Doctoring from home: Physicians’ perspectives on the advantages of remote care delivery during the COVID-19 pandemic

Abstract

Background During the COVID-19 pandemic, stay-at-home orders as well as shortages of personal protective equipment forced primary care physicians (PCPs) to transition rapidly from in-person visits to telehealth. While telehealth expanded extensively in a short period of time, research about the consequences of the shift to remote care is lacking. The objective of this qualitative study was to examine how telehealth benefited PCPs and their patients during the COVID-19 pandemic. Methods From July to August 2020, semi-structured interviews were conducted with 20 PCPs associated with a single academic medical center to examine their perspectives about delivering care remotely during the COVID-19 pandemic. All interviews were recorded, transcribed verbatim, coded, and analyzed using deductive thematic analysis. Results PCPs identified several benefits of remote care delivery for both physicians and patients. They indicated that (1) patients were reassured that they could receive safe and timely care, (2) remote visits were convenient for patients, (3) patients were comfortable receiving care at home, and (4) video visits enhanced patient- and family-centered care during the COVID-19 pandemic. Participants also noted that (1) telehealth accommodated working from home, (2) physicians were equitably reimbursed for telehealth visits, and that (3) telehealth promoted physician work-life balance. Conclusions Our data provides preliminary evidence that PCPs and their patients had positive experiences with remote care during the early months of the COVID-19 pandemic. Physicians identified opportunities by which telehealth could enhance the delivery of patient-centered care by allowing them to see patients’ home environments and to engage family members and caregivers during telehealth visits. More research is needed to understand how to sustain these benefits beyond the global COVID-19 pandemic and ensure patients’ needs are met.

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

“…In contrast to the possibilities highlighted in the literature (56-60), and the rapid expansion of telehealth in other countries (18,20,24,61), surprisingly, video consultations were only reported by 1.5% of participants. In line with findings from Australia the telehealth tool mostly used by GPs in our study was the telephone (24).…”

Frontline Physician Perspectives on Their Experiences Working During the First Wave of the COVID-19 Pandemic

“…For patients, participants were concerned about substance misuse, survivor guilt, grief, and loneliness. The most frequently cited diagnoses included anxiety (30), depression (27), and PTSD (16). They also were concerned for "exacerbation of existing psychiatric disorders due to limited follow up with their doctors" (P38E).…”

“… 4 As the pandemic progressed, more qualitative investigations were conducted exploring physician perspectives on working in subsequent waves of the pandemic, 5 , 6 the impact of COVID-19 on primary care, 7 , 8 integration of palliative medicine into intensive care units, 9 and telehealth. 10 – 16 …”

“…4 As the pandemic progressed, more qualitative investigations were conducted exploring physician perspectives on working in subsequent waves of the pandemic, 5,6 the impact of COVID-19 on primary care, 7,8 integration of palliative medicine into intensive care units, 9 and telehealth. [10][11][12][13][14][15][16] To inform future efforts in the COVID-19 pandemic and prepare for future crises, we must understand frontline physicians' perspectives from the first wave of the pandemic, when the least was known about this crisis. Given their central role in the healthcare system's response, further crisis management without exploration of the perspectives of frontline physicians risks missing opportunities for success as well as opportunities to anticipate and proactively address sequelae for both patients and clinicians.…”

Recommender System for the Efficient Treatment of COVID-19 Using a Convolutional Neural Network Model and Image Similarity

“…During the peak period of infection transmission, having enough oxygen and a ventilator is also a major challenge for hospitals [ 14 , 15 ]. As a result, hospitals and medical practitioners are under a lot of stress trying to deal with critical patients who have been admitted to hospitals [ 16 ]. They concentrate on providing good care to individuals who are hospitalized so that the mortality rate can be lowered, and the patients can recover quickly.…”