrificed, so is the potential for growth and healing. During some of life’s most trying moments… whether this be a chronic illness, grief after a family member’s death, divorce, a recent relapse, or a parent who is struggling with their child’s new diagnosis of a learning disability, the physical presence of another trusted person can make a difference. Just the idea of “knowing you’re not alone” can be comforting in itself. Yes, I can be available to talk with a click, but I cannot be present to sit along side them.
I do believe as providers we are doing the best we can with the resources we have. I remind myself often that I’m doing the best I can with what I can offer to my patients. I also believe it’s important to remember the value of what two people can accomplish in person, and to utilize this when possible as we move forward in healthcare. When I first moved to the east coast, I had several video chats with my office in Indiana along with the telepsychiatry company I am currently working through. We needed a third visit, and I noticed the address of the contact person I had communicated with for over a month at the bottom of his email. His office was only about 30 minutes away, and I offered to stop by for the next meeting. When arriving at the office, I was able to meet all the people who had helped me during the transition. By the end of the hour, I realized that I had become more thankful to those who had helped me over the last month. As I was leaving, the person I had met over video chat previously offered for me to use one of the office’s private meeting rooms anytime I needed a secure place to see patients, and said, “ I don’t get to meet many of the providers we work with. Don’t be a stranger, seriously. I feel like I know you now.” I agreed, and thought to myself… If I hadn’t had the chance to meet you all today… this just wouldn’t have been the same.