The pandemic boosted telehealth—but the future of health care is still in-person

“Some patients might feel that the quality of care is higher with their doctor physically present,” writes Dr. Oliver Kharraz. “Others might be more comfortable receiving care in an exam room than through a screen.”
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Last spring, as the pandemic kept many Americans at home, the use of telemedicine began to spike dramatically. Doctors quickly pivoted to video calls and virtual diagnoses, while journalists tracked the surge and observed that telemedicine “promises to be transformative.” Some estimated that in the future, up to one-quarter of all health care services could be provided remotely.

Today, with many Americans fully vaccinated and beginning their return to a semblance of normal life, it is time to check those predictions against reality. Based on a full year’s worth of data, we now have greater insight into telehealth’s shifting role as we readjust to life post-pandemic.

The bottom line: Given the opportunity, the overwhelming majority of patients are choosing to see their doctors in person again. Last May, only 67% of bookings on Zocdoc were for in-person appointments. A little over one year later, that number is back up to 89%, and is likely to rise as more patients resume seeing their doctors face-to-face.

In many ways, this makes intuitive sense. Certain kinds of medical care can only be provided in person; there’s no way to set a broken leg over Zoom. Additionally, we are likely seeing some pent-up demand for the kind of routine checkups that require physical care—like dental cleanings, annual physicals, mammograms, and more—that patients have been putting off for the past year.

But in-person visits are rising even where a remote appointment might suffice. This is evident across almost every specialty, including practice areas like dermatology, where our booking data showed that nearly 40% of appointments were virtual last May. While it is still possible to have a rash looked at remotely, 90% of patients now choose to receive care in person. Some might feel that the quality of care is higher with their doctor physically present; others might be more comfortable receiving care in an exam room than through a screen.

Data from the early months of the pandemic forecasted this trend. Even when patients booked telehealth visits over the past year, 70% of them still chose to see a provider within driving distance, according to Zocdoc data—presumably because they instinctively knew they might eventually want or need care in person. 

Does all of this mean that health care will return to its pre-pandemic status quo? Not quite.

It’s tempting to look at this data and conclude that telehealth is the Segway of medicine—a much-hyped innovation that failed to achieve long-term traction. The reality, however, is more nuanced. In-person appointments are surging, but at the same time, there are a number of areas where telehealth has caught on and is likely to stick.

Mental health is the biggest one. In May 2020, our data show that bookings for psychiatrists and psychologists were 75% and 80% virtual, respectively. Now, as every other specialty has shifted back to in-person care, mental health services are shifting even more toward virtual care. Last month, 84% of psychiatry visits and 88% of psychology visits were conducted remotely. Unlike physical exams, conversations are easy to conduct virtually, and some people might enjoy the discretion, ease, or efficiency of talking to a therapist from the comfort of their own home. 

Telehealth is also useful for certain kinds of consultations or triage. Doctors can conduct a preliminary assessment over video chat, asking questions about patients’ symptoms and deciding whether a trip to the office is necessary. Virtual visits might also lead directly to a specialist referral, streamlining the process for both doctors and patients. And telehealth is undoubtedly a boon to patients located in rural areas, which are typically medically underserved.

So rather than the Segway, telehealth might be more like the X-ray. When electromagnetic imaging was first invented, the discovery led to a wide variety of uses, from optimizing shoe size in retail stores to recording tongue and teeth movement to studying languages. Eventually, the X-ray’s primary value as a tool for specific diagnostic circumstances became apparent.

As the CEO of a health care technology company, I see many ways that new innovations can help doctors provide better care and create a better experience for patients. But before I became a CEO, I was a physician—one who comes from a 300-year family tradition of providing care. Throughout those three centuries, and despite significant leaps forward in medical innovation, my ancestors and I all relied on the very same primary diagnostic tool: the human body itself. Its unmatched sense of touch, sense of sight, and sense of connection are all more powerful in person. As we begin to emerge from the pandemic, we are discovering that telehealth is a supplement to that—not a substitute for it.

Oliver Kharraz, MD, is the founder and CEO of Zocdoc.

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