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The Illusion of Eye Contact with Telemedicine

telemedicine eye contact

I’m big on eye contact with patients. It’s how we show ourselves as humans. The eyes are the windows to the soul. Through them, we build trust, empathy and reciprocity.

When I’m with a patient face-to-face it isn’t always possible but I do my best.

Like the IRL experience I try to achieve some level of eye contact during telemedicine encounters. But care through a screen presents challenges to eye contact. The problem is that the only way to create that eye-to-eye connection is to look directly at my camera. This way I’m looking right at the patient. What they experience is me connecting directly with them in the most human way. It hopefully serves as an indicator of my focus and bandwidth.

The problem is that telemedicine eye contact is an illusion. Because I can’t see them. All I see is the lens of my camera in this case. Appearing in the margins of my lower field of vision is the mother’s face and the critical cues of her reaction to the things I say. Sometimes I act like I can see with affirming facial expressions. But it’s part of a friendly charade to make the whole thing look real to the family on the other side of the screen.

And, of course, trying to record your note during the telemedicine visit adds a whole other layer of disconnection.

Now there’s the real possibility that if I were to look directly at them on the screen then people would see this lower focal point as actually being eye contact. A kind of detached focal point – a surrogate for IRL contact that the receiving person fully understands. A new kind of human understanding for 21st century connection.

I’ve heard there’s technology where a microcamera dangles down in the middle of the screen. It allows you to see the person on the other side while they see you looking directly at them when they speak. Maybe that’s the answer.

While telemedicine improves access to care it always represents a compromise of human-to-human connection. The illusion of telemedicine eye contact is just one example.


Every 33 charts post has helpful little tags at the bottom of each post that help you find related material. If you like this post you’ll like our Telemedicine Archives. It’s everything written here on telemedicine and my views on its adoption. Just click on the small font tag at way down there at the bottom and check it all out...

Photo by Sebastian Unrau on Unsplash

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