Doctors expect virtual primary care to surpass in-person visits in 5 years: survey

COVID-19 vaccines have been available to the public for more than a year, and doctors are struggling to keep empathizing with their unvaccinated patients.

In a study released by Wheel of 400 doctors and nurse practitioners, half of clinicians said they’ve grappled with “empathy fatigue” in treating patients who are eligible but refuse to get the vaccine.

Even more, 58%, said the stress of the job has caused them to lose passion for their careers. A similar percentage said they’ve considered quitting their job altogether.

Pooja Aysola, M.D., senior director of clinical operations at Wheel and an emergency medicine physician, said treating patients who may go so far as to deny the coronavirus exists altogether can leave providers emotionally exhausted.

“It gets to a certain point where I’m thinking, 'how do I do this? Do I have to keep convincing them as long as I’m giving them the best treatment they can get?'” she said in an interview with Fierce Healthcare.

Increased misinformation and a loss of trust sit at the core of the issue. The survey found 84% of providers say they address misinformation at least weekly in their practice, while 43% said they face it every day.

Vaccine hesitancy had been making its way into treatment rooms long before the pandemic, and Aysola said she tries to combat misinformation with as little judgment and bias as possible.

Yet even one of her most trusted nurses, she said, didn’t get vaccinated at first because she “didn’t want to put it in her body.”

Aysola admits that the pandemic has forced all clinicians to revisit what they learned during medical school about engaging with people who don’t want to listen.

“Hearing her say that was really disheartening. If she can’t believe in the vaccine, it was like all hope is lost,” she said. “We could all use a refresher on how to deal with this.”

Still, providers believe that burnout, exacerbated by the pandemic, could hold worrying consequences for patient care. Four in 10 physicians report burnout is the biggest threat to patient care today, far surpassing the 27% who believe the primary threat to be staffing shortages.

When asked what they would change about their jobs, 50% of clinicians named administrative burdens as the most important issue they’d tackle.

In recent years, electronic health record systems and regulatory requirements have been frequently cited as primary drivers of provider burnout.

But the survey also revealed optimism among physicians about how virtual care could give them more flexibility and lift some of the burdens of traditional practice.

“Part of it is this element of control. I’m being forced to go in every single day, and I feel like I’m not making a meaningful difference in the patient’s life,” Aysola said. “For some people, (virtual care) is about regaining that control, taking ownership of your own career.”

Two-thirds of the clinicians surveyed said virtual or hybrid treatment environments better fit their lifestyles than solely in-person care.

Respondents also suggested they expect telehealth adoption in primary care to continue its upward trend, with 63% stating they believe virtual primary care will bypass in-person care in the next five years.

While telehealth utilization rates across the country have declined from their pandemic peaks, research has shown that a significant percentage of patients want to keep using telehealth services and that virtual care can help avoid unnecessary visits and reduce costs

Many providers want improved education to fit this new norm of care—76% of providers surveyed said virtual care training should be a core competency taught in medical schools.

Telehealth’s role in primary care as well as other specialties would be buoyed by House and Senate bills that hope to make the flexibilities extended to providers during the pandemic permanent.

But lawmakers have bypassed addressing the “telehealth cliff” for months in favor of discussing other issues deemed more pressing.

“We’re seeing those regulations come back into play, and it’s just putting back those walls,” Aysola said. “Now that clinicians have seen what it’s like to have more licenses, it feels like they’re taking away our work.”

Wheel provides a prebuilt virtual care platform for providers, which works to enable more personalized care while attending to provider needs like licensing challenges.

The health tech startup announced a $150 million series C round in January, bringing its total funding to $216 million since the company was founded in 2018.