Bridging the gap: Health through technology

This article was exclusively written for the Sting by Ms Afrida khanam, a final year MBBS student at Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh. She is affiliated to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one. As mankind has entered an era of easily accessible long distance communication, people worldwide have begun availing this opportunity in almost every field, including medicine. Consultations over phone and the internet have slowly gained popularity in a world too busy to prioritize healthcare over convenience. However, whether such practices are actually effective or not, is a matter of debate. Communication over distance– from town to town, or even international- has a clear advantage of requiring less time & effort than a meeting in person. Since consulting over phone is often quicker & easier than attending a physician’s office, it has become a useful option in case of minor ailments. Many choose to ask for medical advice over phone before considering going to a hospital for complaints like a mild fever. It can indeed be helpful in cases of emergency, or in areas where medical assistance is not readily available. Although within a limited scope, it may allow for critical interventions to be taken, and may lessen complications. With remote consultation, individual referral needs may be identified more quickly. The opportunity of receiving advice from distant specialized facilities can help in taking informed decisions regarding the course of treatment. Regardless of the potential, the practical benefits depend on the usage. For example, in Bangladesh the estimated majority of medical consultations through network provided value added services are due to symptoms of common cold and indigestion. The availability of such services there has helped modulate the workload in hospitals & alleviate unnecessary anxiety of the patients, while encouraging the patients to receive advice from qualified medical personnel and avoid indiscriminate use of medicines. Acknowledgement of this effect was important in the establishment of telemedicine services by the government of Bangladesh. While there are certain benefits, the risks of remote consultation are not negligible. Attempting to treat symptoms without direct observation runs a high risk of improper or incomplete diagnosis. Without direct contact, not only is proper examination virtually impossible, but the process of history-taking is also likely to be affected due to limitations of long distance communication. Moreover, the comfort of receiving symptomatic advice may sometimes give the patients a false sense of assurance and temporary relief, which may lead to them delaying a necessary in-person consultation. This delay may cause significant harm in case of time-critical diseases, especially those likely to be misdiagnosed over a distance. For example, a lady with a breast lump, having received a diagnosis of benign disease over phone, may delay further evaluation fearing unnecessary embarrassment, and that delay may prove to be the distance between a pre-malignant disease and cancer. In conclusion it can be said that, despite having a number of benefits, the graveness of the risks should certainly be kept in mind. Hence it is better to recommend the option of remote medical consultation to be regarded not as a substitute, rather as an adjunct to conventional healthcare, so as to ensure appropriate and effective usage within acceptable standards. About the author Ms Afrida khanam is a final year MBBS student at Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.