How physicians can improve their telehealth technique

Timothy M. Smith , Contributing News Writer

The COVID-19 pandemic has made telehealth an indispensable element of clinical practice, but many physicians—trained at the bedside—still struggle to connect with patients over video. Fortunately, it’s quick, easy and inexpensive to fix the things that most often undermine virtual visits.

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In a recent episode of the “AMA COVID-19 Update,” an executive presence coach gave practical tips to help physicians ensure telehealth meets their patients’ needs.

“The No. 1 issue that I see—and this holds true across the board for all professionals, but I feel it's even more important for physicians—is the need to be able to make eye contact on camera,” said Marsha Redmon, who leads workshops for physicians, lawyers and other professionals on virtual presentation skills.

“It's just not natural to stare at the webcam, but that is what we have to do in order for our patient on the other end to feel like we're looking at them,” she added.

The key to making it look natural is to make sure the webcam is in the right place—at your eye level. To do this, put your finger next to your eye and then move it straight out until you hit the vertical plane of your camera. Then move the camera up or down to match it.

“It's important to get that webcam up to eye level, whether it's a laptop or an external webcam, to sit it on books or boxes or whatever it takes to get it to eye level,” Redmon said. “That can make a huge difference.”

It’s also crucial to make sure your webcam has good resolution.

“So if you look like you're in a room full of fog, or if it's very shaky, you might need to invest in an external webcam,” she noted.



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But the in-person visit also relies on the physician’s voice. A conversational tone is vital.

“For a lot of us, smiling—breathing for a moment and really looking at the patient—can help us to do that,” Redmon said.

Learn more with the AMA about lessons from the pandemic on telehealth. Find out more about how the AMA is advancing telemedicine during the COVID-19 pandemic and check out the AMA telehealth quick guide.

It’s also important to account for the basics of video production—for starters, how lighting works.

“A big mistake many of us make is we have light behind us that's shining toward the camera. That’s a big no-no,” Redmon said, adding that this confuses the camera and ends up making your face dark.

An easy trick is to use a desk lamp to bounce light off the wall in front of you. This will soften the light and improve the color of it.

On top of that, avoid wearing colors that don’t translate well on camera. The white lab coat, for example, often doesn’t show up well if your camera has low resolution.

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The same is true of high-contrast patterns, such as “a black-and-white striped shirt, or black-and-white polka dots or something like that, because there's so much contrast it can cause the camera to almost shake,” Redmon said.

And if you’re in a noisy environment, such as a home with rowdy kids or near a busy road, consider using a headset with a noise-canceling microphone.

Also, it helps to carve out a dedicated physical space for video calls because then you've accounted for all the variables in advance.

Finally, consider how hard this experience must be for patients, and suggest they include family members to help keep track of your instructions.

In addition, “I would always recommend that physicians make sure that they have a phone number,” Redmon said. “So in case the internet connection is problematic—in case the video call is dropped—to know in advance that this is the right number, that this is the number that this person can be reached on.”