Are online doctors' visits as effective as in-person appointments?

Physicians prescribe antibiotics nearly twice as often in e-visits

A new study in JAMA Internal Medicine suggests that "e-visits" produce similar outcomes as in-person office visits—but they are more likely to end with a prescription order.   

For the study, researchers compared data on online doctors' visits and in-person doctors' visits for patients with sinus infections and urinary tract infections (UTIs) between January 2010 and May 2011. More than 90% of the 8,000 consultations in the study occurred in-person.

The study found that both patient groups returned to the doctor within three weeks with the same condition about 7% of the time, suggesting that online consultations did not have higher rates of misdiagnosis or treatment failure.

In addition, the researchers estimated that treating a UTI patient cost an average of $74 per e-visit, compared with $93 per office visit.

Meanwhile, the study found e-visits offered patients added conveniences, such as not requiring patients scheduled appointment and avoiding travel to a physician's office when a patient is ill.

However, the study did note one important difference between e-visits and in-person visits: Physicians prescribed antibiotics to patients with UTIs after 99% of e-visit consultations, as opposed to just 49% of in-person consultations.

According to the researchers, physicians may be more conservative when treating infections remotely because that cannot directly examine the patients, Reuters reports.

The link between over-prescription of antibiotics and bacterial drug resistance makes this "something we really need to be careful about and watch for," study co-author Ateev Mehrotra told Reuters (Pittman, Reuters, 1/15).


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