Telemedicine trends among physicians, dermatologists reveal COVID’s impact

Key takeaways:

• Telemedicine alone was favored by less experienced physicians vs. seasoned physicians.
• Limitations to physical exams was the largest telemedicine barrier for dermatologists vs. non-dermatologists (4.8 vs. 3.75).

Telemedicine trends, as evaluated before and after the COVID-19 pandemic, revealed that the practice is most accepted by younger physicians, with dermatologists viewing limits to physical exams as its main barrier, according to a study.

“The COVID-19 pandemic catalyzed a significant shift in patient care marked by increased telemedicine use. ... Few studies have quantified physicians’ perspectives of telemedicine especially across multiple specialties and regions of the U.S.,” Maham Ahmad, BA, of the department of dermatology at Yale University School of Medicine, and colleagues wrote.

To learn more about how physicians perceive telemedicine, the authors conducted a national survey.

Physician characteristics

Of the 95 physicians surveyed, 20 (21%) specialized in dermatology and 68 (72%) did not. The majority of respondents worked in academics (n = 58), whereas the remainder worked in a private practice (n = 25) or “other” setting (n = 12). Sixty-eight physicians (72%) had been practicing medicine for 20 years or less, 14 (14%) for 21 years or more and 13 (14%) were still in residency.

Before the COVID-19 pandemic, 23 (24%) respondents adopted telemedicine; however, this number increased significantly to 65 (68%) after COVID.

There was a significant difference in which physicians and residents would “be OK” seeing a patient only be telemedicine (P = .014). For instance, residents and physicians practicing for 20 years or less were more likely to answer yes vs. physicians practicing for at least 21 years (33 vs. 1).

Further, when considering residents vs. physicians with at least 21 years’ experience, the latter were significantly more likely to require an in-person visit at some point during patient care. When asked what percent of their total telemedicine visits they would estimate as appropriate for telemedicine, a higher proportion of physicians and residents practicing for 20 years or less answered 81% to 100% compared with physicians practicing for at least 21 years (12 vs. 1; P = .003).

“This suggests that younger physicians may be more likely to use and prefer telemedicine, which could implicate the future growth of telemedicine as it shapes the future landscape of medical practice,” the authors wrote.

Telemedicine advantages and disadvantages

On a scale of 1 to 5, with 5 being the most advantageous, the highest-ranked advantages of telemedicine among non-dermatologists and dermatologists included the ability to work from home (4.62 and 3.3; P < .001, respectively), schedule flexibility (4.41 and 3.55; P < .001) and patient preferences/access (4.32 and 3.6; P = .013).

Compared with physicians who adopted telemedicine after COVID, physicians who adopted telemedicine before COVID reported increased financial compensation (2.58 vs. 3.17; P = .028), decreased overhead costs (3.06 vs. 3.91; P = .002) and ability to observe patients in a relaxed home environment (3.02 vs. 4.04; P = .002) as perceived advantages to telemedicine. However, these categories were among the lowest ranked categories for dermatologists.

On the other hand, the highest ranked barriers to telemedicine, which were ranked on a scale of 1 to 5, with 5 being the most disadvantageous, included limitations to patient assessments/physical exams, technological barriers to access and concerns about reimbursement, with dermatologists being significantly more likely to rate limitations to physical exams as the largest barrier compared with non-dermatologists (4.8 vs. 3.75; P < .001).

“Our study suggests that dermatologists’ largest concern with telemedicine is its physical exam limitations, which is consistent with prior research,” the authors concluded.