“He sounded harsh, “my wife said after she hung up the phone with her physician.

In the office, she had found her physician compassionate and warm. But on the phone that day, she felt that the physician was distant and regimented. As a palliative medicine physician practicing at a cancer center, I knew what she meant. When the COVID-19 pandemic began spreading across the globe, waiting rooms of medical offices emptied almost overnight, including our own. Many patients with cancer who were not receiving active treatment stayed home, uncertain about their future, often scared and worried. Telemedicine seemed like a perfect solution to stay in touch, offer ongoing care and counseling, and reach out. Health care systems recognized this, and in a blitzkrieg-like move, transitioned many of their nonurgent outpatient visits to virtual. But neither the patients nor the clinicians were prepared for it.

“I have to ask you a question before we get started, “a long-time patient asked when I reached her via telephone at home: “Are you wearing your white coat?” We both burst out laughing at the absurdity of the image: a physician sitting at his desk, talking to a patient who cannot see him, and yet still wearing a white coat.

During more than 20 years of practicing medicine, I have worked on 2 different continents and in a variety of medical systems and settings. But one thing has always remained constant: the practice of medicine as an in-person endeavor.

The potential benefits of telemedicine are many and easy to appreciate during normal times; in the times of the pandemic they are priceless. Telemedicine allows for quick contact and maintains continuity of care, especially for patients who have an established relationship with the clinician or practice. This option can be particularly helpful for patients who live in remote areas or cannot easily travel, including frail older adults. Patients can be quickly assessed and supported without the risk of being exposed to the virus. The video encounters also offer a direct glimpse into the lives of patients, an updated version of the traditional home visit.

But, compared with the face-to-face interactions, the virtual interactions seem barren, devoid of the richness the personal contact brings. In a specialty like mine, where a lot depends on emotional connection with the patient and their caregivers, the virtual visits demanded more of me and yet felt a lot less fulfil-ling. And they all seemed to be plagued by annoying technical issues: a weak Wi-Fi signal, dropped connections, wrong phone numbers in the chart, malfunctioning headphones, or a broken phone camera. And what to do about the omnipresent background noise of a lawn mower? As I spent more time doing telemedicine visits, I noticed their cumulative effect wore on me.

Times are chaotic now. For all of us. Our health care systems struggle to provide the best care possible. Telemedicine has proven to be incredibly useful, and it is here to stay. Over time, supporting technology and systems will make virtual visits more efficient, better coordinated, and hopefully, more patient-friendly.

But there is no doubt that the virtual visit is a fundamental alteration to the patient-physician encounter. Recent weeks have brought a massive and hurried adaptation that risks changing the ancient and sacrosanct practice of medicine. And as news, discoveries, ideas, and policies spin around in a flurry, now more than ever we must anchor ourselves in and cherish the wisdom of personal interactions. The place where it all starts.

According to the passage, what does the author mean by “practice of medicine as an in-person endeavor”?