The impact of telemedicine on physician time invested in primary care- A large population-based descriptive study

Abstract

Background: Telemedicine, including video visits, telephone visits, and digital correspondence, is increasingly offered by physicians, particularly since the Covid-19 pandemic. It is still unclear whether increasing the variety of services creates an increase in demand and therefore causes an increase in the workload of primary care physicians (PCPs). In this study, we used Accumulated Annual Duration of Time (AADT), an accepted index for assessing the workload of PCPs, to evaluate the impact of telemedicine on demands. Methods: A population-based descriptive study among 464,119 patients who were not diagnosed with Covid-19 and were members of Leumit Health Services, a prominent Israeli health fund, during the 2020-2021 study period. The patients were divided into three groups according to the characteristics of their visits in 2020 and 2021. A comparison of the average AADT in each period considering the changes in the visit types was made. Results: Telemedicine use was higher in older persons, females, those of higher socioeconomic status, and patients with comorbidities. The greater the number of telemedicine visits, the greater the time the PCP spent on visits during the year. The largest increase in AADT (56.1%) was observed in patients who had only face-to-face meetings in 2020 but in 2021 made all types of visits. Overall, there was an increase of 2.5% in time invested in 2021 and a 5.8% increase in the number of patients making digital visits. Conclusions: Policymakers encouraging telemedicine should consider the additional load on PCPs associated with telemedicine use and plan resources accordingly.