Poll: 80% of US patients will 'always prefer' in-person visits to telehealth after COVID-19
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A new survey conducted by The Harris Poll for San Diego-based pharmaceutical company Neurocrine Biosciences found that 80% of U.S. patients will “always prefer” in-person physician visits to telemedicine.
“This poll demonstrates that Americans strongly prefer in-person doctor appointments to telehealth to ensure they are confident in the appropriateness of the care they receive,” Kevin Gorman, PhD, chief executive officer of Neurocrine Biosciences, told Healio Rheumatology. “These findings are significant for policymakers as they examine which aspects of virtual care should become a more permanent part of care delivery, while making sure that the different needs of patients are met.”
According to a Neurocrine press release, the survey was conducted online among 2,589 adults in the United States from June 29 to July 2. Results were weighted when necessary to bring them into line with their actual proportions within the U.S. population. As the survey was not based on a probability sample, no estimate of any theoretical sampling error was calculated, the release said.
According to the survey, 41% of the respondents reported receiving health care services via telehealth since the start of the COVID-19 pandemic, whereas 72% said they have had an in-person appointment.
Although 87% reported they were satisfied with the services they received through telehealth, 66% said they would prefer an in-person appointment in the future, if given the choice. In addition, 82% agreed telehealth appointments were a great option during the pandemic, but that doctors’ visits are best in person, and 80% agreed with the statement, “I will always prefer in-person doctors’ visits to telehealth.”
Among the respondents, 9% reported they had received telehealth services from a rheumatologist since the start of the pandemic, with 5% stating they had an in-person rheumatology visit. Of those who saw a rheumatologist — either in-person or via telehealth — 55% said they would prefer in-person visits in the future, compared with 41% who favored telehealth.
Other results from the survey include:
- 81% of respondents agreed telehealth appointments meet some but not all of their health care needs;
- 79% agreed they like the convenience of telehealth but do not want it to replace in-person appointments;
- 72% said it is important to have health care providers who offer both in-person and telehealth visits;
- 53% cited the possibility of a health care provider missing something, due to limited view or observation, as a disadvantage of telehealth; and
- 37% of respondents have postponed a medical appointment since the start of the pandemic until they could schedule an in-person visit.
“Telehealth was a critical connection to care for many of us during the darkest days of the COVID-19 pandemic and likely will play a key contributing role in our nation’s health care delivery system moving forward” Gorman said in the press release. “These responses underscore the importance of post-pandemic telehealth policies that accommodate the unique needs of different patients and patient groups, for whom telehealth can effectively complement, but should not replace, in-person care.”
Perspective
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J. Nicholas Manwaring, MSN, APRN, FNP-C
The current COVID-19 pandemic has necessitated a dramatic shift in the delivery of health care services across the U.S. in many ways (at least temporarily) from a predominantly in-person health care delivery system to a predominantly virtual delivery system. This shift has resulted in a rapid acceleration in technology around telemedicine.
This timely survey reflects expected results of the increase in telemedicine use over the last year since many clinics across the U.S. have moved to more telemedicine visits during the COVID-19 pandemic. The survey found that the majority of the participants (87%) were satisfied with telehealth services received during the pandemic, but still preferred in person visits to telemedicine (82%).
These findings are not too surprising given some of the obvious expressed limitations of telemedicine: no physical exam; concern for something being missed; lack of vital signs; technical issues; communication concerns, and privacy concerns. On the flip side, not having to travel, less waiting time, convenience, reduced infection exposure risk, more frequent appointments, and access to specialists all seemed to play a role in the acceptance of telemedicine visits.
This study only scratches the surface of the effect telemedicine will have on the delivery of health care services in the future. There are many facets of telemedicine that warrant further investigation apart from its use during a pandemic. For example, 75% of the participants in this study received services from primary care, while the specialty services were largely underrepresented — rheumatology was only 9% of services represented.
Some specialty services lend themselves better to telemedicine than others by nature of the type of service they provide; for example, mental health relies more heavily on history-taking and verbal communication than physical exam, and dermatology relies more on visual identification than hands-on exam. That being said, during a pandemic, telemedicine services are often-times the only option given the innate exposure risks of in-person visits.
It would also be of interest to poll specific demographics of study participants that participate in telemedicine. For example, patients who live in rural and remote areas who are limited by travel constraints would likely be far more receptive to telemedicine even without a pandemic than those who reside in urban areas where travel to their appointments is relatively easy. Income would be another interesting variable to study. Patients with limited income would likely have less access to the higher internet speeds and computer capabilities to support telemedicine visits, and as a result they may be less inclined to want to use telemedicine even during a pandemic.
The COVID-19 pandemic has changed how we view health care delivery and telemedicine is a big part of this. There are still many areas of telemedicine yet to be explored, and hopefully by examining these areas more in depth in future studies, the health care experience can be better tailored to fit the specific needs of each individual patient and improve the delivery of health care overall.
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David A. McLain, MD, MACR, FACP, FRCP
This survey demonstrates that patients prefer in-person visits to telehealth. There is the importance of “touch” in medicine, the laying on of hands, which Abraham Verghese, MD, from the Stanford University School of Medicine, recently highlighted in a TED talk in Edinburgh.
The present-day in-person office visit often has the physician staring at their computer screen while they order medications and tests, often with the physician’s back to the patient. I have had some patients tell me ‘You examined me’ and am surprised to learn that their last doctor never touched them.
As Verghese observed, “when we shorten the physical exam, we’re losing a ritual that I believe is transformative, transcendent and at the heart of the physician-patient relationship.” It is no surprise that patients favor in-person visits to telehealth. As physicians, we should never forget about the importance of touch.
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