When the COVID-19 pandemic began, many physicians and therapists moved quickly to add virtual appointments so they could still see their patients while stay-at-home orders were in place and to minimize transmission when those orders were lifted. Now, more than two years later, telemedicine has been transformed and is recognized as a convenient alternative to an office visit — both for patients and their providers.
Telehealth wasn’t a completely new option in 2020, but it was mostly offered for people with disabilities or some people on Medicare who couldn’t get into the doctor’s office. There were more than 1 billion virtual visits in 2020 alone, and the number of telehealth visits for Medicare patients increased 63-fold between 2019 and 2020, according to the Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation.
Even as conditions around COVID have changed, the Census Bureau has found that telehealth is still in demand. From April to October 2021, 23.1 percent of respondents used telehealth for a virtual appointment, and patients with Medicaid and Medicare are still among the highest users of telehealth, at 29.3 percent and 27.4 percent, respectively.
Many patients who had their first virtual visits with a doctor early in the pandemic discovered benefits — telehealth eliminates the time it takes to travel to and from the doctor’s office and allows patients to wait to be seen in the comfort of their home instead of in the waiting room. Today, it’s the preferred option for many, such as busy parents and professionals and those who have underlying conditions that put them at higher risk if they were to contract COVID.
“I have had health issues which require quite a few follow-up appointments with various specialists and quarterly check-ups, and most of my doctors are about 15 to 20 minutes away, and it isn’t always appropriate to take [my two] boys with me,” says Sidney Sharkey of Fairfax. “While my husband, Tom, works from home, he is not able to watch them for the one to two hours it would take me to get to and from the doctor’s office, and we don’t currently have a babysitter or daycare. With virtual visits, I am better able to stay on top of my health by keeping in contact with my specialists and not disturbing Tom’s or my own work schedules. And because there is no commute time, sometimes Tom can watch them for the 15 to 20 minutes it takes for an appointment.”
Telehealth isn’t just for medical appointments. As the pandemic raised the levels of anxiety and depression in many people across the U.S., virtual therapy has become more common, as well.
“At the start of the pandemic, my anxiety was very high, so I started regular virtual therapy appointments,” says Woodbridge mom Tamieka Muns. “Between my kids’ activities and a demanding job, I have found that I prefer virtual therapy. It makes it easier to fit into my schedule. Even as pandemic restrictions have waned, I have kept up with virtual therapy as I see no added benefit by being in person.”
Sharkey also often opts to have her children seen virtually by their pediatricians. “When the boys are sick or have a rash, we always opt for virtual visits because they are more readily available and easier for our schedule,” she says. “The boys have mostly done well with the virtual visits and oftentimes don’t need to be on the screen for a majority of the call as the forum allows for photos to be uploaded prior — that feature has been especially helpful with my younger son, who has eczema, and sometimes we need guidance with how best to control it.”
For Meghan Lenihan of McLean, the opportunity to have a virtual visit has helped her to keep up with her mental healthcare more easily. “As a newer mom, it has made it so much more convenient to be able to make appointments,” she says. “I have not missed one therapy appointment in the last two-plus years, and I used to miss them all the time because of work or traffic trying to get to appointments.”
Doctors See Benefits, Too
Telemedicine isn’t only convenient for patients — it helps many busy physicians with their schedules, too. Dr. Marwah Tareen, a primary care physician with Johns Hopkins who recently opened an office in McLean, says that telemedicine is one of the silver linings of COVID.
“The ability to conduct telemedicine has been a huge benefit — especially as a mom, it’s made my work-life balance amazing,” she says.
On any given day, for example, Tareen might finish in-person patient visits by noon. Between noon and 1 p.m., she takes her lunch break, picks up her young son from his activities, and brings him home with her. Once home, she can take telemedicine appointments from there, and in between appointments, she can spend time with her son.
Tareen was even able to take virtual appointments while visiting family in Miami. As long as the patient is located in a state where the doctor is licensed, the doctor doesn’t need to be in the same state at the time of the appointment, she explains.
Johns Hopkins has taken the demand for telemedicine and run with it. The hospital has an entire telemedicine department that invests in new technologies and spaces for doctors to conduct virtual visits. There are rooms set up specifically for any doctor to do their telemedicine appointments — all the doctor needs to do is walk into the room, and it’s ready to go. And tech advances help doctors balance their in-person visits with virtual appointments, as well.
“I have an iWatch, so I get notifications on my watch about patients who are in the virtual waiting room for their appointment. I could be seeing a patient, and I know to wrap up and head to the televideo room,” Tareen says. “I think technology for this will grow and grow exponentially — for instance, there are new apps and new tech that’s being worked on where I can see inside a patient’s ear, or technology where the patient can take blood pressure or an EKG themselves and send it to me through their iWatch.
“It’s changed the way we practice medicine, and I think about 60 to 70 percent of patients will stay virtual,” she adds.
Telehealth Doesn’t Work for Everyone
Telemedicine is technical, and it doesn’t come without occasional glitches. Sharkey reports accidentally being let into another patient’s virtual appointment once, and her most common issue is that the link to the appointment doesn’t work, so she’ll need to call the doctor’s office and have them email a new link for her to use.
Tareen reports that any technical issues are typically user error — even patients will admit this.
“My advice to anyone who is new to virtual doctor visits is to make sure you sign on to the app very early so you don’t waste time during your appointment,” Tareen says.
Another downfall to virtual appointments is the disparity in patients who can access the technology. People who live in rural areas without a strong Wi-Fi signal or who don’t have a smartphone or computer can’t have virtual appointments. Because of this, statistics say that, in general, low-income families aren’t able to take part in virtual appointments and still go in person. Even more geriatric patients are seen in person due to a lack of understanding of technology or because they don’t have the right equipment.
“I had one patient in DC who only has a landline,” Tareen says. “She had COVID, and we couldn’t have her come into the office — all COVID-positive patients are only seen virtually. There was no way she could do telemed without a smartphone or computer.”
Of course, not every type of appointment should be, nor can be, virtual. If you need an annual physical, you will need to go into the office for bloodwork and for the doctor to examine you in person, for example.
“Certain things can’t be treated via telemedicine, and I don’t want to harm my patients,” says Dr. Wasel Akbary, also with Johns Hopkins Medicine. “If telemedicine is being used in a proper way, it benefits the patient and physician, but physicians need to be careful of what diagnoses they tackle with telemed because it could lead down a harmful road.”
In that vein, Muns tries to ensure she has certain equipment at home so her doctors have as much information as possible during virtual appointments, and she isn’t opposed to going to the doctor in person for any follow-ups. “I also would recommend having a good thermometer, scale, blood pressure cuff, and pulse oximeter so your doctor has as much health information as possible.”