Can virtual doctors replace in person visits for most health needs?

March 13, 2020

By: Nicole Brady

Originally appeared on The Denver Channel.

Visiting the doctor no longer requires driving to the office, sitting in a waiting room, and doing a physical exam. More patients are taking advantage of telemedicine, or virtual visits, to see a physician over the internet. Denver7 is going 360 to find out the pros and cons of both types of visits.

For some patients, virtual visits are attractive because they’re convenient and can be booked immediately. That was the experience for Jack Bolgard, a student at CU Boulder. During his sophomore year he came down with a sore throat, so he booked an online appointment with American Well, a Boston-based telemedicine company with 6,000 providers.

“She (the doctor) knew right away, there are white spots on the back of your throat, you have strep throat,” Bolgard recalled. “It was very convenient because I could just go and pick up my medication that day rather than missing probably an extra day or two of school,” he said.

Dr. Mia Finkelston, a physician with American Well, believes the most valuable feature of telemedicine is the immediate access.

“Often time these patients have already tried to reach out to their primary care physician, they’ve put the call in and they’ve been told, hey, we have no visits,” Finkelston said.

Another benefit of telemedicine is that it offers privacy for patients. Experts in the mental health field say telepsychiatry is a valuable resource for patients who might not otherwise seek behavioral health treatment.

“People open up more, when they’re in their own home, they can have a conversation where they feel much more comfortable, especially men,” said Moe Keller, Director of Advocacy for Mental Health Colorado.

Dr. James Wantuck, founder of PlushCare, says cost is also a factor driving patients to telemedicine.

“Part of our mission is providing transparency in the process,” Wantuck said. “You know upfront what you’re going to pay; you’re not going to get a surprise bill six months later, which is a huge problem in medicine,” he added.

A Rand Corporation study found telemedicine visits cost around $79 dollars on average, compared to $146 dollars for a traditional office visit, and $1,734 dollars for an emergency room visit. However, the study also found some patients end up booking more telemedicine appointments, so they may spend more on doctor visits overall. More insurance companies are covering virtual visits.

But some say virtual visits are not a replacement for a trusted primary care doctor. Dr. Scott Joy, an internist at Englewood Primary Care, believes it’s important to see a doctor in person at least once a year to get accurate clinical data.

“There is not a visit that I do any day where I don’t get some type of clinical data from having the patient face to face,” Joy said.

He said doctors can catch things during an in-person visit that they may not be able to see over a web camera.

“Watching one of my patients walk down the hall, particularly an elderly patient, I can pick up a lot of what’s happening, I can look for balance issues, I can look for tremor,” Joy said.

Getting an inaccurate or incomplete diagnosis during a virtual visit is something that worries patient Peter Bosman.

“Being online, he (the doctor) can’t see you, he can’t touch you, he can’t do a proper examination” Bosman said. The 82-year old Littleton resident and his wife June visit Dr. Joy regularly, and they say having a whole team they can trust is important.

“Every time we come here it’s like seeing an old group of friends,” Bosman said. “You wouldn’t get that online,” he said.

But what about a combination of both in-person and virtual health care? The Poudre School District has started a program bringing a mobile health clinic to some school campuses. Inside the clinic, a physician’s assistant collects physical data, while the student speaks to a doctor over a video connection.

“We’re not trying to replace primary care models in the community, but what we are trying to do is keep these kids healthy enough to stay in school and learn,” said Merry Hummell, Director of the Virtual Care Program at Lincoln Middle School in Fort Collins.

The non-profit health provider Every Child Pediatrics helped bring the program to the Poudre School District.

“We see that there’s huge potential to expand access to healthcare services to students all across the state by using this telemedicine model,” said executive director Jessica Dunbar.

The virtual model also allows students to connect with behavioral health providers and counseling services.

For now, it appears both traditional and virtual services have their place in medicine. But as more doctors incorporate telemedicine into their practices, and more patients use technology to collect their own health data at home, it seems virtual care will only expand.

“This is the way that medicine is going to be delivered,” said Plush Care’s Dr. James Watuck.

For others, the human element of medicine will always be most important.

“I think touching base with a person once a year really makes a nice difference,” said Dr. Scott Joy. “Just like catching up with your friends and family, our patients become family.”