Fortunately, our hospital is surrounded by a solid telecommunications infrastructure. This experience would be limited in more remote areas of the country. At times, sound quality was an issue, which can be especially problematic for certain patients.
Certain psychosocial implications of the pandemic, including (but not limited to)social isolation and financial hardship, are often associated with increased substance use, and early data support the hypothesis that substance use has increased during this period.2 Delaware seems to be included in the national trend. As such, our already-busy service is being stretched even further. Dr. Horton receives calls and is providing critical recommendations continuously throughout the day for multiple hospitals as well as for his outpatient practice. He used to spend a great deal of time traveling between different sites. With increasing need for his expertise, this model became increasingly difficult to practice. Our new model of attending supervision is welcomed in some settings because the attending can virtually be in multiple places at the same time.
For me, this experience has been positive. For a physician in training, virtual rounding can provide a critical balance of autonomy and support. I felt free on the rotation to make my own decisions, but I also did not feel like I was left to care for complicated cases on my own. Furthermore, my education did not suffer. In actuality, the experience enabled me to excel in my training. An attending physician was there for the important steps of plan formulation, but solo problem-solving opportunities were more readily available without his physical presence.
Aside from the medical lessons learned, I believe the participation has given me a glimpse of the future of medical training, health care delivery, and life in the increasingly digital post−COVID-19 world.
Hopefully, my experience will be helpful for other hospital systems as they continue to provide high-quality care to patients and education/training to their resident physicians in the face of the pandemic and the changing landscape of health care.
Acknowledgment
The author thanks Mustafa Mufti, MD, ChristianaCare Psychiatry Residency Program Director; Rachel Bronsther, MD, ChristianaCare Psychiatry Residency Associate Program Director; and Terry Horton, MD, ChristianaCare Addiction Medicine, for their assistance with this article.