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Kaleidoscope: The importance of seeing a doctor face-to-face

Rika Kayama

One key phrase for the medical community this year is "telemedicine services." Doctors engaged in telemedicine converse with patients by email or other means, and if necessary, the medical facility prescribes and sends the patient medicine. Such services are being put to practical use one after another.

    In the past, telemedicine was thought of as something applied in remote areas without local medical facilities. New services, however, are targeting such people as busy businessmen who struggle to find time to visit the doctor. We might also hear of cases in which patients receive online consultations from famous doctors in faraway areas, saying they have access to a local clinic but want to be seen by a prominent doctor.

    I agree that services like this, which enable people to receive consultations via email and have medicine posted to them, would save those who are too busy to visit the doctor and accordingly discontinue the medicine they need to take. I can already hear people arguing, "No, you can't monitor the color of a person's face and things like that through email." But with video calling systems, it's possible for the doctor and patient to see each other's face during such consultations. And recent video is quite clear, so it's obvious if the other person's complexion is good or not.

    But doubts linger over whether Internet consultations are really OK. In psychiatry, which is my specialty, consultation means having a person come to my consultation rooms. Points such as how the patient enters the room and whether he or she knocks first, whether the patient looks up straight after sitting down, and sometimes even the gloomy or cheerful atmosphere that can be sensed provide material for a consultation. No matter how far the Internet develops, it's unlikely it will be able to convey the atmosphere of things like this.

    And another thing: I wonder about people who say, "I need treatment, but I'm too busy to visit the doctor." In my consultation rooms, patients sometimes say things like, "I've taken time off work to come here, but I don't think I'll be able to continue coming during the week. Find me somewhere that will see me on Sundays." But we really shouldn't have situations in which people are ill but can't secure time to come to the hospital. I'm concerned that with the spread of telemedicine services, more people will start saying, "Rather than taking time off to go to the hospital, you can just undergo a consultation online and have medicine sent to you."

    When a convenient mechanism arises, there will be more instances in which we have to ask ourselves, "Is this really all right?" If you're unwell, you first go to a medical institution for a face-to-face consultation with a doctor -- surely that's a fundamental process. (By Rika Kayama, psychiatrist)

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