Richard Zhang
COVID has changed the entire world, and the healthcare system has definitely not been spared. Healthcare delivery has had to adapt to the additional strain and dangers that COVID has brought, and because of it, we must adapt too to these changes. Here are some of the main changes that I have encountered in my time so far in my clinical rotations, and how I have tried to deal with these changes.
Teleconsults
As a result of efforts to minimize unnecessary contact and reduce transmission wherever possible, teleconsults have taken over a large part of consultations in almost every area of medicine. While a blessing for patients and healthcare workers alike in terms of safety, it does introduce a number of challenges to sensitive history taking. Being unable to see the patient makes it difficult to assess their reactions and body language, which typically guide how we conduct the interview. For instance, when explaining the indications for a particular procedure or treatment plan to a patient, I always pay close attention to whether they look slightly confused, as many patients will still agree to whatever the treating team says, even if they don’t fully understand. With telephone and Zoom consults taking over, now the primary way we can gauge the patient’s emotions and understandings is through tone alone. As such, it is now very important to pay close attention to tone whenever you are conducting an interview. The slightest quaver in their voice or a pause that is just slightly too long may indicate the patient is lost or uncomfortable, and so focusing on these signs can help us replace some of the non-verbal cues that we may have gained from in-person consultations.
Another thing to learn to cope with is bugs in technology. Particularly in video consults, the call may be cut off, the audio may be jittery, or there may just be a long delay in the transmission. All of these problems can quickly get very frustrating, but it’s important to remember to be patient. The patient is already likely irritated, and it will be up to you to keep the consultation productive. If you also become frustrated and annoyed, and the patient picks up on that, it can quickly make the consult a difficult time for the both of you, and you can lose rapport with the patient. In these situations, staying patient and embracing silence can allow you to at least manage some of the issues that may come up with the use of technology.
Decreased physical contact wherever not necessary
It is crucial to maintain safe practices and ensure that potential avenues for the transmission of COVID are kept to a minimum. One of the most important ways you can achieve this is by remembering hand hygiene. Hand hygiene has always been important, but particularly now, it is critical that you remember to wash your hands before each and every patient interaction and contact. Another thing that often gets forgotten is the stethoscope. Please remember to also wipe down your stethoscope after use to avoid transferring pathogens from one patient to another.
Another consequence of COVID to deal with is the mask wearing. Wearing a mask means many non-verbal cues, such as smiling or frowning can be lost, and so it’s important to stay expressive with your eyes and your words. At the beginning of the pandemic, I was often told I seemed ‘a little cold’ by my friends, and it was simply because they couldn’t see me smiling at them. It is similarly important to make the effort to show patients that you care and are listening to them in other ways.
Dealing with difficult patients
COVID has brought out many difficulties that patients may be frustrated by. Some of these are very understandable, such as the longer wait times due to staff having to stay home and isolate, and some may be a little less sympathetic, such as patients refusing to wear a mask in the hospital. In these situations, patience is once again required. COVID has made everything more difficult for everyone, and conveying that you are sympathetic and understanding will always make things run a lot smoother. Another difficulty brought out by COVID is the rise in vaccine-hesitant patients. It is certainly another major change that we have to adjust to as healthcare workers, and we have another blog specifically on how to deal with vaccine hesitancy, which you should definitely have a read of if this is something you’ve encountered on your clinical rotations.
Overall, COVID has changed the way we practice healthcare. In order to stay afloat in the chaos that the pandemic has brought, we’ve had to adjust the way we deliver consultations and interact with patients. Following these tips above will help you stay aware of some of these changes, and the things you need to do to keep up with the rapidly evolving medical landscape.