Angela Onwuzoo
Medical experts say face-to-face medical consultation is very crucial in healthcare delivery, especially in the management of certain health conditions such as HIV and other sexually transmitted infections.
According to them, some patients feel safer having face-to-face interaction with the physician than consultations via telephone, video or email, noting that privacy is important in managing diseases that are associated with stigma.
The physicians stated that seeing patients face-to-face helps many of them to articulate their health concerns better than consultations via telephone, video or email.
Speaking with PUNCH HealthWise, the Director and National Coordinator, Neglected Tropical Diseases Elimination Programme, Federal Ministry of Health, Dr. Chukwuma Anyaike, says face-to-face consultation is still better in the management of diseases associated with stigma.
The physician noted that though the outbreak of COVID-19 has reduced face-to-face consultation and increased telemedicine in some cases, most patients and physicians feel more comfortable having one-on-one discussions.
Anyaike, a consultant public health physician, said, “Medical consultation has a lot to do with psychological permutations and interpretations. For instance, if a patient comes to you, there are certain things he may not want to tell you. But by the time you look at the patient and ask some questions, you will be able to get the right information from him or her.
“Eye-to-eye contact is very important in medical care delivery. It helps in extracting the truth from a patient. There are a lot of impediments in virtual healthcare delivery as a result of poor networks and patients hiding some vital information from the physician.
“So, face-to-face consultation is very important, especially when it has to do with diseases that are associated with stigma such as HIV and other sexually transmitted infections.
“Patients with this type of ailment prefer one-on-one interaction. Some patients feel safer having face-to-face interaction with the physician. Privacy is very important and they also have time to talk to the doctor.”
Commenting on online consultation, Anyaike said, “The person you are talking to on the phone, you do not know. You don’t know what the person is doing with the discussion or whether he is recording you. But if you are talking to a patient in the consulting room, face-to-face, you are sure of what you are seeing.”
A former president of the Nigerian Medical Association, Dr. Francis Faduyile, said face-to-face consultation is very important because doctors can touch patients, noting that touching is an integral part of health management.
He said, “Advancement in any technology follows a stepwise movement. The technology in Nigeria has been laidback and when we are talking about telemedicine, we have to move from one level to the other for us to be able to attain the level that we can say, ‘Yes, we can use technology to see patients, to plan patients and to examine patients.’
“And because of that, we cannot jump from purely manual to digital. You have to pass through some stages.
“In Nigeria, the management of patients has been largely face-to-face, even from medical school. Many of the doctors that we have were trained in one-on-one interaction with patients.
“And, again, you cannot see a patient without touching. Touching is an integral part of management or the process of making diagnoses for doctors.
“You have to palpate. Palpate means you have to touch some parts of the body to see how they are working. You also want to percuss — to see the consistency; and finally, you have to auscultate, that is, using the stethoscope to hear some sounds.
“All these ones have not been improved or undergone the technological know-how for us to able to say, ‘Yes, we have advanced to that stage.’”
He noted that the awareness of patients in the use of technology in accessing healthcare in Nigeria is still limited, coupled with the challenge of poor networks.
For patients to take part in an online consultation, experts say, they need access to a smartphone, tablet or computer with a working camera.
They raised concerns about accessibility for those who don’t have a good internet connection, as well as any potential decline in the quality of regular check-ups.
In an article published in BMJ Open Access journal, the authors said there is a growing need to extend feasible options for patients beyond the traditional consultation model.
“Online consulting may provide an effective and convenient alternative for some groups of patients (such as those in employment) with non-urgent problems, who do not require face-to-face contact with the practice.
“It may also offer an acceptable means by which patients can consult their clinicians about sensitive topics, which may otherwise remain unarticulated,” the authors stated.
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