A patient returning and sticking by the side of the same doctor is most likely a telling sign that the doctor, among other things, has excellent bedside manner. The doctor has perhaps packaged his medical expertise and delivered them well, with extra comfort to boot, which the patient is enveloped in every time he makes a visit.

But what if there is no bedside? As medicine moves towards the digital age, consultations are done via the reaches of technology, most likely over a screen – and not the type that can be pulled. The field of telemedicine is booming and as such, doctors will now have to equip themselves with webside manner to provide comfort and care to patients in developing a rapport over a telemedicine encounter.

Webside manner essential for telemedicine episode success

Telemedicine is not without its hurdles, especially now that it is in a relatively infancy age. The pioneers who dabbled with telemedicine have had to learn through experience and sharing, as webside manner is not yet available in the medical curriculum. Formal training may not be too highly warranted, with most of it being common sense. Needless to say, starting off a virtual visit with the proper 'webside' manner is key to a successful telemedicine encounter.

The technical spectrum of telemedicine plays a crucial role. Kinks will need to be ironed out with regards to webcam resolution, internet speed and audio equipment so as not to get cut off in the middle of the session. Lighting and the backdrop of the doctor’s area is also important. Sitting with his back against the window will probably make the doctor look like a dark shadow. The doctor’s posture and gestures are easily scrutinised over the screen, so even proper attire plays a role. In addition, maintaining eye contact is also vital, just as it is in physical consultations.

Experimental psychologist Elizabeth Krupinski, associate director of evaluation for the telemedicine programme at the University of Arizona reminds telemedicine students to disable their video chat's picture-in-picture feature. "Turn it off and look at the patient,” she says, which can be tricky and requires practice to have the doctor look directly at the webcam rather than at the patient on the screen.

While a doctor may have good bedside manner, it does not necessarily translate to having good webside manner. The doctor may feel overwhelmed with the many precautions of telemedicine that it gets in the way of them administering proper care. It is especially daunting if the doctor is camera shy. "There are some people who are great in person and you put them on camera, they're a dead fish," says Krupinski.

Catering for telemedicine, so doctors can be doctors

Telemedicine is being readily embraced. The paediatric telemedicine programme in University of California in Davis has a special telemedicine clinic built in their hospital to cater for virtual examinations. It is purposely staged like the usual office, with books and a computer, but with better lighting. The whole room is also wired to the microphone so the doctor can speak freely and forgo the bulky headset—which is the norm for doctors conducting telemedicine consultations so as not to have the consultation broadcasted to those off camera.

"We try our best to control as much of the environment as we can, so the doctors can be doctors," says Jim Marcin, director of the paediatric telemedicine programme at University of California, Davis. He also said that 15 minutes of basic video etiquette training was enough for doctors to be comfortable with telemedicine and develop some degree of webside manner.

There are also online services like Teladoc and HealthTap that have a pool of medical professionals ready to dispense advice and conduct consultations remotely to patients whom they’ve mostly not met before. In this regard, experts are sceptical about doctors’ ability in delivering compassionate care to virtual strangers, and was of the opinion that webside manner definitely needed more co-operation (and a different kind of co-operation) than bedside manner. MIMS

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