Introduction: During the COVID-19 pandemic, the use of both video visits (VV) and telephone visits (TV) surged. While insurance coverage for VVs has continued after the pandemic, coverage for TVs remains less certain. We sought to evaluate why patients select TVs over VVs in our academic Urology practice.
Methods: All patients who attempted to schedule telemedicine visits with our practice from 11/2020-5/2021 were first offered a VV. If the patient declined a VV and selected a TV, they were prompted to select a reason from a list. Patient and visit characteristics for both VV and TV cohorts were reviewed and these variables were compared between groups.
Results: 1937 patients (1180 male, 757 female) completed telemedicine visits (27% VVs, 73% TVs) between 11/2020 and 5/2021 in our practice. Patients who opted for TVs were more likely to be male (74.6% of males vs 69.9% of females, p=.02), older (84.2% of >65 years old vs 71.5% of 51-65 years old vs 58.2% of 18-50 years old, p=.03), Spanish-speaking (85.9% of Spanish-speakers vs 68.9% of English-speakers, p<.001), and returning for a follow-up visit (79.3% of follow-up patients vs 44.2% of new patients, p<.001). The population did not vary significantly by race/ethnicity or socioeconomic status. Among 1409 TV patients, 1300 (92.3%) provided reasons for preferring TV over VV. The most commonly reported reasons were limited access to smart devices (39.4%) and lack of desire for a VV (47.7%). Less frequently reported responses included language barriers (2.1%), dissatisfaction with a prior telemedicine visit (2.1%), and data/network limitations (1%).
Conclusions: Within our urban, racially diverse patient population, the majority of patients preferred TVs over VVs. Limited access to video-capable smart devices was a prevalent reason. Further analysis should be conducted into understanding the reasons why certain groups of patients are significantly more likely to opt for TVs than others, including males, older patients, Spanish-speakers, and follow-up patients. Additionally, in order to improve access to care in underserved areas, congressional efforts to continue adequate reimbursement for TVs should be encouraged and further research into barriers to patients’ acceptance of VVs is needed.