Virtual Consultations With Doctors ‘Disastrous’ for Some Patients: UK Study

Virtual Consultations With Doctors ‘Disastrous’ for Some Patients: UK Study
Sandra Dohmen, senior physician at the University hospital in Aachen, uses telemedicine for the treatment of COVID-19 patients, in Aachen, western Germany, on Jan. 20, 2021. (Ina Fassbender/AFP via Getty Images)
Alexander Zhang
11/2/2021
Updated:
11/2/2021

Phone or video consultations with doctors can be “disastrous” for some patients, though some find them to be “more convenient,” a new UK study has found.

According to the study conducted by researchers from Cambridge University, patients regard so-called “telemedicine” to have “increased misdiagnoses, inequalities, and barriers to accessing care,” but more than 60 percent found it to be “more convenient.”

Researchers surveyed 1,340 patients, the majority of whom had inflammatory arthritis or lupus. They also polled more than 100 clinicians between April and July.

The vast majority of respondents—86 percent of patients and 93 percent of clinicians—felt that telemedicine was worse than face-to-face consultations for accuracy of assessment, with some reporting misdiagnoses.

One patient told the researchers: “My rheumatologist cannot see or hear how I move, look at my skin, eyes, hair, hands, bones, how I am … I was diagnosed with something over the phone, which I know isn’t right, and it’s getting worse.”

Some 90 percent of clinicians and 69 percent of patients said that telemedicine made it more difficult to build a trusting relationship between doctors and patients.

There was also concern that telemedicine would put certain groups of patients at a “substantial disadvantage,” including those with undiagnosed or more complex conditions, for whom English was not a first language, or who had hearing, cognitive, or speech difficulties.

One senior clinician said: “The rapid digitalisation and use of telemedicine must stay but appropriate patient selection is key, it is perfect for some but disastrous for others.”

The study, which was published in the journal Rheumatology, said, “The findings identified a place for telemedicine for certain patients, yet a strong overall preference for face-to-face consultations from both clinicians and patients.”

Melanie Sloan, lead author from the Primary Care Unit at the University of Cambridge, said the study had exposed “the inherent risks and benefits of telemedicine for patients with complex conditions, which may have important implications for patients who have other serious or unpredictable long-term conditions.”

She expressed hope that “there will be a thorough assessment of the clinical and psychological risks and steps taken to mitigate those risks, as well as action to address the possibility of worsening existing health inequalities for those less likely to be able to benefit from remote consultations.”

The rise in teleconsultations throughout the COVID-19 pandemic has become an intense topic of debate in medical communities.

Some patients have expressed preference for face-to-face appointments but others have been exasperated at not being able to see doctors when requested.

Data published last week show some 61 percent of appointments in September were in-person. This figure was about 80 percent before the CCP (Chinese Communist Party) virus pandemic.
PA contributed to this report.