In 33 years of practice, I have seen a lot of change. I thought I had mastered the most demanding transition about a decade ago, when I had to go from paper chart to computer record. But I was wrong. On Monday I'll brave my first video encounters. It feels a bit like when I was starting out in medicine, a mixture of excitement and fear.

When I had to adapt to the computer as my mode of record, it changed almost every part of the way I interacted with patients. It changed my posture in the room, my eye contact with patients, my flow of thinking and speaking. I joked with patients that my boss had invited Mr. Flathead into the room, someone who would be beneficial to both of us, but who also required of my attention. ​

Through the change to electronic record, a few parts of the patient encounter serve as a bridge from the past. Even when it is not necessary, I put my stethoscope in my ears, communicating without words: I am listening to what is in your heart. Many of my visits are OB checks, where the patient and I listen together to the heartbeat of a mysterious person who is yet to be. If the visit is solely a discussion about mood, I find a gentle pat on the shoulder gives the message, I am beside you. Touch is an important part of my interaction with patients.

Now I will have to use words to express that I am hearing and witnessing. I am sure I will learn as I go. For OB visits, I will borrow from my midwife colleague Sandy Gerling. I overheard her saying, "After this call, take a few minutes to put your hands on your belly and connect with your baby." A beautiful, empowering message. Creative ways of connecting with and empowering patients may be a silver lining in this dark time.

I did not think I would have such an enormous challenge at this late point in my career. The coronavirus pandemic has turned everything, including routine medical care, upside down. Whether from behind a mask, or over a flat screen, I see Valley caregivers motivated to connect with patients within safe parameters. With tech support, tips from colleagues, and feedback from patients, I am hopeful we will widen our options for meaningful encounters.