Virtual Primary Care is not Telehealth — it’s better

Telehealth is obviously a generic term for a broad category, kind of like “e-commerce.” Technically, it describes any healthcare service delivered electronically. However, over the past decade and through the pandemic, as its adoption has started to pick up, it has become closely associated with one very specific version of itself. Most of us have experienced telehealth as a sort of urgent care hotline, where you can speak with the first available nurse or doctor to triage and treat basic everyday symptoms or concerns. However, this version of “traditional” telehealth stops exactly there in its usefulness. And that’s why virtual primary care is something different…and better.

While even the term “virtual primary care” has come to describe a variety of services, it’s best defined more precisely as one where (i) you meet one primary care doctor of your choice, (ii) your interactions with this doctor are mostly “face-to-face” (by video and not text), (iii) you can continue to see that same doctor over time, and (iv) that doctor takes responsibility for your long-term health, including your wellness and prevention goals as well as any ongoing chronic conditions or issues.

Telehealth vs. Virtual Primary Care

When these criteria are met, virtual primary care presents significant advantages over traditional telehealth.?

• Broader scope of service and usefulness: with an established ongoing relationship with the patient, primary care doctors are more comfortable treating patients for more than just routine refills and minor symptoms. They often treat a wider range of ailments and health goals, manage ongoing chronic conditions, oversee medication use, and take the time to discuss preventative screening and wellness on a periodic basis. This includes some of the most prevalent and costly conditions that plague America: diabetes, obesity, hypertension, hyperlipidemia, anxiety, and more.
• Greater patient trust and adherence: patients who deepen their personal relationship with one doctor over months and years inevitably trust their doctor more. That trust leads to greater adherence and compliance to care protocols and lifestyle changes. It also makes patients more likely to turn to their doctor rather than other unreliable, less trustworthy sources when they have a question or concern.
• More personalized and effective care: when the doctor gets to know each patient’s likes and dislikes, lifestyle, family history, risk factors, and personality, they can better tailor their advice for each patient (and deliver it in a manner that will resonate best with that unique individual).?
• More efficient visits: when a patient sees the same doctor each time, they can pick up where they left off without needing to answer basic questions at the start of each visit just to come up to speed.
• Safer care: there is a significantly reduced chance of medical errors or complications when a doctor has a longitudinal and holistic view of each patient’s health profile and status, given they will have a more complete and up-to-date understanding of their patient’s current problems, test results, medications, allergies, past conditions, and family history.

Office-based Primary Care vs. Virtual Primary Care

In fact, virtual primary care is even superior to office-based primary care in several ways:

• Wider operating hours: brick-and-mortar clinics are expensive to staff, and therefore typically operate during typical business hours. Because virtual primary care allows more doctors to publish any office hours throughout the week, patients end up with more options in early mornings, weeknights, weekends, and even holidays. This flexibility makes it more likely patients make appointments and receive care that fits around their lifestyle, work schedule, and personal responsibilities.
• Broader geographic serviceability: Unlike clinics which are costly to operate in cities and often unprofitable in remote or rural areas, virtual primary care can be delivered anywhere over the internet in all geographies at once at no marginal cost, maximizing its reach and benefit to more people.
• Easier access: many patients lack the ability to transport themselves to the doctor for countless reasons, either because they can’t drive, don’t have a car or adequate public transit, have a handicap, or can’t afford the time it takes (especially with traffic). Seeing the doctor from home is not only more convenient, it allows this segment of the population to access care when they otherwise could not.
• Shorter wait times: virtual primary care is not limited to a smaller number of doctors that must show up to work at a specific physical location in order to see patients. As a result, more doctors have their schedules open to more patients virtually, often resulting in significantly reduced wait times.
• Higher doctor retention, higher patient retention: primary care doctors love virtual work — earn the same, set your own hours, work from anywhere — who wouldn’t? As a result, virtual PCPs tend to be happier and more likely to stay with the same clinic longer. That leads to doctors who deliver a more joyful patient and visit experience, and it minimizes the chance that doctors quit and leave their patients without the care they’re used to.
• Lower cost: because virtual primary care providers don’t have typical office overheads, they can deliver care at a lower cost and pass that cost savings on to patients and their payors.
• More intimate relationships yield better outcomes: believe it or not, primary care doctors often cite being able to develop more intimate relationships with their patients virtually than in office-based clinics. For one, doctors are essentially invited into the privacy of the patients’ homes, getting to see the patients living conditions and gleaning social determinants more readily, which critically inform better clinical decision making. Secondly, doctors are not rushing room to room or using the computer with their back to the patient. They typically have more time, better eye contact, and deeper conversations.
• More accommodating of caregivers: many patients require or prefer a caregiver or family member join them in doctor visits, either for comfort or practical reasons, like interpretation or decision making. It’s often harder for a caregiver to physically accompany patients than it is for them to join virtually, no matter their location.
• More engagement means better outcomes: when care is more accessible, it’s used more. It’s been well-documented that when primary care, in particular, is used more, it reliably leads to healthier patients, longer lives, and reduced medical costs downstream.

All this is not to say virtual primary care doesn’t have its own limitations over office-based care. Of course, virtual PCPs cannot administer vaccines, tend to wounds, collect test samples, or complete simple procedures as efficiently as in an office-based visit. But the stark reality is that few people have the luxury of equal, fungible access to in-person care and virtual care. With long wait times, limited availability, or lack of nearby clinics, for countless Americans, the choice is actually between no care or some care. What people actually need and benefit from can be delivered more effectively virtually.? And just as in any practice setting, if what the person needs is beyond the scope of that setting, the doctor refers so they still get the care they need (and are steered away from care they do not need).

As employers, health insurance companies, and health systems evaluate a decade of purchasing or partnering with traditional telehealth companies, they are feeling disappointed by its low utilization rates, underwhelming impact in long-term medical expense reduction and outcomes improvement, and limited scope of service. As awareness builds for virtual primary care and its benefits, expect a second wave of adoption that will finally help telehealth cross the chasm to widespread use and meaningful impact, once and for all.

Sean Mehra is Founder & CEO of HealthTap, a national virtual primary care provider.