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Managing chronic illness feels like a full-time job. Between the symptoms, treatments, countless doctor appointments, and tests, it’s both time-consuming and energy-draining. Often, I leave doctor appointments feeling both physically and mentally spent. 

The introduction of virtual care in 2020, due to the COVID pandemic, was a breath of fresh air. It meant fewer in-person visits for minor issues like prescription renewals, reducing the time spent traveling and waiting for doctors. 

Dealing with multiple chronic conditions means more time at the doctor’s office, which can be exhausting in itself. Thankfully, virtual care has eased some of that burden. 

The Benefits of Virtual Care 

There have been many benefits of telehealth visits, especially for someone living with a chronic illness like rheumatoid arthritis (RA).  

  • I spend less time in waiting rooms with potentially infectious diseases that would be harder for me to pass off compared to someone without RA. Telehealth minimizes the spread of infectious diseases, which benefits us all. 
  • Thanks to virtual care, I can focus more on living and less on long hours at the doctor’s office. Telehealth has become a valuable asset in managing my RA. 

Yet, as we’ve integrated virtual care into our routine health care over the past few years, it’s important to acknowledge its limitations, especially when dealing with complex conditions like rheumatoid arthritis. 

The Limitations of Telehealth

After three years of virtual care or telehealth, here are a few things that I have noticed:

It may prolong wait times 

Since the rise of virtual care, many health care providers now opt for a virtual consultation before scheduling an in-person visit. While this can be efficient in some cases, it can also extend the wait time for those who require a physical examination, as it essentially adds an initial step of virtual triage. 

There can be missed social and visual cues

Social cues can get lost in telehealth and virtual care. It feels odd discussing personal health matters or revealing sensitive symptoms to someone whose full facial expressions or body language you can’t gauge. 

 As someone who leans heavily on visual learning, the lack of visual cues poses a challenge. A lot of communication nuances come from what we see, and without it, there’s a heightened risk of miscommunication or distraction. I often find myself getting sidetracked, and it can be tough to keep pace with my doctor’s verbal explanations without visual aids to refer back to. 

I’ve forgotten my appointments easier

Cognitive dysfunction can be a challenge when living with RA. There have been times when I’ve been distracted with daily life or just too tired to remember I had a scheduled call later in the day. One time I forgot my rheumatologist was calling me and I went to the beach. Luckily, I was able to take her call while relaxing in the sand.  

Communication can feel rushed

Not everyone is good on the phone. Sometimes providers rush through telehealth appointments, connections aren’t always stable, and regulations can be confusing.  

Currently, there is a family physician shortage in my province, and I know this is also common all over North America. Tracking down a physician who can take me in the soonest is daunting and exhausting. I never know who I’m going to get and how they are going to respond on the phone to my inquiries.  

While virtual care improves access to health care, there needs to be enough providers in the first place. Not to mention, providers who aren’t dealing with burnout from already being overworked. 

It can’t replace a physical exam

I’ve had providers try to access me via Zoom or over the phone and it does not work. When my rheumatologist was finally able to see me in person, she was shocked to see swelling in my joints. I wasn’t experiencing pain in those joints, so I was not able to catch that myself. I needed a physical exam from a skilled professional to notice it.  

I walk less

With fewer places to go, I’ve gotten fewer daily steps. While I can focus on self-care with the free time I save from carting myself to and from appointments, a lot of my steps were accomplished on the days of my appointments. I would often go for walks after an appointment to digest what was going on. With fewer places to go, I walk less.

I still feel disconnected

 The last three years have been lonely, especially for those living with a chronic illness that makes us susceptible to infections. Oddly enough, I have found myself missing going to appointments. It was an excuse to get out of my pajamas, get a delicious coffee, and engage with people. 

Chronic illness definitely diminished by social life, so when the pandemic started my social life got even smaller. As much as I enjoy the convenience of Zoom meetings, I’m still left feeling lonely and disconnected from the world.  

Advocating for yourself is even more important 

If I need to see a doctor in-person, it is important for me to raise my voice.  

Clear, open communication is the best way to approach virtual care. I also recommend taking notes and not feeling bad when you need to ask the health care provider to repeat what they’ve said. Once I finish my notes, I reflect back to the provider what was discussed to make sure nothing was missed.  

Be a More Proactive Patient with ArthritisPower

ArthritisPower is a patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and share with your doctor. Learn more and sign up here.

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