In Absentia healthcare, or distance medicine, occurs when the patient and care giver are at different locations, but still communicate by audio and video, or sometimes without any personal contact.
[1][2] Some people argue that this type of in absentia medical care may derail the traditional sequences of examination, diagnosis and treatment, and that such a detour may challenge existing values of modern medicine.
[4][5] Aspects of online medicine have been described as an "asynchronous written exchange," and a "disembodied relationship," with "few analogues or precedents in medical practice.
"[1] This trend has also been viewed as perhaps "anarchic" with potential to "set off a revolution in remote care" and promote "self-diagnosis.
[7] During the height of Arabic and Jewish medicine (732–1096 CE), diagnosis called for an orderly sequence where examination, "by the feel of the hands," played an essential role.
At a later time when astrology, animal products, magic and incantations were part of the healing arts, formal contact with healers may have gradually become unnecessary.
Apparently, Galen was so skilled in understanding symptomatology that there were times when he preferred to diagnose without questioning the patient.
This booklet enabled a patient to receive a diagnosis and treatment by post without a personal visit to the physician.
[13]: 209 In Europe and England, between 1600 and 1800, dispensing and advising without direct contact with ailing persons had become a common practice.
"[15]: 45 Diagnosis depended heavily on the listener's interpretive skills, and treatment relied more on compassion than medicinal chemistry.
Another major obstacle to face-to-face contact was the difficulty posed by distance and poor travel conditions.
John Morgan (1735–1789) of Philadelphia, a founder of the University of Pennsylvania medical school in 1765, was equally active with regard to postal consultations.
In addition to letters from patients, early physicians also recognised the importance of examining bodily excretions in establishing a diagnosis.
Julius Herisson, an early inventor of sphygmomanometer (blood pressure measuring apparatus) in 1834, recommended that numerical aspects (quantitative data such as beats per minute) of pulse were more informative than their descriptive characteristics.
His live radio broadcasts diagnosed diseases of patients who wrote to him describing their symptoms.
Contemporary technology allows the transmission of videos, photos, and data to distant sites.
It is cheaper, quicker, and more convenient at a time when – some might say – that traditional health insurance and the cost of drugs are straying beyond the reach of many.
The worried-well may seek care for discomfort that past generations would have dismissed as trivial or inevitable.
[13]: 684–687 The same electronic information technologies that aid the health-providers also empower the health-seekers who can gain easier access, whilst remaining anonymous.