Study: Increasingly popular telemedicine visits may have shortcomings

Telemedicine is hot. About a third of visits with primary care doctors are happening virtually. But, a Johns Hopkins Bloomberg School of Public Health expert warns they’re not always best.

The number of blood pressure checks declined by half, and cholesterol checks dropped by more than one-third during a period when telemedicine visits were experiencing an “unprecedented surge” from 1.1% of total primary care consultations to 35.3% in the second quarter of 2020.

That’s according to a study evaluating April-June 2020 data, comparing them to data from the second quarters in 2018 and 2019.

“There are many, many good reasons why people may still need to see a doctor face to face,” one of the study’s authors, Dr. Caleb Alexander, of the Johns Hopkins Bloomberg School of Public Health, said.

Alexander said evaluating blood pressure, cholesterol and other cardiovascular risk factors are critically important when it comes to preventing heart attacks and strokes.

“One of the concerns about the increased adoption of telemedicine is that we may be leaving — some very important parts of what historically has happened face to face — behind,” Alexander said.

His advice?

“If you’re a patient wondering whether or not you should see your doctor face to face — pick up the phone and call them and ask,” Alexander said.

Alexander stressed that telemedicine is a perfectly reasonable platform for some types of primary care and even some types of specialty care, but he believes it’s not right for every condition.

“There’s not a one-size-fits-all approach here,” Alexander said.

He especially suggests in-person visits when conditions develop unexpectedly.

“If you have new symptoms, new shortness of breath, some other new physical complaint — it’s just really hard to thoroughly evaluate that by telephone or over a computer,” Alexander said.

The study also found that the number of primary care consultations fell by more than 21% during the second quarter of 2020, but Alexander said coronavirus concerns shouldn’t keep you from seeking help.

“Hospitals and health systems and doctor’s offices are all working, and they’ve all redesigned their workflow to varying degrees in order to decrease the risk that COVID is transmitted through the course of routine clinical care,” Alexander said.

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