Can a doctor really make a reliable diagnosis by phone, videocall or even chat? Which health problems can be solved by remote treatment? For whom is telemedicine suitable? What challenges do we encounter in telemedicine? Where are the limits of remote treatment?

Even if the word telemedicine is new, the remote treatment of a patient is old as the family medicine and the phone itself. Who does not know it: before he made his way to the doctor’s office, he first called the doctor to ask for advice and get a recommendation. Often the doctor can tell us at distance what the problem is and even issue a prescription for the necessary remedy. We can save the time to go to the practice and to wait there. Who has not discussed his lab results or other findings with a doctor by phone. A self-evident service that does not seem modern or strange. Exactly what modern telemedicine offers. A convenient and easy-to-use service for everyday health issues, as well as answers to any health related questions anytime and anywhere.

Innovation
Nowadays the technical possibilities and the special training of a telemedicine doctor enable a much better and more reliable diagnosis and the therapy on distance. While earlier we used to have only the phone call, now we can talk to the doctor by videocall as we were sitting in front of him. The doctor can assess much better the health state of the patient. For example, during a videocall I can see if the patient is pale and sweats or if he has difficulty to breath. I can teach the patient how to examine himself. For example, I can show him how to examine the abdomen or an injured articulation by demonstrating it on myself. In addition to their medical training, telemedicine doctors are specially trained in remote examinations and diagnosis making. A telemedicine doctor has learned how to substitute direct examination with other remote methods. In addition, there are more and more technical aids available to facilitate the diagnosis in telemedicine. There are otoscopes for the examination of the ear, stethoscopes for auscultation of the heart and the lungs and much more aids which can be connected to the smartphone and transfer the visual and auditive impressions directly to the doctor. Laboratory results and other findings can be exchanged between physician and patient and between physician and health centers and can be discussed remotely.

Tradition
But not everything is new in telemedicine. In telemedicine, more than ever before, the old good medical wisdom applies that with a good medical history, a large part of the diagnoses can be made even before a patient is examined. A good and careful questioning of current symptoms, previous illnesses, medications, and illnesses in the family, allergies and others are becoming more and more important after that the anamnesis has been pushed back into the background during the recent years with the increasing technological progress in medicine. The dialogue between physician and patient returns to the foreground. The doctor has to take more time again for the patient. He has to learn to listen to him again. Partnership between doctor and patient is very important in the remote examination. If I want to examine the patient by a videocall sometimes I have to demonstrate the movements on my own body. This way I can better put myself in the position of the patient. Telemedicine can therefore create proximity although it works from distance.

Telemedicine is only for younger patients?
No, telemedicine is suitable for everyone, young and old, families and singles alike. For each of the mentioned groups for different reasons. For the younger tech-savvy people, because they are already used to doing many everyday things online. Telemedicine is suitable for people who have little time or are travelling a lot. Telemedicine is family friendly. Young parents often have questions about there children’s health. These can be easily answered outside the office hours and from home. For older people, telemedicine is helpful if they are less mobile. They can ask a doctor for advice at any time, even if there is no one who can bring them in a doctor’s office. This brings independence and security in older age. The conversation between doctor and patient, which elderly people can do at any time and comfortable from home, is also important for psychosocial reasons.

Which health problems can be solved by remote consultation and treatment?
Many health problems can be solved by remote treatment. The spectrum is wide and includes diseases of all fields of the medicine. Monitoring and follow-up can be done well by telemedicine from home of the patient. Even if technical diagnostic is required (laboratory, ECG, radiology, etc.) or therapy that requires direct contact between physician and patient, telemedical triage can save time and money. Second opinions can be obtained very well via telemedicine and facilitate the decision making for a particular therapy. Telemedicine has been approved as a health assistance service for stays abroad (safe on vacations , 11.05.2019)