Telemedicine for Surgical Consultations – Pandemic Response or Here to Stay?

A Report of Public Perceptions

Meredith J. Sorensen, MD, MS; Sarah Bessen, MPH; Julia Danford, BS; Christina Fleischer, BS; Sandra L. Wong, MD, MS

Disclosures

Annals of Surgery. 2020;272(3):e174-e180. 

In This Article

Abstract and Introduction

Abstract

Objective: This study aims to determine the public's perception of telemedicine surgical consultations, during the COVID-19 pandemic and beyond.

Summary Background Data: With rapid expansion and uptake of telemedicine during the pandemic, many have posited that virtual visits will endure even as in-person visits are reinstated. The public's perception of telemedicine for an initial surgical consultation has not been previously studied.

Methods: A 43-question survey assessed respondents' attitudes toward telemedicine for initial consultations with surgeons, both in the context of COVID-19 and during "normal circumstances." Participants were recruited through Amazon Mechanical Turk, an online crowd-sourcing marketplace.

Results: Based on 1827 analyzable responses, we found that a majority (86%) of respondents reported being satisfied (either extremely or somewhat) with telemedicine encounters. Interestingly, preference for in-person versus virtual surgical consultation reflected access to care, with preference for telemedicine decreasing from 72% to 33% when COVID-related social distancing ends. Preferences for virtual visits decreased with increasing complexity of the surgical intervention, even during the pandemic. A majority felt that "establishing trust and comfort" was best accomplished in person, and the vast majority felt it was important to meet their surgeons before the day of surgery.

Conclusions: The public views telemedicine as an acceptable substitute for in-person visits, especially during the pandemic. However, it seems that an in-person interaction is still preferred when possible for surgical consultations. If telemedicine services are to persist beyond social distancing, further exploration of its impact on the patient-surgeon relationship will be needed.

Introduction

The COVID-19 pandemic has catalyzed an unprecedented need to deliver care remotely. Within just a few days of widespread advisories for social distancing and shelter-in-place mandates, there was rapid expansion of telemedicine services across specialties and sites to continue to meet patients' ambulatory care needs. Long touted as an underused, but promising, mode of delivering care, telemedicine has become a putative "game changer" during the pandemic.[1,2]

As physicians rapidly converted to either televideo or telephonic appointments, many came to realize that nearly all (or all) components of the visit were able to be completed virtually. Many have, albeit anecdotally, reported high levels of both provider and patient satisfaction with telemedicine. Indeed, the development and expansion of platforms for the delivery of virtual services and the resultant increase in capacity and/or readiness to sustain telemedicine may be a positive unintended consequence of population-wide social distancing.[3]

However, as payers and policymakers make decisions about the future of waivers and temporary/emergent policies around the delivery of telemedicine visits, public perception of and patient satisfaction with virtual visits will be needed to inform decision making. Based on analyses of internet search volumes, it seems that broad interest in telemedicine is increasing.[4] However, acceptance of telemedicine in the setting of the pandemic may be a consequence of the perceived risks associated with in-person visits, not to mention the nearly universal suspension of them. On the other hand, ease of access associated with telemedicine may result in sustained changes in care delivery.

We conducted this online, crowd-sourced survey to learn more about the public's willingness to use telemedicine for an initial consultation with a surgeon and to understand how their attitudes are affected by the unique factors posed by the COVID-19 pandemic.

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