Gaps in telemedicine training

The use of telemedicine has exploded since the start of the pandemic. However, the training of doctors in this new practice is not yet optimal, according to a researcher from the University of Montreal.

In research he led, Dr Jean-François Echelard and his team analyzed 1,733 scientific articles on digital health training in several countries.

“There is a general impression: the training is generally sub-optimal”, says the researcher in an interview with Metro.

Indeed, the study notes that the learning of telemedicine would be hampered by a lack of resources, support, practice and funding. In addition, there would be a lack of knowledge about digital security issues.

This problem is also known to the College of Physicians. Yves Robert, secretary of the Collège des médecins du Québec, recalls that since January 2019, a regulation of the College obliges the continuing medical training of members, in particular at the level of new technological tools.

Still, many doctors are still unfamiliar with the technology, he believes. In his opinion, the lack of knowledge of telemedicine technologies would mainly affect doctors who have been practicing for a longer time, Robert believes.

“Some physicians closer to retirement may in some cases be less motivated to upgrade.”

Adapt your practice

Mr. Echelard notes that the exam is much more limited by phone or videoconference, a reality that is not always studied in medical schools.

He has experienced this problem in his own practice.

For example, a patient with a dermatological problem during a telephone consultation will have to describe his skin problem.

The doctor must then form a mental representation of the patient’s description, and adapt his questionnaires to the situation.

“It’s a ‘challenge’. It really takes to be creative, ”he says.

An increasing practice

Since March, telemedicine has experienced a major expansion in the province. According to data compiled by The Canadian Press, more than 1.5 million Quebecers consulted in telemedicine from March 16 to June 8, 2020.

In Quebec, the Legault government is also banking on this practice in order to speed up access to a family doctor.

Despite this increase, the majority of telemedicine consultations are still done by phone, says Robert.

This fact could be explained in particular by a lack of knowledge of technologies, and limited access to the Internet in some patients.

Limits

Despite the multiple advantages of telemedicine, Mr. Robert points out that this practice has its limits.

According to him, the College recommends that a doctor not adopt this practice for all his consultations. It should therefore be a complementary practice, not a primary one.

Mr. Robert believes that certain medical practices simply do not lend themselves to telemedicine. Urgent needs can never be met from a distance.

“One thing telemedicine won’t do is empty emergency rooms,” he notes.