Telemedicine

Is a “medical virtualist” specialty on the horizon?

In a new JAMA viewpoint article, two physicians — Michael Nochomovitz and Rahul Sharma — discussed the potential behind creating a new specialty: the medical virtualist. Such a provider would spend most of his or her time caring for patients via a virtual medium.

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Telemedicine and digital health are on the rise. Additionally, as the medical field advances, more and more specialties are being added to the mix.

These factors prompted two physicians — Michael Nochomovitz and Rahul Sharma — to pen a JAMA viewpoint article on the potential behind a new specialty: the medical virtualist.

“This term could be used to describe physicians who will spend the majority or all of their time caring for patients using a virtual medium,” the authors wrote.

In the article, Nochomovitz and Sharma make their way to this conclusion based on a number of factors.

For one, telehealth isn’t only being used to treat minor ailments anymore. Now, clinicians are leveraging it to communicate imaging and lab results, change patients’ medications and manage more complex chronic diseases. Not to mention the role it can play in home visits and remote monitoring.

This push for technology has driven the development of various medical specialties. “For instance, critical care was not a unique specialty until 30 years ago,” the authors note. Hospitalists, laborists and extensivists are also relatively new specialties. Laparoscopic and robotic surgical equipment prompted the creation of specialties like interventional radiology, electrophysiology and general surgical oncology.

The success of a medical virtualist specialty would require key stakeholders to work on multiple factors.

First of all, the healthcare world would need to establish a set of core competencies and formalize certification for such a specialty.

Training would include techniques for achieving proper webside manner, or the way a physician is able to communicate and convey empathy to a patient during a telehealth visit. It encompasses a host of factors: how close the provider is sitting to the camera, the background of the room they’re in, the lighting, what they’re wearing and a proper Internet connection. Additionally, a training curriculum would highlight the legal and clinical limitations of virtual care, on-site clinical measurements and continuing education notes.

If such a specialty is developed, Nochomovitz and Sharma note that “there could be a need for physicians across multiple disciplines to become full-time medical virtualists with subspecialty differentiation.” Urgent care virtualists, intensive care virtualists, behavioral virtualists and neurological virtualists are a few examples.

Despite the increasing prevalence of technology in healthcare, the authors note that in no way will the medical virtualist replace the traditional clinical encounter.

“‘Bricks and clicks’ will prevail for patients’ convenience and value,” they wrote. “Physicians will lead teams with both in-office and remote monitoring resources at their disposal to deliver care.”

Photo: bernardbodo, Getty Images