- Telehealth has gained significant traction, especially due to the COVID-19 pandemic, offering benefits such as accessibility, convenience, and cost-effectiveness. However, it faces challenges including quality of care, data privacy, and unequal access, particularly in rural areas with limited internet connectivity.
- While telehealth is suitable for routine follow-ups, minor illnesses, and mental health consultations, in-person care remains crucial for more serious conditions, initial diagnoses, and procedures that require a physical examination or specialized tests.
- Mira offers a healthcare plan that combines both virtual and in-person services, aiming to provide comprehensive care. For an average of $45 per month, subscribers can access various healthcare services, including virtual primary care, discounted prescriptions, and urgent care visits, making it an affordable option for those without traditional health insurance.
Note: we use the terms virtual care and telehealth interchangeably since they refer to the same thing.
Telehealth vs. In-Person Care
Although telehealth services have been around since the 1950s, the onset of the COVID-19 pandemic has resulted in a massive increase in telehealth use. Navigating telehealth services have proved to be a challenging task for some, but offers a number of benefits. In-person care, involving face-to-face interactions, has remained as the traditional method of receiving care and will certainly always be necessary for completing particular appointments. However, implementing high-quality virtual care holds the potential to work better for both patients and physicians alike. Consider the following table that breaks down the pros and cons of in-person versus telehealth care.
|Virtual Care/ Telehealth||In-Person Care|
|Accessibility||Easy to access from anywhere, reducing geographic barriers.||Physical presence allows for more thorough examination.|
|Convenience||No need to travel; can be done from the comfort of home.||No technical issues; straightforward appointment setup.|
|Time-Saving||Often shorter wait times and quicker service.||No need to set up devices or troubleshoot technical issues.|
|Anonymity||Can offer more privacy and anonymity for stigmatized issues.||Direct interaction can sometimes lead to a stronger doctor-patient relationship.|
|Scope||Easier to consult specialists across long distances.||Wide range of services and treatments, including surgeries and physical exams.|
|Cost||May be less expensive due to lack of travel and time off work.||Insurance is more likely to cover, and costs are well-established.|
|Quality of Care||Limited to what can be diagnosed or treated remotely.||Time-consuming; may require taking time off work and travel.|
|Technology Barriers||Requires a good internet connection and a capable device.||No technology barriers to entry.|
|Communication||Nuances of symptoms may be missed; harder to build a relationship.||Easier to communicate and convey symptoms or concerns.|
|Physical Examination||Limited ability for physical touch, important for some diagnoses.||Physical exams are more thorough.|
|Emergency Services||Not suitable for urgent or life-threatening conditions.||Equipped to handle emergencies and offer immediate treatment.|
|Insurance and Regulations||Coverage may be limited; state or country regulations could be a barrier.||Usually well-covered by insurance; established legal framework.|
When Should I Use Virtual Care vs. In-person Doctor?
Telehealth refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance. Virtual health care, a smaller component of telehealth, involves one receiving health care services through a virtual visit with one’s provider. Healthcare providers may use telehealth platforms like live video, audio, or instant messaging to address a patient’s concerns and diagnose their condition remotely. (See Mira's article “How Does Telemedicine Work?”).
According to California Healthline, “telemedicine is effective in cases that would typically send you to an urgent care clinic, such as minor injuries or flu-like symptoms, including fever, cough, and sore throat.” The chart below can assist in determining when to use telemedicine vs. in-person health services:
|Conditions||Appropriate for Virtual Care||Appropriate for In-Person|
|Minor Illnesses||Common cold, sinus infections, allergies||Severe flu, pneumonia|
|Chronic Conditions||Routine follow-ups for diabetes, hypertension, asthma||Initial diagnosis, severe flare-ups|
|Mental Health||Therapy and counseling sessions, medication management for stable patients||Severe mental health crises, initial psychiatric evaluations|
|Skin Conditions||Acne, minor rashes, dermatitis||Severe burns, surgical dermatology|
|Digestive Issues||Irritable Bowel Syndrome (IBS), minor heartburn||Severe abdominal pain, gastrointestinal surgeries|
|Infections||Urinary Tract Infections (UTIs), yeast infections||Severe or complicated infections requiring IV antibiotics|
|Musculoskeletal Issues||Follow-ups for chronic conditions like osteoarthritis||Fractures, dislocations, severe sprains|
|Reproductive Health||Birth control consultations, STD screening for asymptomatic patients||Pregnancy, gynecological surgeries, severe menstrual issues|
|Pediatric Concerns||Minor ailments, routine follow-ups||Newborn care, vaccinations, severe illnesses|
|Preventive Care||Lifestyle advice, weight management||Vaccinations, cancer screenings|
|Follow-up Care||Post-surgical follow-ups for stable patients, medication adjustments||Post-surgical complications, wound care|
|Prescription Refills||Routine refills for stable conditions||New medications requiring thorough evaluation|
Type of Medical Specialists Available via Virtual Care vs. In-person
Virtual care has shown versatility, particularly in the realms of primary care, mental health, and follow-up consultations for chronic conditions across multiple specialties like cardiology, endocrinology, and gastroenterology. It is also a convenient platform for minor issues in dermatology, urology, and pediatrics. However, in-person care remains essential for more complex or invasive procedures, initial diagnoses, and specialized tests. For example, surgeries, chemotherapy, and advanced diagnostic tests like echocardiograms, colonoscopies, and allergy testing generally require an in-person visit. The landscape is continuously evolving, and while virtual care offers unparalleled convenience and accessibility, there are inherent limitations that make in-person care indispensable for certain medical needs.
