3 reasons physicians resist telehealth

Telehealth usage has boomed throughout the pandemic, but many physicians are unsure about its sustainability. Here are three key reasons some physicians are reluctant to adopt the care delivery model.

Payer trouble 

Many states are relaxing COVID-19 restrictions and dropping public health emergency designations, moves that affect payers' decisions on how to reimburse for telehealth services. Amid these changing policies, many hospitals say their telehealth programs are in limbo.

Physicians believe the biggest barriers to their use of telehealth are payer related, according to survey results released in March by the American Medical Association. The rollback of COVID-19 waivers, the lack of insurer coverage of telehealth services and low reimbursement were the top three obstacles identified in a survey of more than 1,500 physicians. 

"Permanence drives behavior," Randy Davis, CIO at Sterling, Ill.-based CGH Medical Center, told Becker's in February. "Institutions find it hard to commit resources to ingrain a workflow into the fabric of their organization when they believe the underlying policies and remuneration realities have all the longevity of a snowflake in April."

Janice Devine, CIO at Greensburg, Pa.-based Excela Health, agreed, saying that rolling back telehealth coverage will have a significant negative effect on telehealth and force health systems to revert to the in-person model.

Tech woes

More than half of physicians said their patient population's challenges with technology is an obstacle to telehealth, according to the AMA's March study.

Many physicians are also frustrated with telehealth platforms' inability to integrate interpreters for non-English-speaking patients and prefer using in-person visits for non-English speakers, according to an October study published in the National Library of Medicine. The study revealed other technology barriers as well, including lack of training on telehealth platforms and difficulty connecting more complex technology to telehealth platforms for non-tech-savvy patients.

Physicians have also expressed frustration about telehealth platforms' limited interoperability with their hospital's EHR system. Nearly 60 percent of clinicians said they were not able to access telehealth technology directly through their EHR system in a March 2020 study conducted by the COVID-19 Healthcare Coalition.

Ego

Telehealth represents a new form of service for patients, cutting out the traditional aspects of a physician's visit that many may envision. Instead of signing in and sitting in the waiting room, being called in by the physician and sitting in an office, now patients can simply log on to a video platform or pick up the phone in the comfort of their own homes. 

This disruption of the traditional care experience may be seen as an ego threat to some physicians. There is a history of resistance to change in medical professionals, as many keep an emotional attachment to the traditional methodologies they were taught and thus are dismissive of innovations. 

In a 2010 study, University of Chicago researchers found physicians are often very confident people, as one would hope, allowing them to reassure patients and make diagnoses. However, this high confidence also meant some physicians have fragile self-esteem and if their ego was challenged, they would respond by citing their lack of vulnerability to conflicts of interest, as compared to their peers. The study "raises the issue of how motivational factors might, in some cases, interfere with the soundness of physicians’ clinical judgments."

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