Doctor's visits via Web cam get thumbs up

Patients like face-to-face doctors' appointments, but videoconference visits were almost as popular in a small trial in Boston.

In a pilot study at Massachusetts General Hospital reported in the journal Telemedicine and e-Health, 30 patients who had come to see their primary care physician for routine follow-up or acute care agreed to first have a visit via a computer equipped with a Web camera. Their physician, Dr. Ronald F. Dixon, sat in another room to conduct the visit, asking questions while patients pointed to where it hurt, for example.

After patients and the doctor completed questionnaires about the virtual visit, they met face to face and went through a second visit, but this time with a hands-on physical examination.

Not surprisingly, patients liked the face-to-face visit better, saying they preferred the doctor’s manner in person. But as far as how much time was spent, how well the doctor gave explanations, and how competent he appeared, both kinds of visits got the same marks. Twenty-six of 30 patients said they would recommend videoconference visits to friends as a way to save time.

Dixon, who wrote the journal article with Mass. General colleague Dr. James E. Stahl, said virtual visits like these could never replace care that requires physical examinations, but for some conditions, such as upper respiratory infections or back pain, videoconferencing may work just as well. A larger, randomized trial involving more patients and doctors is under way at Mass. General. The pilot study was supported by the Center for the Integration of Medicine and Innovative Technology, a consortium of Boston-area hospitals and universities.

“One can envision the need to develop some form of triage for the proper use of this technology,” the authors write. “We feel such alternative methods of care delivery will contribute positively to patient satisfaction and economic efficiency.”