Bhargava Shashank, Sarkar Rashmi
Department of Dermatology, R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India.
Department of Dermatology, Lady Hardinge Medical College, New Delhi, India.
Indian Dermatol Online J. 2020 Sep 19;11(5):712-719. doi: 10.4103/idoj.IDOJ_240_20. eCollection 2020 Sep-Oct.
COVID-19 pandemic has disrupted healthcare systems throughout the globe. It has affected dermatology practice to a great extent. Since most of the consultations (except emergencies) in dermatology are deferred as a precautionary measure, dermatologists have taken the route of virtual appointments in order to continue treating patients in the present lockdown state. However, the concept of telemedicine is quite new for doctors as well as for patients in India.
An online questionnaire was circulated among Indian dermatologists which included participant demographics, changes in their practice and teaching during COVID-19, use of virtual or e-health technologies, and attitudes/opinions on their experiences. We also wanted to understand doctor perspectives on their own roles, wellness, and hospital responses to the pandemic.
A total of 260 responses from qualified dermatologists of different parts of India were received between 1 and 8 April 2020 and were analyzed. Two-thirds of the respondents were within 10 years of starting practice. Virtual consultations have increased by almost three-fold during the pandemic, which is a major change noticed in the practice when we compare before and during the pandemic. Earlier the focus of teledermatology (TD) was mainly for follow-up care (85%), whereas during the pandemic, both new and follow-up patients were provided virtual consultations. The number of patients coming to them for a consultation has drastically reduced. Only 2% of the responders are still performing minor procedures with proper care. Almost two-thirds do not have systems in place to train their residents and fellows due to the disruptions caused by the pandemic. The rest of them have started to take the virtual route of teaching through webinars, virtual rounds, and providing access to online journals to continue their teaching. Only 18.6% of dermatologists at work were provided with personal protective equipment. TD has opened new doors to virtual consultation and it was evident that 54.4% of doctors are willing to continue it in the future even after the pandemic is over.
TD platforms hold great promise to improve access to high-quality dermatologic care in the future. Results from this survey of Indian dermatologists suggest that TD is the future of dermatology as it will be accessed by patients in remote areas and it is a cost-effective move for the patients.
新冠疫情扰乱了全球医疗体系，对皮肤科诊疗造成了极大影响。由于皮肤科的大多数会诊（急诊除外）作为预防措施被推迟，皮肤科医生采取了虚拟问诊的方式，以便在当前的封锁状态下继续为患者治疗。然而，远程医疗的概念对印度的医生和患者来说都相当新颖。
在印度皮肤科医生中发放了一份在线问卷，内容包括参与者的人口统计学信息、新冠疫情期间他们的诊疗和教学变化、虚拟或电子健康技术的使用情况，以及他们对自身经历的态度和看法。我们还想了解医生对自身角色、健康状况以及医院对疫情应对措施的看法。
2020年4月1日至8日，共收到来自印度不同地区合格皮肤科医生的260份回复并进行了分析。三分之二的受访者从事皮肤科工作不到10年。疫情期间，虚拟会诊增加了近两倍，这是我们比较疫情前后诊疗情况时注意到的一个主要变化。此前，远程皮肤病学（TD）的重点主要是随访护理（85%），而在疫情期间，新患者和随访患者都能获得虚拟会诊。前来找他们会诊的患者数量大幅减少。只有2%的受访者仍在谨慎地进行小手术。由于疫情造成的干扰，近三分之二的受访者没有培训住院医师和研究员的体系。其余的人开始通过网络研讨会、虚拟查房以及提供在线期刊访问权限等虚拟方式继续教学。只有18.6%的在职皮肤科医生配备了个人防护装备。TD为虚拟会诊打开了新的大门，显然54.4%的医生即使在疫情结束后仍愿意在未来继续采用这种方式。
TD平台在未来改善高质量皮肤科护理的可及性方面具有巨大潜力。对印度皮肤科医生的这项调查结果表明，TD是皮肤科的未来发展方向，因为偏远地区的患者也能使用，而且对患者来说是一种经济高效之举。
