Email consultations, was ADDICTION ALCOHOL
Posted: Tue Aug 24, 2004 1:32 am
While everybody has fun watching the New Olympics of Pissing Contest, I would like to give my personal experience of email consultations.
In the last 3 years, I had about 30 patients, mostly overseas, who for some reason decided that I was the only one who could help them (go figure....) and were adamant at having email consultations.
As Dave correctly mentioned, there were always many things missing: first impressions, way the patient parks his car (I look at this too....), way of walking, dress, tone of voice, odours, colours of dress, use of words, reaction to questions or to provocative words, etc,.... we all know that.
Nevertheless, especially in physical, organic pathology or functional problems, with some probing, a first, second and more prescriptions, often successful, were possible.
But when the deep seated problems came to the surface, even with total honesty from the patient (and indeed it is often easier to write about very sensitive problems than to speak about them in person, face to face) there has often been "something" missing that made the final prescription(s) difficult or impossible.
In one case, it was the emotional outburst of one patient to a totally unfair situation, written in haste, ander and despair and sent to me as a friend and not as a therapist that allowed me to get to the remedy. Reviewing the case later on, I do believe I would have zeroed in a lot earlier had that patient been in front of me and not on the other side of Earth.
So, my experience is that it is possible to have a valid consultation through email, but very difficult to get to the bottom of the case. It should be used only in cases where there is no other option at all.
Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"
[Non-text portions of this message have been removed]
In the last 3 years, I had about 30 patients, mostly overseas, who for some reason decided that I was the only one who could help them (go figure....) and were adamant at having email consultations.
As Dave correctly mentioned, there were always many things missing: first impressions, way the patient parks his car (I look at this too....), way of walking, dress, tone of voice, odours, colours of dress, use of words, reaction to questions or to provocative words, etc,.... we all know that.
Nevertheless, especially in physical, organic pathology or functional problems, with some probing, a first, second and more prescriptions, often successful, were possible.
But when the deep seated problems came to the surface, even with total honesty from the patient (and indeed it is often easier to write about very sensitive problems than to speak about them in person, face to face) there has often been "something" missing that made the final prescription(s) difficult or impossible.
In one case, it was the emotional outburst of one patient to a totally unfair situation, written in haste, ander and despair and sent to me as a friend and not as a therapist that allowed me to get to the remedy. Reviewing the case later on, I do believe I would have zeroed in a lot earlier had that patient been in front of me and not on the other side of Earth.
So, my experience is that it is possible to have a valid consultation through email, but very difficult to get to the bottom of the case. It should be used only in cases where there is no other option at all.
Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind"
[Non-text portions of this message have been removed]