Is telehealth as good as in-person care? What to know

A new study published in Annals of Internal Medicine says that telehealth may be just as effective as in-person primary care visits when it comes to addressing a patient’s needs.

The Kaiser Permanente Division of Research study, which looked at the health records of over 1.5 million adult patients between April 2021 and December 2021, tracked when people returned to their primary care doctor for a second, in-person visit after their initial telehealth appointment.

The intention was to see how well telehealth vs. in-person visits addressed patients’ needs; if people were returning for another primary care visit, it was an indication that their concerns were not initially addressed.

The key findings

The study found that in-person return visits were only somewhat higher after a telehealth appointment, compared with in-person primary care visits.

“The vast majority, 85% or more of telehealth visits, addressed the person’s needs enough that they did not need to come back for another visit, which we found pretty reassuring,” lead author Mary Reed tells Yahoo Life. “Our general take-home from the study is that video and telephone medicine can be useful and can mostly address a person’s concerns at rates that are similar, but not exactly the same, as in-office appointments.”

Reed says that people with pain conditions, like musculoskeletal issues, were more likely to return for a follow-up in-person appointment, which she says makes sense, as they may be more likely to need a physical exam in order to assess the cause of pain. People with mental health conditions were most likely not to seek a follow-up with a primary care physician.

It’s important to note, however, that if a patient did not follow up with a primary care doctor, it did not mean they abandoned seeking professional help. What the research did not track, Reed says, was whether or not patients sought out specialists — such as a mental health provider — in order to further address their needs.

There may be more research needed into the success of telehealth. But in general, Reed says, this research should alleviate fears that telehealth would fall short compared with in-patient care.

“I don’t see that happening here,” she notes.

What are the unique benefits of telehealth?

While this study sought to see how equivalent telehealth was to in-person care visits, it’s also important to note that telehealth has unique benefits.

Dr. Ngoc-anh Nguyen, an ER physician at Houston Methodist Hospital, tells Yahoo Life, “Telehealth allows patients to receive medical care without the need to travel, reducing time and transportation costs. This is especially beneficial for individuals with mobility issues, those in rural areas or those with busy schedules.”

Typically, telehealth providers are able to be more efficient, allowing for shorter wait times between patients, she says. And, during the height of the COVID-19 pandemic, it was a much safer option, allowing people to receive medical care without risking exposure.

Drawbacks of telehealth

One drawback of telehealth versus primary care is that doctors don’t have the ability to checking vital signs. This can include taking someone’s blood pressure or doing a urinalysis. These procedures, when done in an office, may help diagnose a problem or reveal symptoms that a patient may be unaware of. Some examinations also require a more hands-on approach, such as feeling for swollen lymph nodes or even just looking in the back of a throat with a flashlight for signs of certain conditions.

C. Vaile Wright, the senior director of the Office of Health Care Innovation at the American Psychological Association, says that another issue with telehealth that was clearly evident during the COVID-19 pandemic was that it exposed a “digital divide.” This divide separated people who did not have access to smartphones or high-speed internet that would enable them to connect with a telehealth provider, as well as people who were simply not tech savvy.

“There are also individuals who maybe don’t have privacy — they live in a studio apartment, or with a very large family, where it can be hard to find that space for a private conversation,” she explains.

One potential workaround for people with privacy issues and who do not feel comfortable with technology, she says, is “audio-only” telehealth sessions. Phone calls can be taken outside of the home, and they may be more comfortable for adults who “don’t have that same level of technology literacy.”

Yet even the most dialed-in person can deal with tech issues. Wright also says you should go into a telehealth appointment with the understanding that technology isn’t perfect and that sometimes “Zoom just doesn’t work.”

“I think that can cause some real anxiety, and you have to recognize that it happens to everybody,” she says. “You may have to troubleshoot and solve things that you wouldn’t have to in-person.”

How can you make the most out of your telehealth appointment?

Dr. Elizabeth Swenson, an ob-gyn at Wisp, a sexual-health-focused telehealth company, says that it’s important to come into a telehealth appointment prepared.

“List any questions or concerns you want to discuss with your provider,” she says. “Make sure you have a stable internet connection and a quiet, well-lit space for the visit. You should also be ready to provide your full medical history, as well as your list of medications, and any other relevant information. Then, once you’re on the phone or video with your provider, actively engage in the conversation, ask for clarification if needed, and make sure you understand your treatment options and any necessary follow-up plans.”

Wright says that it’s important to go into a telehealth appointment with an open mind.

“If you go into telehealth thinking it’s going to be ‘less than’ an in-person appointment, then you might be setting yourself up for [failure,]” she says.


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