By John Schall
For many Americans, medical care over the past 18 months has been easier than ever: Patients use their phone or computer to log into a telehealth portal, where they see and talk with a doctor to get needed care. But it isn’t always so simple or straightforward.
One of the most critical drawbacks is that not everyone has access to internet fast enough to support video visits. And audio-only visits are hampered by limitations on the type of assessment a doctor can perform without being able to see or touch a patient. There is also the comfort factor. Many patients – 79% in a recent Harris poll – express that they like the convenience of telehealth, with the caveat that they do not want virtual visits do not replace in-person care.
Many patients prefer to receive care in-person, where they and their caregivers can foster the patient-doctor relationship and their doctor can get a full picture of a patient’s situation, facilitating accurate screening, diagnosis and treatment. In fact, 62% of Harris poll respondents strongly agree that if they can’t see their doctor in person, they might not get the care they need.
Telehealth, unfortunately, can also cut out caregivers, further risking quality patient care in the process. Caregivers often facilitate communication between health care providers and patients. And they help carryout treatment plans between visits, so their presence to receive those instruction and ask questions, if necessary, is vital.
While some telehealth platforms allow more than two participants, others permit only two parties – the doctor and the patient – to join. If a caregiver is not in the same location as the patient, a common occurrence during the pandemic, they are shut out of the appointment.
In contrast, many patients are well suited to telehealth. Those who can self-report accurately and completely, for example. And many follow-up care situations are appropriate for telehealth. Still, 78% of Harris poll participants agree that something might be missed if they do not have an in-person appointment, and this is almost certainly higher among subgroups for whom caregivers comprise a critical part of the health care team.
Periodic in-office visits serve as a safety net supporting quality care. When a symptom is missed during a telehealth visit, detection and diagnosis may be delayed. On an individual patient level, this is a terrible misfortune and mistake that can lead to worse health outcomes. On a system level, delayed diagnoses and deferred care can translate into increased overall health care costs, which may precipitate future cuts that affect the quality of care we all get, regardless of whether we rely on caregivers for our needs.
For patients who rely on caregivers to play an active role in their health care, preserving the option of in-person visits is critical. As we observe National Family Caregiver Month during November, let’s pause to recognize how important caregivers are to the health and wellbeing of those they support. And let’s encourage policymakers to affirm caregivers’ importance through policies that allow them to fully participate in their loved ones’ visits.
John Schall is CEO of Caregiver Action Network.