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Patients prefer speedy patient portal care over in-person visits

Consumer preferences for patient portal messaging warrants a second look at strategies for managing inboxes, including AI tools and billing for portal messages.

Sara Heath
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Published: 29 Jan 2026

Faced with the choice of a three-day turnaround to a patient portal message or a longer wait to visit with their primary care provider, a new study revealed that patients prefer the former.

These findings, published in the newest edition of the Annals of Family Medicine, underscore the need for a judicious patient portal management policy, as providers are inundated with more messages and bigger workloads.

Although long considered a key part of any organization's patient engagement strategy, patient portal utilization largely took off during the COVID-19 pandemic. Forced to social distance, patients took to the patient portal to chat with their doctor and get answers to pressing medical questions.

Patients have continued that trend, with 2025 ASTP/ONC data showing that 65% of patients were offered access to the tool and used it. That's compared to 42% of patients in 2014. Indeed, patient portal messaging has become so popular that it's eating up more and more of providers' time, leading some clinics to start billing for patient portal messaging.

The patient portal is an attractive way to connect with one's provider. Sending a message doesn't require an appointment, a benefit for patients who need quick answers and can't wait the average 31 days it takes to get an appointment on the books. Providers are often quick to respond, taking only a couple of days to get back to patient queries.

Still, facetime with one's provider is sought after, with the researchers acknowledging high demand particularly for in-person medical visits and telehealth visits for behavioral health. Although patients know they'll have to wait longer for an in-person appointment -- and perhaps even longer to see the provider of their choosing -- in-person and telehealth visits remain popular.

So, what do patients want? Would they prefer to see their provider face-to-face (or screen-to-screen), or do they want a quicker response from their clinicians via the patient portal?

Patients overwhelmingly favor patient portal messaging

A team of researchers from the University of Michigan explored these tradeoffs using a discrete-choice survey of just under 2,500 patients. Respondents assessed six hypothetical health concerns and chose one of the following four modes of care with different time frames:

  • Patient portal messaging with their primary care physician (three-day wait).
  • Video visit with a different physician (three to seven-day wait).
  • Video visit with their primary care physician (two-week wait).
  • In-person visit with their primary care physician (six-month wait).

In all six scenarios, patients would prefer to wait three days for a portal message from their primary care physicians than wait any amount of time to have a video or in-person visit with a physician.

However, the extent of those preferences varied based on clinical need.

Patient portals prevail for follow-up questions

Patients overwhelmingly preferred a patient portal message for a follow-up question to a known physical health condition (78%) or a new question about a medication or supplement (86.2%).

Patients also favored patient portal messaging when they had a new symptom, such as a headache, but to a lesser degree. While 64.2% of patients would opt for the patient portal in these cases, 23.4% said they'd wait the three to seven days to have a video visit with another provider. In this scenario, patients did not feel it necessary to visit with their personal doctor.

A similar trend occurred when patients had follow-up questions about a known mental health condition. Just under two-thirds (61.7%) said they preferred the patient portal, while 17.1% said they'd wait for a video visit with another provider. About a fifth of patients would either wait for a video or in-person visit with their own physician in this scenario.

Patients want in-person care for new, worsening symptoms

Things got murky when assessing care preferences when a patient has a new or worsening symptom, whether it be related to their physical or mental health.

For example, faced with new or worsening symptoms for a physical health condition, 37.1% of patients said they'd prefer the patient portal message. A comparable 35.5% said they'd wait to video visit with another doctor, while 13% said they'd wait for a video visit with their own doctor and 14% said they'd wait for an in-person visit.

Things were similar for the mental health scenario. When patients had a new or worsening mental health symptom, 41% said they'd prefer sending a patient portal message, while 30.9% said they'd wait for a video visit with another doctor. Meanwhile, 18.3% said they'd wait for a video visit with their own doctor and 9.8% said they'd wait to meet in-person with their doctor.

Preparing for more patient portal use

Importantly, the researchers flagged that their survey did not assess the "why" behind patient choices. However, it stands to reason that patients preferred face-to-face or screen-to-screen contact with a doctor when they had a new or worsening symptom, or something that worried them.

They might be more likely to rely on the patient portal for more administrative tasks, like clarifying an instruction or a medication question.

Regardless of the rationale, it is clear patients value the patient portal as a channel to connect with their providers. But as provider workloads go up, it might be hard to manage portal inboxes.

Billing practices for patient portal messaging, better provider training and consideration of emerging tools like generative AI warrant further examination to support providers.

Sara Heath has reported news related to patient engagement and health equity since 2015.

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