One main concern is that telemedicine will further strain the physician-patient relationship by creating physical and psychological distance between the patient and the physician. The Patient perception of physician is, if you are not able use tactile adjuncts to communicate, then what remains of empathy and compassion in the current medical interaction will eventually disappear completely.

Which personal thoughts and attitudes are communicated to others and the manner in which they are expressed may be different in digital vs traditional face-to-face settings. Some individuals may exhibit unusual acts of compassion in online settings, while others may devolve into sarcasm, harsh language, uncouth criticisms, and even cyber bullying. It is not uncommon to read vitriol-filled remarks on social media applications or in the comments section of online news sites. Disrespect and thus a lack of empathetic concern for others is all too evident in contemporary online discussions. In many instances, those unsavory comments are unprovoked and unwarranted.

Empathic communication skills can be easily taught to physicians and physicians in training. Training in empathic verbal and non-verbal communication skills has been shown to improve all aspects of the patient-physician interaction by facilitating effective transmission of information, improving the effectiveness of questioning, improving patient perceptions of the interaction, and encouraging partnerships and participatory decision-making.   There has also been shown be greater adherence by patients to prescribed treatment plans, and more open discussion of risks, benefits, alternatives, and expectations of treatment.

Conversely, Patient perception of physician, when physicians failed to recognize expressions of affect by patients and provide immediate empathy and concern, patients expressions of emotion were often escalated to the point of the physician labeling the patient and/or interaction as “difficult.”  Patients rarely offered direct communication of emotion during the interview, and it was necessary for the physician to utilize empathic listening skills to avoid missing opportunities to connect with and encourage patients.   A lack of acknowledgment of patient emotional needs and responses is a threat to the patient-physician relationship and has been shown to be a predisposing factor in many lawsuits.