How to Conduct a Professional Telemedicine Visit Using Good Webside Manner
Summary
TLDRDr. Tanya Elliot shares her expertise on enhancing patient interactions through video consultations. She emphasizes the importance of setting up a professional background, dressing appropriately, and ensuring proper camera framing for effective eye contact. Dr. Elliot also discusses the nuances of communication, such as maintaining warm facial expressions and obtaining patient consent. She advises on clinical documentation during the encounter and the value of setting expectations for any multitasking. The video concludes with the significance of summarizing the visit and providing patients with written instructions to ensure clarity and confidence in their next steps.
Takeaways
- đ©ââïž Dress professionally for video consultations, just as you would in an office setting, to maintain a professional appearance.
- đ Choose a simple, non-distracting background for your video calls, avoiding doors directly behind you to prevent a sense of urgency to leave.
- đč Ensure your face is centered in the camera frame to maintain a professional and approachable demeanor.
- đ Practice making eye contact by looking at the camera lens, which can be counterintuitive but is essential for effective communication.
- đŁïž Start the consultation by introducing yourself and asking for the patient's permission to proceed with the video visit.
- đŻ Be mindful that facial expressions are more pronounced on camera, so maintain a warm and friendly demeanor throughout the call.
- đïž Use the reflection of your face on the screen as a 'cheat sheet' to monitor your expressions and maintain good eye contact.
- đ» If you need to type or look at another screen during the consultation, inform the patient to set expectations and reduce distractions.
- đ During the physical examination part of the video visit, guide the patient through each step and explain what you are looking for.
- đ Summarize the consultation by providing a clear plan and next steps, and offer to send written instructions to the patient for reference.
- đ Follow up with the patient by sending a summary of the visit and any agreed-upon action items through their patient portal for clarity and retention.
Q & A
What is the importance of dressing professionally for video consultations as mentioned by Dr. Tanya Elliot?
-Dr. Tanya Elliot emphasizes that dressing professionally for video consultations is crucial as it sets the stage for professionalism, just as it would in an in-person office visit. Wearing a white coat or maintaining the same professional attire as in the office helps establish trust and conveys a serious approach to the consultation.
Why should the background of a video consultation be considered?
-The background of a video consultation should be considered because it contributes to the overall professionalism and comfort of the interaction. A plain white wall or a bookshelf can be used, but being directly in front of a door can make patients feel uneasy, as if the doctor wants to leave. Therefore, the background should be non-distracting and conducive to a professional setting.
How does Dr. Elliot suggest maintaining eye contact during video consultations?
-Dr. Elliot suggests that to maintain eye contact during video consultations, one should look directly at the camera lens rather than at the video feed of the patient or themselves. This counterintuitive approach ensures that the patient perceives direct eye contact, which is essential for effective communication.
What is the significance of framing one's face correctly within the camera view during video consultations?
-Framing one's face correctly within the camera view is significant because it ensures that the patient can clearly see the doctor's facial expressions, which are crucial for non-verbal communication. Being too close or too far, or being off-center, can lead to a less personal and professional interaction.
Why is it important to ask for the patient's permission at the start of a video consultation?
-Asking for the patient's permission at the start of a video consultation is important because it sets the stage for mutual respect and understanding. It acknowledges that the video consultation is a new experience for both parties and establishes the encounter with the same level of professionalism as an in-person visit.
How can doctors leverage their own video feed during consultations for better communication?
-Doctors can leverage their own video feed by occasionally glancing at it to ensure they are maintaining appropriate facial expressions and not making any unintentional 'funky' expressions that could distract or confuse the patient. This real-time feedback helps in honing communication skills.
What should doctors do if they need to type or look at multiple screens during a video consultation?
-If doctors need to type or look at multiple screens during a video consultation, they should inform the patient beforehand. This transparency helps manage patient expectations and reduces the potential for distraction or misunderstanding, ensuring the patient feels included in the process.
Why is it beneficial to involve the patient in the physical examination process during a video consultation?
-Involving the patient in the physical examination process during a video consultation is beneficial because it ensures the patient's active participation and understanding of the steps being taken. It also helps the doctor obtain the necessary information for an effective consultation by guiding the patient through each aspect of the examination.
How should doctors summarize and conclude a video consultation according to Dr. Elliot?
-Dr. Elliot suggests that doctors should summarize the consultation by reviewing the patient's history and the findings from the physical examination. They should then discuss the diagnosis, next steps, and any recommended actions. This summary helps in shared decision-making and ensures the patient leaves the consultation with a clear understanding of what to do next.
What is the value of providing written instructions to patients after a video consultation?
-Providing written instructions to patients after a video consultation is valuable because it reinforces the information discussed during the encounter. It helps patients remember the next steps and recommendations, which is particularly useful given that patients often remember only a small percentage of what is discussed during medical consultations.
