Behind the Mask

The Work-From-Home-Force

The COVID-19 pandemic has provided an opportunity for many to lean heavily into telework and digital medicine, but for one UK based cardiologist, it’s led him to reevaluate his work/life balance in a way he’s never been able to before.

“Where I work had changed and I can’t see it changing back. Whereas before it would be unusual, if ever possible, to work from home at all, now this is the new normal except for days of patient care. I am working an amended rota of 7 long days followed by a week of leave, followed by 3 weeks of remote work.”

While initially he was tentative about how productive he could be without seeing patients in person, he came to find that it was easily incorporated into his day-to-day.

“Ends up that going to see patients in person is largely overrated. Certainly in ITU, for example, going to see a patient is largely a wasted effort for cardiovascular issues…with a good electronic patient record (even without electronic prescribing) and the ability to view observations remotely, and a telephone call or ad hoc tele-conference using an approved service like Starleaf, then largely this has avoided the need for in-person patient reviews.”

However, more than an emergency mechanism to avoid potentially dangerous in-person visits and face to face meetings during a time of pandemic, he found that tele-visits have been unexpectantly positive in terms of efficiency of patient care.

“It is amazingly efficient. It is much easier to hang up on someone (politely, as you have another patient waiting for a call) than to get someone to leave your clinic room because there is someone in the waiting room. I am seeing 50% more patients in the same time as face-to-face clinics.”

Even beyond tele-visits, tele-meetings have also been a boon to his daily life, removing the tediousness of travel while keeping the personal connection.

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MDTs invariably happen at bad times (early, late, lunch). That means they are squashed in with all the other responsibilities around. Now, no one is late as they don’t have to physically travel. We still have time for social interactions at the beginning and end, and everyone is more mindful of aural space for everyone. People in hospital and those at home can still join in without missing out if they have to be on a ward round or prepping for theatre. It is a joy.

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Overall these changes have been beneficial to his life and work, allowing him to still fulfill his duties while connecting more directly with his family. This was truly a blessing during pandemic, when other stressors had come to the fore.

“I am less tired, less grumpy I think largely related to not commuting. I have bought a bike to commute 15miles in total daily on the days I do need to go to work. My work-life balance is better – I feel a better parent for being around my kids more and instead of having lunch or dinner in an anonymous canteen or more likely whilst walking between buildings, I now build family time into my working day and cherish those moments.”

But as with all things, there are drawbacks. For starters, he was acutely aware of the socioeconomic divide highlighted by remote forms of communication that rely on access to technology:

“While it is certainly true that there are advantages to tele and video clinics and working in general, there are negatives to this way of working… It excludes large sections of society that are marginalized already by our systems – those with communication barriers such as not having English as a first language, deaf persons, speech impediments; poorer patients who cannot afford smartphones or similar to have video consults, those who live in situations or want to discuss issues where privacy of a consulting room is the haven they need to open up.”

In addition to the unequal access to technology, there are personal drawbacks to telehealth, the first of which is an element of loneliness. A feeling shared by many who have been working from home in the past months.

 “Although digital working is more efficient, I think for me this is at the expense of my usual human-ness in the interactions I usually have. I no longer talk about the weather, commuting, clothes at the beginning of consultations – it is more efficient yet colder and less personable.”

While he misses the collaboration and spontaneity which can come with in-person hospital work, he believes there is likely a solution to this we haven’t stumbled into yet.

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With remote working comes the loss of team and comradery, the loss of serendipity for ideas, the loss of belonging to an institution. There probably is a clever social sciences solution for this but I do not know it yet.

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Large swaths of the workforce are now the work-from-home-force, and this has caused some big shifts in the way people live their lives. While it may not have seemed like it would impact the medical field, there are some sectors where remote work naturally fits in. What will be key as we move forward will be finding ways to incorporate telehealth into the medical field without compromising the level of access to medicine available to different communities, while continuing to stimulate and grow medical professionals.

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