There’s no longer any doubt that telemedicine is here to stay…to what extent is anyone’s guess. What impact will this have on the practice of medicine? How will it change the doctor-patient relationship? The quality of patient care? For the time being, there are more questions than answers.

“Make telemedicine your first choice for most doctor visits.” That’s the message from some employers and insurers who are now embracing the idea of “virtual-first” health care plans, according to a recent Associated Press report. The idea is “to get people to use telemedicine routinely, even for planned visits like annual checkups,” cutting the cost of health care in the process.

Many doctors are concerned that patients will delay or avoid in-person care if they become too dependent on “virtual-first” visits. “There is a lot lost when there is no personal touch, at least once in a while,” said Dr. Andrew Carroll, Arizona family physician and board member of the American Academy of Family Physicians.

If “virtual-first” visits become widespread, medical practices will have to increase their capacity to work remotely. However, only 15% of medical groups said they plan to increase their remote workforce this year, said Anders Gilberg of the Medical Group Management Association in an interview with MedPage Today. “Medical groups are subject to countless privacy and security regulations, so a remote workforce is easier said than done in terms of cost and compliance considerations.”

From the patient’s viewpoint, Gilberg points out that a 2019 FCC report estimates that more than 21 million Americans don’t have broadband access. “Further, researchers have estimated that 41% of Medicare patients lack access to a desktop or laptop computer with a high-speed internet connection at home.” This highlights the importance of continuing Medicare reimbursements for telephone visits once the pandemic is over.

An often overlooked application of telemedicine is its popularity in providing virtual visits for pregnant women. A recent Vanderbilt University survey showed that a majority of both patients and providers felt that telemedicine was an acceptable way to provide prenatal care, even outside a pandemic.

By most indications, the rapid growth of telemedicine services is exceeding expectations. Advocates for expanding the role of telemedicine have good reason to be optimistic, despite the challenges that lie ahead.