Separating the Physician and Patient: A Paradigm Shift for Routine Otolaryngology Examinations in COVID-19-Like Aerosol-Contaminated Environments

Abstract

Objective: To evaluate the attitudes of physicians and patients toward physical examination in physically separated environments using a laryngoscopic examination model. Materials and Methods: Six experienced laryngologists performed laryngoscopic examinations in 30 patients in a closed-chamber examination unit. The physicians and patients were asked to compare all domains with their previous standard laryngoscopic examination experience using a 10-point visual analog scale (0, poor performance; 10, good performance), including effectiveness of communication, difficulty of examination, perception of safety against airborne transmission of COVID-19, applicability of the unit for future examinations, perception of protective environment, and overall comfort. Results: All laryngoscopic examinations were performed successfully. Effectiveness of communication, difficulty of examination, perception of protective environment, and overall comfort did not differ between physicians and patients (P > .05 for all comparisons). However, both physicians and patients found the examination to be difficult. While physicians evaluated the system as safe against airborne transmission of COVID-19, patients were not confident that the system was safe (8.70 +/- 1.93 vs 2.87 +/- 2.37, respectively, P = .001). Physicians also gave a higher score to future applicability of the unit for examinations than patients (8.90 +/- 1.42 vs 7.10 +/- 2.62, respectively, P = .001). Conclusion: Physically separating the physician and patient is a feasible method of physical examination in aerosol-contaminated environments.