Michigan State University College of Human Medicine Department of Family Medicine

Posted in Teaching

by Luis Espinoza, MD

Over the course of the past three weeks, I have been surprised by my increasingly conflicted feelings about in-person primary care health visits.  I am naturally a very gregarious and welcoming person who enjoys interacting on a face-to-face basis and actually scoffed once at the idea of virtual health visits.  “Not a chance the patient-doctor consultation would ever be a productive one” I thought to myself, remembering back on the times I saw my own patients, shook their hands, physically touched them during the exam portion of the visit, and talked them through their concerns about their medical issue.  I never envisioned getting this same sense of fulfillment and satisfaction via video or, much less, a phone call.

That initial skepticism has all but faded.  I am paired up with Dr. Marcos Machado, a physician who knows his patients well and is very much in tune with their health history.  It is quite obvious to me that his patients really enjoy having him as their primary care physician and latch onto his every word.  Having this kind of relationship with his patients has undoubtedly helped make virtual medicine a successful venture for Dr. Machado.  Sometimes there are setbacks with his older patients who are less acquainted with technology, but by and large his patients really enjoy virtual visits.  Dr. Machado has addressed everything from diabetes to cancer to weight management to electrolyte abnormalities, all the while conducting exams as thoroughly as he can and developing a great plan of attack for the patient.  He laughs with his patients, consoles them, patiently addresses question after question, and brainstorms with the patient when an answer eludes him.  I have found through all of this that his virtual visits are incredibly effective, efficient, and meaningful.  When he has had to talk with patients via phone instead of through video chat, the visit is still successfully conducted and the patient hangs up just as fulfilled as he/she would have been if the visit had been in person!

All of this is to say that I am now a firm believer in virtual medicine.  It is incredibly useful and practical.  The patients I have had to call do not bat an eye – they talk me through their issues and I give them a plan much like I would in the office.  One man even commented that he was going to take a nap right after we hung up, which was amazing to me since I recall a patient driving 1.5 hours to see a primary care physician with whom I worked during my family medicine rotation!  Obviously, virtual medicine is futile when the physician has to physically see a skin lesion, wart, or anything that requires in-person intervention.  However, for the most part, I now believe that most visits could and should be conducted virtually if the patient prefers it that way.  It saves people time and gas money, it decreases the frustration of sitting in waiting rooms for long periods of time, it lessens air pollution, it decreases the risk (especially in places like Michigan) of older patients slipping on ice or hurting themselves, and it is overall just as effective as an in-person visit.  I vouch for virtual medicine fully and feel that a shift in its direction is imminent.


The following are links to virtual health articles I found compelling:

  1. Implementing telehealth in practice. ACOG Committee Opinion No. 798. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020;135:e73–9.
  2. Khairat S, Meng C, Xu Y, Edson B, Gianforcaro R. Interpreting COVID-19 and Virtual Care Trends: A Call for Action. DOI: 2196/18811https://preprints.jmir.org/preprint/18811 
  3. Sultan, Assem, Acuna, Alexander, Samuel, Linsen, et al. Utilization of Telemedicine Virtual Visits in Pediatric Spinal Deformity Patients: A Comparison of Feasibility and Patient Satisfaction at a Large Academic Center. [published online ahead of print April 07, 2020]. J. pediatr. orthop.. Available from: Journals@Ovid Full Text at