In-person vs. Telehealth: Patient Preference and the Future of Engagement

Fewer than one in five adults in the US say they are confident and willing to make in-person doctor visits, as Americans continue to emerge from the COVID-19 pandemic and related restrictions on many face-to-face activities. Some Americans clearly favor virtual appointments, while for a large segment of the population, preferences are mixed. Understanding patients’ attitudes can be a key factor in how dermatology practices adapt to the evolving health care landscape and meaningfully engage with patients for treatment success.

Martec Group launched its survey of consumer attitudes with the intent to understand patients’ feelings regarding re-engaging with the health care ecosystem in the post-COVID world. The company’s proprietary Emotion Intelligence tool helps us understand the emotions associated with decisions and with situations. The survey was fielded to a consumer population that is representative of the national demographics of the consumer population.

While a few months have passed since the survey was fielded—we’ve had more vaccines approved and, of course, a significant proportion of the US population now vaccinated—the findings provide a snapshot of the health care environment and, importantly, help provide some insight into patients’ attitudes and offers perspective for the doctors seeking to reach them.

Four Patient Segments

Based on responses to our survey of the general population regarding individuals’ feelings about reengaging with their health care providers remotely or in-person, we identified four distinct segments with in the general population.

Confident re-engagers skew a little bit younger—generally in the 35-54-year age range. The majority of them are urban, and more than 90 percent are married. They’re on a fairly high income level and fairly high education level. These individuals are confident not only in re-engaging in-person, but also very confident and comfortable with continuing to reengage remotely.

Interestingly, this group showed the lowest drop in mental and emotional health during the course of the COVID pandemic.

On the other end of the continuum from the confident re-engagers are what we labeled as the apprehensive re-engagers. These individuals have the most significant concerns with both types of re-engagement—in person or virtual—and a lot of unpleasant emotions associated with both methods. Among concerns identified by this group are fears of co-infections, contracting COVID, and other concerns related to exposures in the clinical environment. Regarding telehealth or remote visits, they have concerns about the accuracy and thoroughness of re-engaging in that way.

Apprehensive re-engagers are in the same age range as the confident engagers, however they are mostly suburban. About 80 percent of these individuals are married, and they tend to be in a relatively high, but not the highest, income bracket.

These individuals had a very high self-described drop in mental health related to the COVID-19 pandemic. These are individuals who report that they have suffered from COVID generally speaking since lockdowns and restrictions went into place.

Concerned re-engagers tended to report some frustrations and uncomfortableness—rather than apprehension—with telehealth technology. They also said they missed the sense of connection they had with their health care professionals. The telehealth experience, it seems, is not as rewarding or does not feel as connected for these individuals.

The remote re-engager represents a very young demographic that is generally tech savvy. They have embraced remote visits, and they don’t see as much of a need for in-person visits. They’re probably engaging less often with the health care ecosystem, generally, with many attending annual check-ups and having little interaction with the health care system otherwise. They’re healthier and younger. They highly value the convenience of remote visits, and they embrace telehealth technology solutions.

Be Flexible

Health care providers must understand that one size is not going to fit all in this environment; you’ve got people along the spectrum. Health care providers must understand that these segments exist out there, and it may be necessary to tailor options to work for people. There will likely be some shifting of attitudes over time, as Americans continue to emerge from the acute phase of the pandemic and adapt their behaviors. However, a majority of informed observers seem to believe that telemedicine will continue to play a role in patient care well past the pandemic. Therefore, integrating telehealth into a practice’s long-term service offerings is probably an option to seriously consider.

Practices should attempt to gauge patient attitudes and preferences. A simple two- or three-question survey may be sufficient to get a sense of attitudes regarding re-engagement among existing patients in a practice. While patient preference can be important, the physician’s expertise is also important. There may be certain diagnoses or types of patient concerns that must be seen or treated in-person, and the practice should establish policies for these.