The Role of Embodiment in Being with the Doctor Online: Phenomenological Perspective on Patient Experience of Teleconsultation

The global crisis of the COVID-19 pandemic has considerably accelerated
the use of teleconsultation (consultation between the patient and the doctor via
video platforms). While it is clear that video-based online clinical encounter
has certainly taken away many possibilities for action accessible to both the
patient and the doctor, such as, for example, the possibility to touch the other
person, it is not clear how the absence of the physical body has modified the
interaction between the physician and the patient. The aim of my paper is to
find out how the patient experiences being with the doctor online and what
is the role of embodiment in this experience? This question is motivated by
two things. Firstly, by insights expressed within phenomenology of medicine
regarding the nature of clinical encounter (Edmund Pellegrino, Kay Toombs),
namely, that the clinical encounter contains a face-to-face relationship between
the patient and the doctor, ensuring a successful healing process, which
among other things presupposes patient’s experience of “intimacy, closeness,
expression, emotion and contact” (Dolezal) with the doctor. Secondly,
the question is motivated by the suspicion expressed by contemporary
phenomenologists (Hubert Dreyfus, Tomas Fuchs, Havi Carel, Luna Dolezal)
regarding the nature of online video-based interaction, namely, that it differs
significantly from the embodied face-to-face contact. For example, with
reference to the concepts of embodiment and intercorporeality, found in the
works of Merleau-Ponty, Dolezal argues that a video encounter will always fall
short of the on-site encounter due to the lack of embodied proximity to theother person. I will approach the issue from the perspective of phenomenology,
including both insights from the phenomenological philosophy and the
results from the phenomenologically informed qualitative research study
about patient experience of teleconsultation, which I have conducted. Firstly,
I will show that based on the results of the qualitative research study, patients
do experience emotions, expression, closeness, and contact with the doctor,
which in some cases is even higher than in on-site face-to-face consultations.
Secondly, I will argue, that this has less to do with the embodied nature of
the interaction and more to do with 1) the lack of the clinical environment
(lack of the doctor’s office, waiting room, etc.); 2) the particularities of the
online environment (such as the undivided attention from the doctor); and
3) the previous relationship between the patient and the doctor. Thus, I will
argue that the on-site embodied interaction is not a necessary condition for a
successful healing process.