With a total of 224 participants, an in-person consultation was preferred by 62.1% prior to surgery and 67.7% post-surgery.
Clinical Pearls
This study surveyed patients from outpatient dermatology clinics, investigating the patient preferences regarding telehealth in pre- and postsurgical care.
With a total of 224 participants, an in-person consultation was preferred by 62.1% prior to surgery and 67.7% post-surgery.
The most commonly cited reason for an in-person visit was a desire for physical interaction with their surgeon. Patients of older age had a greater preference for in-person visits.
The preference of in-person visits pre-surgically or post-surgically was similar regardless of sex, immunocompromising condition, prior dermatologic surgery, anxiety level for contracting COVID-19, and perceived level of office safety.
Discussion:
Health care delivery in the U.S. is shifting rapidly and the influence of COVID-19 has encouraged the use of alternatives practice visits, such as telehealth appointments. Previous literature suggests that telehealth services can increase access to care by reducing the number of clinic visits, and may also afford early detection of post-operative complications. Understanding patient preferences regarding telehealth visits in dermatologic surgery will be of particular importance in delivering patient centered care in the era of COVID-19.
This study surveyed 224 patients from the Northwell Health Department of Dermatology outpatient dermatologic surgery clinics from August 18, 2020 to April 25, 2021. Patients completed a predesigned survey in the outpatient office on the day of their scheduled surgery visit. The primary outcome of interest was the patient’s preference for an “in-person office appointment”, “teledermatology virtual appointment”, or “no preference, open to either appointment” for both presurgical and postsurgical visits.
Survey results found that 62.1% (95% CI, 55.7–68.4) of respondents, preferred an in-person presurgical consultation. Furthermore, this response was favored due to desired physical interaction with their surgeon (83%), followed by fear of something being overlooked during a telehealth appointment (30%). Regarding the post-surgical visit, 67.7% (95% CI 61.6–73.8) of patients preferred an in-person appointment. This response was most favored due to desired physical interaction with their surgeon (81%), fear of something being overlooked (35%), and increased likelihood of a better cosmetic outcome (26%). In both presurgical and postsurgical visits, patients of older age were more likely to prefer in-person visits and patients currently taking immunosuppressives and those perceiving themselves as less attractive were less likely to prefer in-person visits. Patient preference for in-person vs. telehealth visits were similar regardless of sex, immunocompromising condition, prior dermatologic surgery, anxiety level for contracting COVID-19, and perceived level of office safety.
Overall, this survey provides dermatologists with a current view on patient preferences toward telehealth appointments in the perioperative period of dermatologic surgery. As practice patterns change across the country, more often including telehealth, it is important for dermatologic surgeons to understand the preferences of their patients. Furthermore, future studies evaluating the feasibility and provider satisfaction of virtual perioperative dermatologic surgery visits will be needed.
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