Medical Technology

Survey: The majority of patients prefer in-person visits over the convenience of telehealth

According to a study published in JAMA Open, the majority of Americans are happy to have video consultations with their doctor to offer non-urgent medical attention. However they prefer to visit their doctor in person.

When the hypothetical cost of out-of-pocket expenses are assessed, the paper says, people still value in-person treatment more than video-based interactions. However, the choice is cost-sensitive.

RAND Corp. conducted a nationally representative survey , asking respondents to indicate their preference for in-person or telehealth services following the COVID-19 pandemic.

2,080 adults took part in the survey of 2,080 adults. They were provided with internet-connected devices and were compensated for their participation. The sample that was weighted were on average 51 and slightly more than half of them were women. Minorities were also included on the panel.

Sixty-five percent of participants (66.5%) would prefer to have at the very least one video visit in the near future.

However, break it down and an interesting picture emerges: Given a choice between an in-person visit and a video visit to a meeting that could be conducted either way:

  • 53% of people prefer an in-person visit.

  • 20.9 percent prefer a video visit.

  • 26.2% did not have a preference or did not know.

45 percent of respondents reported having had at least one video visit since March 2020. This group includes:

  • 44.2% prefer a face-to-face meeting.

  • 31.4 percent of people prefer a video visit.

  • Only 2.3 percent of respondents said that they would not want to make more video visits in future.

60% of those who had never had a video visit preferred an in-person visit to the rest. Only 12.2 percent prefer a visit via video. The remainder didn’t have a preference or didn’t know.

Younger, wealthier, and better-educated people were more likely to enjoy video visits. Black respondents preferred visits in person, whereas Latino respondents were more likely to enjoy video visits. The differences in race and ethnicity were statistically significant. But the differences due to income and age were more significant, according to lead author Zachary Predmore, PhD, an associate policy researcher at the RAND Corp.

Young people, he claims, are likely to favor video visits because of their knowledge of technology “and growing to be part of an internet-connected world.”

Costs can make a difference

The survey also asked participants what kind of visit they’d prefer if they were forced to pay more or less out of their pocket for one over other. Respondents who indicated a preference for an in-person or video visit were asked which option they’d prefer if their copayment was $30 for the preferred method and $10 for the other. These costs were chosen, the study said, because they represent the lower and upper limits of the typical copayments for outpatient visits.

When in-person visits cost $20 more than video visits, almost half (49.8 percent) of respondents who at first preferred telehealth stayed with in-person visits, whereas 23.5% switched to preferring video visits and 26.8 percent didn’t have a preference or didn’t know.

When video visits cost $20 more than in-person visits 18.9 percent of respondents who initially preferred telehealth still favored video visits, whereas 61.7 percent switched to preferring in-person visits and 19.1 percent did not have a preference or didn’t know.

Overall 47% of participants were willing to pay for an in-person visit. Only 20.2% of respondents said they would spend money on a video visit. Researchers discovered that 23 percent participants valued both methods equally, and would prefer the cheaper option.

Why patients prefer visits to the doctor

“There are a number of possible explanations for why people attach more value to care in person,” Predmore says.

First, he says, is they’re used to it. It’s also more thorough in visits that require a physical examination or important signs to be observed.

For those reasons, he says “people might put more value in a personal meeting.”

There are many reasons why people may prefer in-person treatment over telehealth, according the study. One is that patients may like telehealth in certain circumstances (such as emergency care for minor illnesses) but may not perceive video visits to have the same value as in-person healthcare.

Patients may find that in-person visits allow them to refer for diagnostic testing. Telehealth visits don’t have the same effect as the interaction in-person with a doctor.

The third of participants who did not see any value in video visits in their treatment tended to be older, less well-off, less educated, and more likely to live in rural areas than those who preferred a hybrid model of care. Ironically, the authors noted that telehealth could improve access to care for all these groups. The survey findings are, they stated, a sign that “ongoing efforts to promote the equality of access to telehealth must take into consideration these preferences.”

While the people mentioned might have other reasons to choose in-person medical care, Predmore said, building out broadband internet access could make a big difference in their decisions. They are closely linked, but distinct issues: the ability and quality of the internet connection. To be successful in a Telehealth Visit, you need both of these.

He said that the research’s most important conclusion was that “among those who have used telehealth there was a very high level of willingness to be done again.” Only 2.3 percent of them were not willing to try it again.”


Zachary Predmore PhD, associate policy researcher, RAND Corp.

JAMA Network Open: “Patient Preferences for Telehealth Post-COVID-19.”

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