The answer to this question is, "it depends" as becomes apparent on considering this article:
The future of health care service in orthopedic practice: telemedicine or in-person visits?
These authors assessed patient satisfaction and preference for telemedicine vs. in-person visits for outpatient shoulder and elbow musculoskeletal consultation during the coronavirus disease 2019 (COVID 19) pandemic. They invited patients who had telemedicine visits for shoulder and elbow musculoskeletal complaints to respond to a post-visit survey focused on the patient’s satisfaction with the telemedicine visits during the pandemic and preference for using the telemedicine platform in the future.
Of the 386 patients who used telemedicine during the study period, 153 patients participated in the study. 16% had new patient visits, 29% had followup visits and 37% had postoperative visits.The mean time from telemedicine visit to survey contact was 75 days.
91% of patients reported that their concerns were adequately addressed, 89% would recommend telemedicine to a friend, and 94% stated that they would use the telemedicine platform again in the presence of a situation similar to the COVID-19 pandemic. The majority of patients (76%) reported a preference for in-person visits for the same musculoskeletal complaint if it were not for COVID-19.
A telemedicine visit duration > 10 minutes and a first-time telemedicine visit correlated with higher satisfaction rates.
Comment: As pointed out by the authors the patients in this study were from an urban environment and had to travel relatively short distances to meet a physician in person: the residential addresses of two-thirds of the patients in this study (102 of 153 patients, 67%) were within 16 miles of the clinical site whereas only 5 patients lived >60 miles from the location of the outpatient clinic. Therefore the majority of patients had to travel only short distances by public transportation or private car.
By contrast, many practices in the U.S. and around the world serve a much more widely dispersed patient population. Travel is time consuming, expensive and - at certain times of the year - can be risky:
Many surgeons are refining their art and skill of telemedicine, optimizing access, safety, and cost-effectiveness. Involving family members in the visit, discovering ways to examine active and passive range of motion, sharing imaging studies, providing information on diagnosis and treatment options, demonstrating rehabilitation exercises, checking on wounds, tracking progress, answering questions, and showing respect for the patient's time and safety can create substantial value and satisfaction. And of course, patients usually prefer the telemedicine waiting room in their home to the waiting room in a doctor's office. And as an added benefit, no masks are required!
We have an opportunity to change the way we serve many of our patients.
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