Telemedicine is OK, but doctors and patients prefer in-person care

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While most primary care doctors and patients were satisfied with video visits during the height of the COVID-19 pandemic and appreciated their importance for providing care, majorities of both groups would prefer in-person visits going forward, a new study finds.

The study, conducted in the spring of 2021, asked primary care doctors and patients about:

• Their overall satisfaction with and perception of the value of video-based medicine during the pandemic,
• Their perceptions of the quality of their video visits, including rapport and time spent in the visit,
• Technical problems experienced during their visits, and
• Whether they prefer future visits to be virtual or in-person.

The national survey took place during the spring of 2021 and included 337 primary care doctors and 1,417 patients.

The results showed high levels of general satisfaction with video visits during the pandemic, with 90% of both doctors and patients saying their visit went “very” or “somewhat” well. Close to 90% of physicians felt that video visits were important for being able to reach their patients, and 50% of patients said that without access to a video visit they would have either delayed seeking care or not gotten it at all.

On the other hand, 60% of physicians said the quality of video visits was “a little” or “much” worse than in-person visits, although that percentage varied according to the type of visit. For example, about two-thirds said video-visit quality was worse for routine or preventive care, while only 25% said it was worse for providing mental health care.

Large majorities of doctors and patients (92% and 90%, respectively) cited the challenges around conducting a physical exam for what they felt was the lower quality of video visits. Other reasons related to physical exams included difficulties in getting vital signs (mentioned by 67% of physicians) and concerns about accuracy when patients took their own temperature or blood pressure readings (32% of patients).

When it came to establishing rapport, 45% of doctors but only 20% of patients said video visits were “a little” or “much” worse compared to in-person visits. The authors speculate the difference may be because that unlike doctors, patients haven’t had to face the “cumulative burdens” of video visits.

The survey also showed that older and/or less educated patients and patients who were Asian were less likely than other groups to want to continue video visits. The authors say these findings are consistent with concerns over a “digital divide” in telemedicine in favor of younger, wealthier and White patients.

Looking ahead, the authors say their findings show that “a health system with a meaningful minority of care delivered virtually may be a significant improvement compared with the prepandemic status quo.”

Enabling the continuation of some video visits would make it easier to expand the service quickly in a future pandemic, they say, and satisfy doctors who want to continue providing most of their care virtually. Virtual care options, whether by video or telephone, would also make care more available to patients who face difficulties accessing it in person.

The study, “Video Telemedicine Experiences in COVID-!9 Were Positive, But Physicians And Patients Prefer In-Person Care For The Future” was published in the April 2023 issue of Health Affairs.