|Available for Virtual Care||Generally Require In-Person Care|
|Primary Care||General Practitioners|
|Mental Health||Psychologists, Psychiatrists|
|Cardiology||Follow-up consultations, medication management|
|Dermatology||Consultations for minor skin issues|
|Endocrinology||Diabetes management, hormone therapy consultations|
|Gastroenterology||Follow-ups for IBS, acid reflux|
|Obstetrics & Gynecology||Prenatal check-ins, birth control consultations|
|Oncology||Follow-up consultations, medication management|
|Orthopedics||Consultations for chronic conditions like arthritis|
|Pediatrics||Minor illnesses, routine follow-ups|
|Neurology||Follow-ups for epilepsy, migraine management|
|Urology||Follow-ups for chronic conditions, UTI consultations|
|Ear, Nose, Throat (ENT)||Follow-up consultations, minor issues|
|Allergists||Consultations for known allergies, medication management|
|Nutritionists||Diet consultations, weight management|
|Physical Therapy||Exercise guidance, consultations for minor issues|
Controversies and Debates Around Virtual Care
Virtual care, despite its many advantages, has stirred up a variety of controversies and concerns. Below are some of the key points of debate:
Quality of Care
One of the most significant concerns about virtual care is whether it can maintain the same standard of care as in-person visits. Critics argue that the absence of a physical exam could lead to misdiagnoses or an oversight of critical symptoms.
Virtual consultations require the transfer of sensitive medical data over the internet. There are concerns over how this data is stored, who has access to it, and the potential for data breaches.
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Inequality in Access
Not everyone has access to the high-speed internet and devices required for virtual care, which can exacerbate existing healthcare inequalities. Rural areas, in particular, may face challenges due to less reliable internet connectivity.
Regulatory and Licensing Barriers
Regulations around telehealth vary by jurisdiction, creating complexity for providers who wish to offer services across state or national lines. Licensing becomes particularly tricky for international telehealth services.
Insurance policies may not universally cover virtual care, or may provide a different level of coverage compared to in-person care, leaving patients with unexpected costs.
Overuse or Misuse
The convenience of virtual care could potentially lead to overuse for minor issues that do not require medical consultation. This overuse could strain healthcare resources and incur unnecessary costs.
Telehealth services sometimes outsource medical consultations to doctors who may not be familiar with the local medical guidelines, culture, or patient population, leading to ethical concerns about the quality and appropriateness of care.
Reliability of Technology
Technical issues like poor video or audio quality, connectivity issues, and software glitches can impede the quality of a virtual consultation, and this unreliability can be a significant barrier to effective care.
Building a strong patient-doctor relationship is considered a cornerstone of effective healthcare, and there are concerns that the remote nature of virtual care might undermine this relationship.
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Telehealth vs. In-Person Care Frequently Asked Questions (FAQs)
Consider this additional information when it comes to utilizing telehealth and in-person health services.
How do I access telehealth services?
Accessing telehealth services can be done through specific providers or telemedicine hubs that offer their own access to various doctors. Many health insurance plans will reimburse you for telemedicine visits, depending on the state you live in and the service provided. If you do have health insurance the best way to know is to ask the doctor's office directly if they offer telemedicine visits and what their self-pay rates are.
Is Telehealth cheaper than an In-Person visit?
In general, telehealth tends to be less expensive than an in-person office visit, but as mentioned, costs vary between telehealth services and depend on a few factors (eg. insurance coverage, condition/symptoms, and the healthcare provider being seen).
What is the difference between telehealth and telemedicine?
The terms telemedicine and telehealth are often used interchangeably, but technically telemedicine is a subset of telehealth. Telehealth includes non-clinical, as well as clinical care, uses of telecommunications technology such as self-monitoring, patient education, and even medical records management.
How do I establish a good relationship with my physician virtually?
Meeting a new provider can be a daunting task, the majority would not just turn to a stranger on the street and disclose our deepest fears, our digestive issues, or our medication lists. Healthcare is different. Providers are held to high standards for discretion and HIPAA laws ensure this as well, even over virtual visits. It’s best to be honest and open about your physical and mental health so that your provider can obtain a comprehensive understanding of your past and current health state. Just remember that your provider is there to help you and trust is central to the patient-doctor relationship!
I am not that tech-savvy, can I still use telehealth services?
Have you ever used Skype or Facetime? It is virtually the same process for many telehealth appointments! Patients of all ages (even well into their 90s) have used different telehealth services. Doing a virtual doctor's visit can be just as simple as going in. Your provider, or an affiliate, will generally send a link prior to the appointment to help you prepare for the virtual appointment and list a number to call should any issues or technical difficulties arise.
The Bottom Line
Only you know which method of care is best for you, whether it be exclusively in-person visits, exclusively telehealth, or a combination of the two. The latter is where most people find themselves, as many of the previously mentioned pros and cons could go either way. For example, cultivating a relationship with your physician - some may find it easier to communicate and share information over telehealth options, whereas some may prefer face-to-face interactions.
Mira aims to provide quality health care at a low price so that you don’t have to make these decisions. If you are unemployed or cannot afford health insurance, Mira is a great affordable healthcare alternative. With Mira, you can receive lab testing, urgent care visits, and up to 80 percent off prescriptions for an average of $45 per month. Sign up today.
Kendra Bean is from Maui, Hawaiʻi. She is currently enrolled at the University of Hawaiʻi at Mānoa, specializing in Epidemiology. She is passionate about improving health literacy and access to care, specifically in rural areas.