Living with kidney disease can be a challenging journey, requiring constant monitoring and medical care. In-person visits with health care professionals are crucial in managing the condition effectively. As a former peritoneal dialysis and in-center hemodialysis patient currently living with a kidney transplant since April 2017, I have experienced firsthand the advantages and disadvantages of in-person visits for people with kidney disease. This article will explore these benefits and limitations, highlighting the significance of in-person visits in patients' lives.
Advantages of In-Person Visits
Personalized care: In-person visits allow health care professionals to holistically assess patients' overall health, physical symptoms, and mental well-being. This personalized approach enables tailored treatment plans and interventions that address individual needs effectively.
Physical examination: A substantial advantage of in-person visits is the ability of health care professionals to conduct comprehensive physical examinations. This includes checking for signs of fluid retention, palpating the abdomen for tenderness, measuring BP, and examining the transplantation site (for patients who underwent transplant). These examinations provide valuable insights into the patient's condition and inform necessary adjustments to their treatment plan. It also allows me to get a better understanding by asking questions either during or after the examination regarding my examination results. There are too many limitations to personalized care by using telehealth or a virtual consultation.
Direct communication: Face-to-face interactions facilitate more transparent and direct communication between patients and health care professionals. Patients can express their concerns, ask questions, and receive immediate feedback and guidance. This direct engagement strengthens the patient–provider relationship and fosters trust, leading to better adherence to treatment protocols.
Emotional support: Living with kidney disease can take an emotional toll on patients, and in-person visits offer an opportunity to seek emotional support from health care professionals. These visits provide a safe space to discuss fears, anxieties, and psychological challenges associated with the condition. If necessary, health care professionals can offer reassurance, coping strategies, and referrals to mental health resources.
Limitations of In-Person Visits
Accessibility and travel: In-person visits may pose challenges for patients living in remote areas or those with limited access to transportation. Traveling to health care facilities regularly can be physically demanding and financially burdensome, especially for individuals with limited mobility or financial resources. Another consideration is the toll it takes some kidney patients to find a parking space, walk, or use a mobility device to get to the medical facility and the added stress of being able to afford to pay for parking.
Exposure to infections: Health care facilities are potential sources of infections, and patients with compromised immune systems, such as those with kidney disease, are more susceptible to acquiring infections. As observed during the recent pandemic, in-person visits increase the risk of exposure to contagious diseases, including seasonal flu or novel viruses like coronavirus disease 2019.
Time constraints: In-person visits often require patients to take time off work or other commitments, leading to potential disruptions in their daily routines. This can be incredibly challenging for individuals who depend on employment for financial stability or those with caregiving responsibilities. This can be highly taxing on single parents and those who lack a support system to assist them during their in-person visits or provide childcare while at their appointments.
The Significance of In-Person Visits
In-person visits play a vital role in the holistic care of patients with kidney disease. While telemedicine and virtual consultations have recently gained popularity, they cannot fully replace the value of face-to-face interactions. In-person visits allow health care professionals to conduct thorough physical examinations, assess patients' overall well-being, and provide personalized care tailored to individual needs. Furthermore, these visits foster direct communication, enabling patients to seek emotional support and guidance, increasing patient satisfaction and better treatment adherence.
Nevertheless, it is essential to acknowledge the limitations of in-person visits, such as accessibility challenges, exposure to infections, and time constraints. As health care systems evolve, efforts should be made to address these limitations by offering alternative solutions, including telemedicine services, transportation assistance programs, and extended clinic hours.
In conclusion, in-person visits remain a cornerstone of care for patients with kidney disease. The benefits of personalized care, comprehensive physical examinations, direct communication, and emotional support outweigh the limitations associated with accessibility and potential exposure to infections. Striking a balance between in-person visits and advancements in telemedicine can ensure that patients receive the most effective and comprehensive care possible, empowering them to live healthier lives despite the challenges.
Acknowledgments
The content of this article reflects the personal experience and views of the author(s) and should not be considered medical advice or recommendation. The content does not reflect the views or opinions of the American Society of Nephrology (ASN) or Kidney360. Responsibility for the information and views expressed therein lies entirely with the author(s).
Disclosures
P.O. Gee reports the following: Employer: Self-Employed; Health & Wellness organization and iAdvocate, Inc.; Self-employed; P Gee Consulting, LLC; Honoraria: American Kidney Fund, Amgen, APOLLO APOL1 Long-term Kidney Transplantation Community Advisory Council (CAC), Bayer International, Boehringer Ingelheim, CareDX, FOUNTAIN (Bayer International), NephCure International, Patient Family Advisors Network (PFA Network), Patient Family Center Care Partners (PFPC partners), PxP, Robert Woods Johnson Foundation, Traverse, VCU, and Vertex International; Speakers Bureau: Boehringer Ingelheim and CareDX; and Other Interests or Relationships: AKF Ambassador and Kidney Health Coach, AKHOMM Workgroup, ASN Diabetic Kidney Disease-Collaborative Task Force, CareDX Ambassador, ESRD Health Equity Advisory Board, KHI APOL-1 Steering Committee, KPAC Member, National Kidney Foundation Spring Clinical Meeting Planning Committee, NCC PFE-LAN SME, NKF KAC, PCORI Ambassador, Quality Insights Renal Network 5 PAC Chair, and UNOS Ambassador.
Funding
None.
Author Contributions
Writing – original draft: Patrick O. Gee.
Writing – review & editing: Patrick O. Gee.