Outlines
đ©ââïž Setting the Stage for Video Consultations
Dr. Tanya Elliot shares her expertise on conducting video consultations with patients, emphasizing the importance of setting up a professional environment. She suggests wearing a white coat or professional attire, choosing a neutral background like a white wall or a bookshelf, and avoiding sitting directly in front of a door to prevent patients from feeling rushed. Dr. Elliot also advises on proper camera positioning to ensure the doctor's face is centered and at an appropriate distance, and the necessity of doing a video test beforehand. She stresses the importance of making eye contact with the camera lens to establish a connection with the patient and the need for clear communication, including asking for the patient's consent before proceeding with the consultation.
đ» Enhancing Communication and Documentation in Video Consults
In the second paragraph, Dr. Elliot discusses the nuances of communication during video consultations, highlighting the need for clear and open dialogue. She advises on the importance of patient consent and setting expectations for the consultation. Dr. Elliot also addresses the challenges of clinical documentation during the encounter, suggesting that doctors inform patients if they will be typing notes to avoid distraction. She mentions the use of multiple screens or tabs for efficient consultation and the importance of keeping patients informed about any actions that might divert the doctor's attention. The paragraph concludes with a recap of the consultation process, including obtaining patient history, conducting a physical examination with patient involvement, and summarizing the visit with a shared decision-making approach. Dr. Elliot also recommends providing written instructions to patients via email after the consultation to ensure they understand and remember the discussed actions and next steps.
Mindmap
Keywords
đĄProfessionalism
đĄEye Contact
đĄBackground
đĄFacial Expressions
đĄClinical Documentation
đĄMultiple Windows
đĄPhysical Examination
đĄShared Decision-Making
đĄPatient Instructions
đĄTelemedicine
Highlights
Dr. Tanya Elliot shares her experience with over 7,000 patients through video visits.
Key aspects of exceptional website manner in video consultations are discussed.
Wearing a white coat or professional attire can maintain professionalism in video encounters.
Background setup recommendations include a white wall or bookshelf, avoiding direct placement in front of a door.
Proper framing of the face within the camera view is crucial for effective communication.
Eye contact in video consultations is achieved by looking at the camera lens.
Initiating the consultation with eye contact and warm facial expressions sets a positive tone.
Asking for patient consent before starting a video consultation is important for setting expectations.
Facial expressions and body language are more exaggerated on camera and should be mindfully managed.
Using a 'cheat sheet' like one's reflection in the video window can help monitor expressions.
Clinical documentation during the encounter should be communicated to the patient to avoid distractions.
Having multiple windows or screens can be useful but requires informing the patient to maintain transparency.
Physical examination in video consultations requires patient participation and clear instructions.
Summarizing the consultation and providing next steps helps in shared decision-making.
Providing written patient instructions after the visit aids in reinforcing the consultation's key points.
Dr. Elliot emphasizes the importance of setting expectations and maintaining a professional approach in video consultations.
Transcripts
hi I'm dr. Tanya Elliot as some of you
may know I've seen over 7,000 patients
through video visits and so I'd like to
think that I've started to nail down the
key aspects of having exceptional
website manner when I interact with
patients so this takes some practice and
getting used to and I've taken a lot of
patient feedback in and trained a lot of
doctors on how to have exceptional
communication skills through this
modality of video consultation now it's
different from what we're taught in
medical school when we have standardized
patient examinations and you're doing
this in the office it's just a bit of a
different setup so first things first in
terms of setting up an appropriate
background and setting the stage for
professionalism I recommend if you wear
your white coat in the office which I
often don't but if you do wear your
white coat in the office feel free to go
ahead and wear your white coat for the
video encounter however you dress
whatever your professional dress is for
the office whether you wear a dress a
shirt and tie
if you wear scrubs do the same thing for
the video consultation in terms of a
background you can have a white wall
that's perfectly fine it might be a
little bit bleak so you may want to put
a painting up behind that or perhaps a
bookshelf that's perfectly fine as well
one thing you don't want to do is be
directly in front of a door studies have
shown that when patients see is a door
directly behind the practitioner they
feel sensation that the patient that the
doctor wants to turn around and leave
right away and so you want to avoid
being directly behind a door it's okay
to have a doorway away in your
background like I do but you don't want
to be directly in front of a door also
making sure that your face is perfectly
framed up within the middle of the
camera you don't want to be like this
talking to the patient you don't want to
be like this talking to the patient you
don't want to be over here you don't
want to be over here so making sure that
you're the appropriate distance right
now I'm a proxy
only two feet away from the camera so
again making sure your face is framed
and doing a video test beforehand so
that the patient doesn't have to wait
while you properly position the camera
the next aspect is eye contact and this
can be really challenging because when
you're talking with a patient through
video you want to be looking directly at
the patient so right now I'm looking
quote directly at the patient I'm
looking directly at myself however I'm
not making eye contact with them I was
not making eye contact with them I
actually have to look directly at the
lens of the camera in order to make eye
contact with the patient so it's a
little bit counterintuitive our eyes
often shift to either look at ourselves
or to look at the patient directly but
the patient isn't perceiving that you're
looking at them directly so make sure
that your eyes are parallel to the lens
of the camera that's how you make eye
contact through a video visit and it
makes a big difference your eyes your
