Inside the big variations in telehealth use among physicians

The nation’s doctors are poised to make telehealth a permanent part of their practices—if Congress will let them, according to an AMA survey that identifies trends in telehealth use, barriers to wider adoption and opportunities for improvement.

The survey of 2,232 physicians (PDF) conducted online in late 2021 found that telehealth use has dropped off somewhat since adoption skyrocketed at the start of the COVID-19 pandemic, but interest in maintaining virtual visits remains high.

Telehealth is being used by 85% of survey respondents, with 56% of respondents reporting that they are personally motivated to increase their use of telehealth, and 70% saying that their organization's leadership is interested in continuing to offer telehealth.

Only 5% said they were still in the implementation phase, while most others were focused on sustaining telehealth integration efforts, improving existing operations or expanding telehealth offerings into other services and locations to provide more comprehensive virtual care.

Supporting telehealth is a critical component of the AMA Recovery Plan for America’s Physicians. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And the AMA is ready.

Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.

Not all physician practices are making equivalent use of telehealth, the AMA survey found. About half (46.8%) said up to 20% of their patient visits were conducted via telehealth. One-fifth of respondents (21.3%) reported seeing more than 80% of patients through telehealth.

While just 1.3% said they did zero telehealth visits, another 30.6% were spread across a wide range of telehealth-visit use buckets—from 21% of patient visits via telehealth up to 80%.

Here are additional key findings from the AMA survey:

• 80% conduct telehealth visits in the clinic, while 64% also do them at home.
• 72% use telehealth to deliver medical management.
• 68% use telehealth to manage chronic diseases.
• 63% said 75% or more of telehealth visits are with established patients.
• 44% use telehealth to provide mental or behavioral health care.

Read more about the AMA survey data that shows doctors’ steadfast commitment to telehealth.

For these efforts to continue, however, Congress must pass reforms that permanently remove geographic and site restrictions for telehealth services and permanently allow for equal payment for online and telephone virtual visits.

At the start of the pandemic, Congress waived the outdated regulations governing these aspects of telehealth use for the duration of the COVID-19 public health emergency (PHE). A provision in the recently passed $1.5 trillion Consolidated Appropriations Act, 2022, extended this waiver for five months after the Biden Administration declares an end to the PHE.

Bernadette Lim, an AMA digital health project manager, described the need for continued coverage as one of the “key takeaways” from the survey.

“As physicians and practices plan to expand telehealth services, they say widespread adoption hinges on preventing a return to the previous lack of insurance coverage and little to no payer reimbursement,” she said.

The AMA has telehealth resources to help guide physician practices through the successful implementation of telehealth.

The convenience of allowing the patient and the physician to conduct the visit from their own homes is seen as boosting the satisfaction level of both parties.

“I am a wife, mother, and in a dual-physician partnership, and telehealth allows me to balance my professional and family obligations without leaving my profession for family reasons in the middle of my career,” one survey respondent commented.

“The option of providing care via telehealth has increased my professional satisfaction and actually has delayed my decision to retire in a time when many in our field are retiring prematurely and exacerbating the physician shortage,” said another.

Though telehealth was seen as improving patient access to care, survey respondents raised concerns about patient access to technology and broadband internet being barriers to care.

The AMA supports more funding for telehealth infrastructure, such as broadband internet and internet-connected devices, and continues to promote research on the telehealth impacts on health equity, care quality and cost, patient satisfaction, implementation science and clinical appropriateness.

The AMA Telehealth Immersion Program offers a comprehensive curriculum to help physicians navigate the world of telehealth alongside peers through a series of webinars, interactive peer-to-peer learning sessions and boot camps.