The Network Effect of Passion: An ICU Physician's Perspective on Virtual Care

I’m a pulmonologist and a critical care intensivist. Despite my scientific and level-headed approach to most subjects-- including medicine-- I’ve been described as a passionate person. And yes, it’s true. I believe that’s probably the most important character trait of a clinician, otherwise how else could we sacrifice so much for this profession? It has to start with passion.

The latin root of the word 'passion' is 'pati,' which means suffering. And as clinicians, boy do we. We endure pain if we aren't practicing, and indeed we practice until we feel pain. More often than not the latter manifests indirectly: long hours away from home; time apart from family and friends; fractured relationships. Case in point, the high divorce rate for surgeons and other medical professionals is often due to the time commitment, but also the emotional toll of the work.

“We endure pain if we aren't practicing, and indeed we practice until we feel pain.”

Now, here we are facing a pandemic like our generation has never before seen firsthand. The current environment is a strong reminder of that indirect suffering, but even more so the direct pain we as clinicians feel when we hear about our colleagues who fall ill-- or even die-- while working to save and protect others from COVID-19. It’s a frightening time we’re living in.

But we as clinicians are wired to rise up in just this type of moment. The passion and suffering are two parts of the whole. I’d speculate that 99% of medical professionals have been more than willing to run towards the burning building, rather than away from it. We are seeing it in social media and on the news: the clinicians who are beat down, exhausted, anxious about contamination, or even fearful of bringing the virus home to their family. But we keep showing up. We keep moving. We keep working. We keep giving. Because we’re passionate.

“That passion, for me, has also manifested in my deep, deep belief in the power of virtual care.

That passion, for me, has also manifested in my deep, deep belief in the power of virtual care. Why? Telehealth is the best possible intersection of social distancing, quarantine and medical care. It has the power to reckon with the exponential effects of this virus. It also has the ability to protect our medical community, so they can keep fighting for the patients that need in-person care the most. Consider this:

One patient experiences COVID-19 symptoms. They get screened online through a telehealth visit, and are then tested by one medical professional in their home. They test positive, then are cared for remotely by a virtual care clinician-- presuming they aren't one of the patients who become sick enough to require critical care interventions.

They’ve effectively had ONE interaction with another person. Just one.

They didn’t get on a bus or subway with a dozen or more people.

They didn’t walk into an extremely crowded ER and sit in the waiting room.

They didn’t expose the admin who checked them in.

They didn’t expose the nurse who triaged them.

They didn’t expose the medical assistant who took their vitals.

They didn’t expose the lab technician who swabbed them.

They didn’t expose the radiology tech who x-rayed them.

They didn’t expose the rounding physician.

They didn’t expose the custodial staff who cleaned up after they were sent home.

Now that’s a powerful concept.

Again, there are clearly exceptions-- patients needing immediate in-person care and possibly even ventilation. But that’s my whole point. I am passionate about having the ABILITY to show up for those intensely sick patients who need me present in the CCU. Because I’m wired to do everything I can to help them. If I get taken down by COVID-19 because of the exponential effects of one person who didn’t need to come into my ER-- who could have been tested and cared for while limiting their exposure to a hundred people (with a network effect of thousands more)-- then my chances of saving someone’s life is significantly reduced.

“I am passionate about having the ABILITY to show up for those intensely sick patients who need me present in the CCU.”

The power of telemedicine is real, It could save the lives of my colleagues-- those in the trenches running toward the pain of others, ignoring their own pain because that’s how their passion manifests itself. I don’t want us to treat fewer patients-- I challenge us all to be more sophisticated in our approach to treating each and every patient who needs us. We can be smarter about our strategies. The tools associated with virtual care are within reach.

Join me. Muster up that passion. Preach to the medical community. Educate those around you. We clinicians aren’t backing down, we’re stepping up to the call because we’re hardwired to do so. But we have to do it the right way so we can keep showing up-- again and again and again.

Let’s harness the power of virtual care-- so we can keep fighting.