How PCP Perception of Telehealth in US Compares to Other Countries

New survey results show that more US primary care physicians view telehealth as an effective tool in addressing behavioral healthcare than their peers in other high-income countries.

A new report details how US primary care physicians' (PCPs) perceptions of telehealth differ from PCPs in 10 other countries, including that more PCPs in the US believe telehealth allowed them to effectively assess mental and behavioral health needs than their counterparts abroad.

The report by the Commonwealth Fund includes findings from the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, which aimed to explore PCPs' perceptions of telehealth use and efficacy after the height of the COVID-19 pandemic. The survey was conducted in 10 high-income countries from February through September 2022. Participant sample sizes ranged from 321 to 2,092, and response rates ranged from 6 percent to 40 percent.

In Switzerland, Germany, the US, France, and Australia, more than half of PCPs reported using telehealth to conduct between 1 percent to 25 percent of patient visits. In the US, 65 percent of physicians said they conducted 1 percent to 25 percent of patient visits via telehealth.

This figure was higher in Switzerland and Germany, where 84 percent and 77 percent of physicians, respectively, reported conducting 1 percent to 25 percent of patient visits virtually.

In contrast, a majority of PCPs in the United Kingdom (67 percent) said they conducted between 25 percent and 75 percent of patient visits through telehealth.  

Overall, more than half of PCPs in the US (75 percent), Canada (72 percent), Australia (72 percent), the UK (72 percent), the Netherlands (69 percent), and New Zealand (64 percent) reported that telehealth allowed them to assess the mental and behavioral health needs of their patients to "a great extent" or "to some extent."

But only 43 percent of PCPs in Switzerland and Sweden, 30 percent in France, and 28 percent in Germany said the same.

Germany also had the lowest percentage of PCPs (19 percent) who used telehealth and believed it improved timeliness of care "to a great extent" or "to some extent." Meanwhile, 90 percent of PCPs in Australia, 85 percent in the UK, 83 percent in Canada, and 82 percent in the US stated that telehealth use boosted the timeliness of care.

Telehealth implementation did not appear to be difficult for PCPs across most of the countries studied, according to the report. A majority of PCPs in eight of the 10 countries surveyed reported that implementing a telehealth platform was "somewhat" or "very" easy.

In the US, 72 percent of PCPs stated that telehealth implementation was easy. This figure was the same in France but higher in the UK, Canada, Australia, New Zealand, and the Netherlands. But in Germany, only 30 percent of PCPs reported finding telehealth implementation easy.

With regard to the impact of telehealth on finances, about 86 percent of PCPs in Australia and 80 percent in the US said that telehealth allowed their practices to offset potential financial losses resulting from the COVID-19 pandemic.

On the other end of the spectrum were Germany and Switzerland, where only 17 percent and 38 percent of PCPs, respectively, said telehealth offset potential pandemic-related financial losses.

However, by and large, PCPs appear to be satisfied with telehealth. More than 50 percent of PCPs in eight of the 10 countries surveyed said they were "very satisfied" or "somewhat satisfied" with practicing telehealth. In the US, 77 percent of PCPs expressed satisfaction, following PCPs in Australia, Canada, the UK, the Netherlands, and New Zealand.

"For telehealth use to make further gains, policymakers and health system leaders will need to understand which telehealth services, and which forms of telehealth, are most frequently used by providers and patients," the report authors stated.

Though research has shown that Americans are satisfied with their virtual primary care experiences, telehealth use dropped by over 30 percent across various primary care specialties in 2021 and 2022.

FAIR Health data released last week showed that the percentage of patients seen via telehealth dropped by 36 percent each among physician assistants, nurse practitioners, and internal medicine physicians between 2020 and 2021. It also declined by 35 percent among pediatricians and 32 percent among family medicine physicians during that period. Additional, though smaller, decreases were seen from 2021 to 2022 across all specialties.

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