I am a physiotherapist for the musculoskeletal system, women's health and pediatric pelvic health. I spend a lot of time educating my patients. But I also spend a lot of time touching my patients – m Annual therapy was a big part of my practice. The idea of telehealth has always fascinated me. South Africa has a great shortage of women's health, particularly pediatric pelvic health physiotherapists, and patients often travel far to visit my colleagues or me. In South Africa, telehealth has never been well supported by our Health Care Council. There were quite a few hoops to jump through to treat a patient with telemedicine. Covid-19 has made so many changes, and although most changes have been difficult to adjust, some have forced us to rethink our practice.
I deliberately turned away from telehealth during this pandemic. I was so overwhelmed with all the changes in life that I thought I would not make any further changes. Can I really treat someone effectively without actually touching them? At the same time I complained to everyone who wanted to hear about wearing masks! Masks are important to prevent Covid-19 transmission. However, I have difficulty communicating with my patients while wearing a mask. It is so difficult to grasp nonverbal cues when you can't see someone's face! My greatest passion in physiotherapy is communication, and the non-verbal cues during the interview are crucial for controlling your interview structure and management plan. This is all the more true if you see patients with chronic pain, women with health and children struggling with bedwetting or accidents during the day. I didn't know how important the nonverbal cues and facial expressions were until they were taken away from me.
The universe intervened in my little block against telemedicine. First, the new Telerehab platform was published on physioplus. My curiosity overcame me, and I played around with it and started seeing how good software can make a telemedicine session work. Second, a good friend of mine, who lives very far away, had problems with her 9-year-old child, who wet the bed every night. She lives in a small town and there was no help for her. Since there are travel restrictions, she cannot travel to get the help she needs. I decided to take the plunge and made my first telemedicine appointment.
I quickly took a look at the Physioplus courses on telemedicine, which was very helpful to show me how to get started. The Telerehab platform on the PhysioPlus website is so user-friendly that I had no problems setting up the appointment and emailing the meeting to the patient. I think it's good that you schedule the appointment with certain times and automatically send everything to the patient (even a reminder just before the appointment). The entire booking process took less than 2 minutes. When it was time for the appointment, signing up was easy and everything worked perfectly. That was until a hailstorm hit and disrupted our internet connection. Fortunately, this was right at the end of the session when we were talking, so we managed to get everything done. Apart from an act of God, the whole process went so smoothly. I like the platform because it shows the videos of you and the patient side by side instead of on other platforms where it switches between the speakers. You can also display the screen share on the screen if you want to share resources or educational information with them.
What I loved most was that I was allowed to see their faces. I haven't seen a patient's face in 3 months! It made a big difference. The appointment itself went well. I managed to give a comprehensive management program, and my patient was grateful for the opportunity to receive treatment that she could never have otherwise received.
Physiotherapy has moved in the direction of active rather than passive management. Teaching a patient how to manage themselves is really high quality care. Physios are amazing educators and have so much to give. I love my manual therapy and will always appreciate the power of touch. However, we are not just manual therapists. We need to be aware that education, counseling, exercise prescription, functional rehabilitation and everything we give our patients as self-management strategies do not have to be face to face. Yes, there are always circumstances in which patients must be seen in person. While we must have self-isolation for a long time, I will enjoy seeing the faces of my patients for the time being. And I will appreciate the fact that I can help them deal with their problems, even if we cannot see each other personally.
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