Paradox of telemedicine: building or neglecting trust and equity

The Lancet
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Paradox of telemedicine: building or neglecting trust and equity

Two sides of a coin

In this The Lancet article, you'll learn about:
  • An estimated US$ 259 billion in health care spending could be shifted to virtual health care. Black patients are more than four times more likely than White Americans to seek health care in the emergency department over telehealth services, even when adjusting for comorbidities and preferred language. The lack of trust is likely to undermine the potential for telemedicine to mitigate health disparities. Telemedicine visits reduce doctor–patient connection and promote dissatisfaction and mistrust most prominently among those identifying as Black, Hispanic, and Native American. Telehealth suppliers should consider offering the option for patients to arrange appointments with concordant physicians.

  • Medical students should have the opportunity to engage with patients of minority backgrounds to ensure that their care is socially and culturally conscious. Training on provision of care via telemedical platforms ought to be made compulsory in medical education. But the need for strong patient–clinician relationships extends beyond the realm of telehealth and relies on trust that is built during in-person visits. In-person care can be leveraged as a mechanism of raising awareness regarding the benefits of using telehealth services. We unlock its potential to further health equity by acknowledging its paradoxical nature: promise of convenient access but exclusion of marginalized groups.

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