Prior to the COVID-19 pandemic, telemedicine accounted for a mere one percent of overall physician-patient interactions. Now, at its peak, the Harvard Business Review reports that virtual consultations make up 50-80 percent of appointments. Telemedicine has been hugely beneficial for a multitude of reasons: it has made scheduling easier, increased overall convenience for patients, and negated the risk of COVID-19 transmission from patient to doctor, or vice versa. Yet there are also a number of barriers and pitfalls that characterize telemedicine. Listed below are a few of the key challenges worth mentioning:

1. Telemedicine has been shown to put greater stress on already-exhausted physicians. Not only have virtual appointments been correlated with increased screen fatigue, but studies have found that doctors participating in telemedicine during the pandemic are experiencing longer workdays and reduced work-life boundaries with their patients.[1] Post-pandemic telemedicine will likely have to evolve firmer restrictions on physician access to prevent already-high burnout rates.
2. Telemedicine may perpetrate existing inequities in healthcare. Studies have found that patients over the age of 65 had a significantly decreased likelihood of using a telehealth platform, and that White or Asian patients used the platform more than their Black or Hispanic counterparts.[2] Therefore, historically underserved populations are more likely to suffer from the transition to telemedicine, a fact which should be highly concerning to healthcare workers and politicians alike.
3. The doctor-patient relationship is fundamentally different. Even though telemedicine comes with benefits such as increased access to one’s physician, it reduces the amount of in-person interaction, which is an important aspect of building a longitudinal patient-physician relationship. It also makes it less likely that the physician meets other members of a patient’s family– an interaction which can be highly informative about a patient’s habits, at-home considerations, and cultural background.
4. It might not actually reduce healthcare costs. One of the biggest issues facing American healthcare currently is the exorbitant cost of receiving treatment. Although telemedicine outwardly appears like a convenient solution, a study recently found that the increased access to healthcare which has been associated with telemedicine may actually increase overall spending.[3] This means that Americans may go into even greater debt to pay off medical bills.

Given these considerations, it is clear that telemedicine involves a number of unique challenges and pitfalls. However, given that it remains in the early stages of development and widespread use, there remains ample opportunity to make key changes which will better support physicians and patients alike.

References

[1] Keasberry, J., Scott, I. A., Sullivan, C., Staib, A., & Ashby, R. (2017). Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice. Australian Health Review, 41(6), 646–664. https://doi.org/10.1071/AH16233

[2] Weber, E., Miller, S. J., Astha, V., Janevic, T., & Benn, E. (2020). Characteristics of telehealth users in NYC for COVID-related care during the coronavirus pandemic. Journal of the American Medical Informatics Association, 27(12), 1949–1954. https://doi.org/10.1093/jamia/ocaa216

[3] Ashwood, J. S., Mehrotra, A., Cowling, D., & Uscher-Pines, L. (2017). Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending. Health Affairs (Project Hope), 36(3), 485–491. https://doi.org/10.1377/hlthaff.2016.1130