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The One Good Thing That Came Out Of The Pandemic

Discussion in 'General Discussion' started by Mahmoud Abudeif, Jun 30, 2021.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    If there’s one good thing that came out of the pandemic, it’s the expansion of telehealth. That’s according to a recent survey of doctors, who were asked to weigh in on how the expansion of telehealth has affected their total work burden and job satisfaction, as well as how electronic visits compare with traditional in-person patient encounters.

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    Slightly more than 500 physicians responded to our survey, and 86% said their practice involves telehealth. Among the standout findings, we asked doctors: On a scale of 1-10, with 1 being completely dissatisfied and 10 being completely satisfied, how would you rate your overall satisfaction with telehealth visits? The average rating was a 7, the median was a 7, and the mode was an 8.

    Doctors offered myriad reasons for their apparent satisfaction with the rapid emergence of this new technology.

    “The pandemic has shown that this type of technology allows for safer check-ups and communication,” one pulmonologist said.

    “It’s a great option for appointments where no physical exam is necessary,” said a family medicine physician.

    “It’s more economical from a time standpoint,” said a psychiatrist.

    The pandemic effect

    The data indicate that the pandemic pushed physicians toward telehealth in droves. Among the respondents, 68.4% said their telehealth hours increased after the pandemic hit. The number of weekly hours ranged from 0-150 (we hope that’s a typo, because that doctor logging 150 telehealth hours weekly has about 18 hours weekly for sleep and other necessities). The average number of hours was 14.39 (admittedly thrown by that 150 figure). The median and mode were 10 hours.

    Remarkably, the increase in telehealth hours hasn’t translated to an increase in overall work hours for many surveyed physicians. Among the doctors, 57.3% said their total hours were the same, 21.8% said they’re working more hours, and 8% said they’re working fewer hours.

    First, do no harm, right? Amid a highly stressful period in medical history, 81.9% of respondents said telehealth had a neutral or positive effect on their job satisfaction. We asked physicians, How has telehealth affected your job satisfaction?
    • 29.6% said their job satisfaction had improved.
    • 52.3% said it was the same.
    • 18.1% said it had declined.
    We asked each of these categories (Improved, The Same, and Declined) what they would change about their telehealth practice. The responses were illuminating.

    Among the doctors with greater job satisfaction, one internal medicine physician said they would be happy to continue a telemedicine practice into retirement. Seems like a good side hustle to us. One psychiatrist said there’s a need for “clearer laws and guidelines,” adding that guidance from the American Telemedicine Association is unclear. Finally, one neurologist said they would love to have a few telehealth-only days each week so they could work from home.

    Can you hear me?

    A common refrain among the doctors who said their job satisfaction was the same–and throughout the survey in general–was connectivity issues.

    “Better access to WiFi for my patients who want to use telehealth,” said one family medicine physician. “Biggest complaint is planning a telehealth visit only to have a connection that is poor, choppy, or poor video (hard to see a rash when the image is grainy and blurry).”

    Despite the connectivity issues, it appears that overall, the surveyed physicians are pleased with telehealth platforms. We asked them, On a scale of 1-10, with 1 being completely dissatisfied and 10 being completely satisfied, how would you rate your overall satisfaction with telehealth technology? The average response was 6.9, the median 7, and the mode 8.

    One urgent care physician in this category said they’d like to see better patient education as to what is appropriate for telehealth and what’s better addressed in person. Finally, one internal medicine physician called for higher reimbursement for telehealth visits.

    The 18.1% of respondents who said their job satisfaction declined after the rollout of telehealth made some interesting observations. One neurologist put it bluntly: “Liquidate this form of practice.”

    Among the complaints of the dissatisfied–and the survey in general–was a lack of robust IT support for telehealth services. Interestingly, a recent study showed that improved IT support for EHRs can have a meaningful effect on physician burnout.

    One orthopedist said that telehealth requires “dedicated IT and administrative hospital support to make visits work smoothly at our hospital.” A dissatisfied oncologist called for “better technology, reliable access, and less burden of documentation.” They also noted that telehealth is also inappropriate for complex visits, and for end-of-life issues.

    Better in person?

    One of the things we were particularly interested in was how physicians compare telehealth patient outcomes with in-person outcomes. On a scale of 1-10, with 1 representing completely disagree and 10 representing completely agree, we asked doctors to respond to the following statements:

    Telehealth leads to health outcomes that are comparable to in-person visits:
    • Average: 6.2
    • Median: 6
    • Mode: 5
    Telehealth leads to health outcomes that are better than in-person visits:
    • Average: 4.4
    • Median: 4
    • Modes: 2, 5
    Telehealth leads to health outcomes that are worse than in-person visits:
    • Average: 5.1
    • Median: 5
    • Modes: 5, 6
    So, it would seem that in-person visits aren’t going anywhere soon. But on the whole, our survey indicates that the majority of responding physicians are happy to have telehealth as an option.

    “Telehealth should remain in place as a reimbursable service,” said a family medicine physician. “Although certain complaints require an exam and a responsible physician would insist on a face-to-face visit when warranted, there are many primary care issues that can be competently managed remotely. Telehealth promotes more direct communication by the physician since it is now reimbursed. I can’t believe it took the profession this long to have our time reimbursed like every other profession has always enjoyed.”

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