What! No video?

I cannot recall a discussion of use of Skype or similar technologies in psychiatry or even medicine in general, unaccompanied by dire warnings of what critical information the professional will miss as a result of inability to smell or touch the patient or otherwise suffer by comparison with face-to-face contact. I wonder whether risk management consultants issued similar warnings when physicians first considered use of that older new technology, the tele-phone, arguably the first and original tele-medicine and tele-psychiatry.

For years we have taken for granted audio-only contact with patients. Who would suggest avoiding such contact because of its limitations? Can you imagine refusing to answer a phone call from a patient because of inability to smell them?

Perhaps instead we should compare the telephone and other audio-only technologies to those that also allow us to see the patient during the encounter. Certainly this added sensory input adds at least as much information as the ability to smell or touch the patient. At a minimum I can more readily recognize almost anyone I know by sight than by voice alone.

I say the time has come, while we consider all these communication technologies, including text and email, to recognize video feed as the standard of care whenever talking to a patient, except in extreme situations when it is not available, and in which case we should warn of its limitations.

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