facial expressions all of those things
are more exaggerated when you're on film
when you're on camera so just make sure
that you have nice warm kind eyes if
you're looking directly at them and buy
directly at them I mean looking directly
at your camera and initiating the
consultation that way another thing that
helps set the stage for a video
consultation is to ask their permission
to ask their consent so if it's a new
patient you introduce yourself hi I'm
dr. Elliot it's nice to meet you
and then the next section is do I have
your permission to treat you through
this video consultation setting that up
is tremendously important because both
for the doctor and the patient
this entire encounter is new and so you
want to make sure that you frame it up
with the same level of respect and
professionalism that a patient
experiences when they walk into your
office okay so we've checked off
background dress and professionalism how
to frame up the camera and then we
started to talk a little bit about
communication skills so making eye
contact with the camera again
tremendously important and then making
sure you're keeping your facial
expressions in
remember everything is exaggerated on
camera so you may be scowling you may be
making a certain face you may be looking
away and all those things are
exaggerated when you're on video so just
keep that in mind now often times when
you're doing a zoom or FaceTime or any
video modality you actually have a
little cheat sheet so you might not have
been aware of and that's your face in
the upper or lower right or left hand
corner so every now and then while
you're doing the encounter glance over
at your face just give it a bit of a
reality check make sure you're not
making any funky facial expressions and
leverage the fact that you can see
yourself and get real-time feedback
during the encounter it's tremendously
helpful as you continue to hone your
website manner skills the next thing
that's very important is your clinical
documentation and at what point you do
that during the encounter if you decide
that you want to do documentation while
you're interacting with a patient that's
perfectly fine but let them know that
you're going to be typing while you're
interacting with them so I'll often say
to the patient you may hear me typing
right now and that's because I want to
make sure I get down every detail of
what you're explaining to me the reason
that's important is the patient can hear
you typing so if you're going and
clicking while the patient is talking
and you're clicking and clacking on your
computer it could be very distracting to
the patient but if you let them know up
front and you set those expectations up
front it oftentimes is perfectly fine or
the patient may say oh I prefer that you
don't because it's distracting to me
which is okay as well but again setting
those expectations up front is very
important now the other piece is having
multiple windows open so some doctors
will have two computer screens up and
they're looking back and forth between
the two screens and some doctors have
multiple tabs up so they can be typing
and talking with the patient and then
looking away because they're looking at
another tab on their computer screen
again it's perfectly fine to do that and
to look away and even look up something
while you're on the consult with the
patient as long as you let them know so
I will let my patients know just want to
make you aware that I have
two computer screens up right now so if
you see my eyes darting away it's
because I have your patient record on
one side and that's what I'm looking at
when you see my eyes move over here and
then of course I want to make sure that
I make eye contact with you so letting
your patients know that or letting them
know that perhaps you're looking up the
most recent guidelines all of those
things are completely appropriate well
received by patients you just want to
let them know that you're doing that up
front
again all these nuance things that are
slightly different through video so you
want to just go through this journey
together with the patient and set those
expectations up front now I've talked a
lot about physical examination and how
to frame up the visit and so just to do
a bit of a recap you want to set up the
conversation obtain consent from the
patient ask open-ended questions to have
them tell you about what's going on and
the history of present illness and if
there are new patient past medical
history medications allergies oftentimes
video encounters will be much more
consolidated than in an office visit
because they're very efficient you're
making direct eye contact with the
patient and both of you are getting to
the point so you get that history of
present illness and then you do the
appropriate aspects of a physical
examination and in order to be effective
at that your patient has to be a partner
with you on that journey talk them
through each aspects of a physical exam
if you're going to be evaluating the
sinuses let them know up front we're
going to do the sinus evaluation now
here's what I need you to do then we're
gonna move on to the respiratory exam
here's what I need you to do and setting
those expectations along the way enables
you to get the objective information
that you need in order to conduct a
successful visit the last piece of a
video visit is to sum up everything that
has occurred so patient based on your
history of what you told me as well as
the aspects of the physical exam here's
what I think is going on and with the
telemedicine visit we may not be able to
make the complete diagnosis we may have
next steps that are recommended whether
it's to get a lab tests or
it's a higher level of care or higher
level of acuity and all that's perfectly
fine but after you go through this
journey with the patient getting that
intake getting those objective measures
of the physical examination now it's
time for the shared decision-making and
making that plan and conveying that
information to the patient the last
thing I do for my patients is I write
down everything that I've discussed in
the form of patient instructions that
they then email over to them through
their patient portal and patients find
this very valuable because all of this
is new for them and they're struggling
to remember everything you say and we
know that patients typically only
remember about 10 percent of what we
tell them in the office so let them know
that you're going to be writing up
instructions for them that have reviewed
next steps and all the things that you
have discussed during the encounter so
that they feel confident that they know
what to do next
that's all for now thanks for watching
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