You might have called your family doctor or the doctor friend to get some medical advice in the past. You call them, tell them about your health problems, they will ask you some more questions and then finally text you the names of some medicines and instructions on how to take them. At that time, you do not consider it as a virtual or online doctor consultation. It doesn’t matter if they haven’t seen you in person or if they have not examined you by touching you. All that matters is whether your illness has been relieved with the medicines they texted you.
All of us have been doing this for many years and yet we haven’t thought about it. Have you ever thought about the training that friendly doctor who has received to consult virtually? What if they are not comfortable doing virtual and audio call consultations?
At Dofody, we have figured it out in such a way that it works best for both users as well as doctors, the way they want it. Our doctors are well experienced, and trained to consult online and virtually. They will decide if a particular condition can be treated online or not. They know how to talk with patients and do virtual examinations by instructing the patients to do the tests. The doctors we select at Dofody are well trained doctors who have years of experience under their belt.
Using a stethoscope is needed only to listen to breath sounds and heart sounds. This type of examination is termed as “auscultation”. But, most of the persons and sometimes even doctors don’t’ realize that auscultation is only the last part of a local or systemic examination. Other parts are:
Here the doctor looks at the system being examined, if it’s a lump or swelling, the size, shape and color of the swelling as seen by the doctor is recorded. If the patient has asthma the respiratory effort of the various muscles involved in breathing are inspected by the doctor and then recorded. This can be easily done using a video consultation. The type of rash, the character of that blister, the wound everything can be looked into using the patients smartphone camera. And keep in mind that the cameras that are now being integrated with the modern smartphones are 8MP or higher in resolution that can take real good pictures and videos. The technology is advancing at a rapid rate and there’s no reason not to harness that technology in delivering medical services.
Let us consider the following questions from the Dofody doctor regarding ‘inspection’.
“ Can you please move the camera a little bit farther so that i can have full picture view?”
“Would you please turn on another light so that i can have good look at the color of the rash?”
“Can you please make Mr. Raj to lie down on his chest so that i can have a look at his bed sore?”
This is the second part of a systemic examination where the doctor has to touch the patient to find out certain characters. For example, if the patient has a mass, the doctor gently touches it, feels the temperature of the skin above the swelling, elicits tenderness and then feels the consistency of the mass. I know what you will be thinking! How is the doctor going to do this step virtually, right? Well, the doctor can ask the patient to do it himself and tell the doctor. Consider the following questions:
“Please touch on the swelling and tell me if it’s temperature is a bit higher compared to the surrounding skin”
“When you apply gentle pressure on the swelling, is it hurting you?”
“Can you move the swelling by applying pressure sideward?”
“How is the consistency of the swelling, is it soft, hard or mixed?
If the patient is not able to do this by himself, he can ask another family member to do the examination and then let the doctor know.
This type of examination is valid only in the abdomen and chest areas. Gross ascites, pleural effusion, pneumothorax are some of the common conditions where percussion is needed. Using the doctor’s fingers, he tries to elicit resonance or dullness when tapping on the finger placed at the site of examination. Dullness, shifting dullness, stony dullness, resonance can be elicited by percussion technique. Now, coming to virtual consultations, consider the following questions.
“Please ask one of your family member to help me out do the percussion tests”
“I want you to keep your left hand fingers spread on his tummy and then tap the left middle finger with the tip of your right middle finger”.
“Can you hear a resonating sound?”
As explained earlier this is the step where the doctor uses his stethoscope to listen for breath and heart sounds. Most people think that this is impossible to do in the case of virtual doctor consultation but, what if the patient knows how to listen and use a stethoscope? What if there is a healthcare professional in your home? If the doctor feels that he needs to do an auscultation before arriving at a diagnosis then he may ask you to meet him in person. If the same doctor is far away from your home, the doctor will give you a prescription where he records his examination findings and provisional diagnosis. This prescription can be produced at a local hospital where you are consulting next time.
Modern stethoscopes are now equipped with bluetooth and sound clip recording features who can simply record the heart and chest sounds by placing the diaphragm of the stethoscope in the areas where the Dofody doctor instructs you. In case you are using such a digital stethoscope the recorded sound clips can be easily sent to our doctors over the internet using the Dofody app.
This article is intended to make an awareness along users and doctors about the possibilities of virtual doctor consultation. It is certainly a practical solution in most of the health problems that we face and in some cases it is not so. Let the Dofody doctor decide whether he or she can help you online. To read more online doctor consultation scenarios and cases, go to “Use case” What do you think about this article if you have more points to add this article kindly share it in the comment section below, and don’t forget to share this article in your favourite social media’s.