Virtual primary care can result in better doctor-patient relationships - The Dallas Morning News

Twenty days. That’s how long patients in major metropolitan areas waited on average last year for an appointment with their primary care physician, according to a survey by AMN Healthcare, a firm that provides workforce solutions in the health care industry.

When the appointment finally comes, a typical patient spends around 20 minutes in the waiting area before being led back to an exam room. In the exam room, they may spend additional time offering up their medical history and having their vital signs taken. Perhaps there’s a blood draw or an electrocardiogram. A few more minutes waiting, and then the doctor may finally walk in.

Add it all up, and a typical primary care visit results in less than 15 minutes of time with the doctor, but consumes several hours of a patient’s day. The commute to and from the doctor’s office can tack on even more time — especially for the two-thirds of rural patients who live where health professionals are in short supply.

Since the dawn of modern medicine, doctors have more or less insisted on seeing their patients in person. But that insistence is outdated. Thanks to technology, primary care no longer needs to be delivered in person.

Doctors and patients alike may bristle at that notion. But the chief service a primary care physician delivers is not a medical procedure — it’s a relationship, a conversation, a professional counseling session that can empower a person to achieve their health goals.

That kind of service is more efficiently delivered virtually.

Many people first encountered virtual care during the COVID-19 pandemic. But what began out of necessity as a protective measure against the spread of infection quickly became a popular alternative to in-person care. In one survey by the American Medical Association, over 85% of Americans reported that virtual medicine made it easier to get the care they needed.

Those sentiments have proven durable. Nearly nine in 10 people express a desire to continue using virtual visits for non-urgent care post-pandemic, according to Healthcare Finance. In one recent study by McKinsey and Company, a consulting group, 55% of patients reported that they are more satisfied with their virtual appointments than with traditional doctor visits.

Much of what “going to the doctor” used to entail can now be delivered more efficiently and at less expense at home. For most people, the “routine” in-office physical examination isn’t required because the virtual appointment includes the most important elements of a doctor’s visit. What’s more, equipment for monitoring vital signs, including wearable technology, is getting more sophisticated by the day.

Soon, doctor-patient portals will analyze the video and audio feeds in real-time to give doctors information on vital signs and measures of a patient’s mental and emotional well-being.

All these technological enhancements will leave more time for doctor and patient to truly communicate with one another, more deeply and more frequently than the once-a-year, 15-minute status quo.

Research shows that stronger relationships between primary care physicians and their patients yield significantly better health outcomes. One study found that sticking with the same primary care doctor over time significantly reduces early deaths.

Harvard Business Review reported on one provider program that was able to reduce ER and specialist visits by 14% and inpatient visits by 60% as a result of prioritizing patient relationships.

All this research makes intuitive sense. When patients feel comfortable, the conversation tends to be much more open and honest, leading to better diagnoses and treatment.

And the virtual model lends itself to better conversations. Primary care physicians and patients can command the full attention of one another when they’re ensconced in their offices or homes, undistracted by the bustle typical of a busy doctor’s office.

Indeed, a recent study from the Journal of the American Medical Association found that virtual care led to better or equal performance on 13 of 16 quality-of-care measures.

Virtual care has also shown great promise for treating 6 in 10 American adults living with chronic disease. A study of patients with chronic gastrointestinal conditions, published in the National Library of Medicine, found that prescription fill rates for patients treated in the virtual environment were 9% higher than for those seen in-office.

For patients with diabetes, virtual care and monitoring are associated with significantly lower HbA1c levels, increased rates of medication adherence and improved physician-patient communication.

Simply put, virtual primary care helps physicians take better care of their patients by concentrating on the “human” aspects of the job. It’s all the intimacy of an old-school “house call” — but with the full backing of modern medical and communications technology.

Geoff Rutledge is a board-certified internist and the chief medical officer and co-founder of HealthTap. He wrote this column for The Dallas Morning News.

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