Department of Urology, University of Michigan, Ann Arbor, MI; University of Michigan Medical School, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Helen Diller Family Comprehensive Cancer Center at UCSF, San Francisco, CA; Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Surgery. 2024 Jul;176(1):115-123. doi: 10.1016/j.surg.2024.03.033. Epub 2024 May 10.
BACKGROUND: Surgeons rapidly adopted video visits during the COVID-19 pandemic. However, video visit use among surgeons has significantly declined, pointing to the need to better understand current attitudes and barriers to their use in surgical care. METHODS: From August 2022 to March 2023, a nationwide survey was conducted among practicing surgeons in 6 specialties. The survey included multiple-choice and free-response questions based on an implementation determinants framework, covering demographics, provider, patient, and organizational factors. RESULTS: A total of 170 surgeons responded (24% response rate). Overall, 67% of surgeons said their practice lacked motivation for video visit implementation. Additionally, 69% disagreed with using video visits as the sole means for preoperative surgical consultation, even with relevant medical history, labs, and imaging. Nearly 43% cited the need for a physical examination, whereas 58% of surgeons said video visits carried a greater malpractice risk than in-person visits. Other barriers included technological limitations, billing, and care quality concerns. Nevertheless, 41% agreed that video visits could improve outcomes for some patients, and 60% expressed openness to using video visits exclusively for postoperative consultations in uncomplicated surgeries. CONCLUSION: Surgeons recognize the potential benefits of video visits for certain patients. However, perceived barriers include the need for a physical examination, technological limitations, care quality concerns, and malpractice risks.
背景:外科医生在 COVID-19 大流行期间迅速采用了视频访问。然而,外科医生对视频访问的使用显著下降,这表明需要更好地了解当前他们在外科护理中使用视频访问的态度和障碍。
方法:从 2022 年 8 月到 2023 年 3 月,对 6 个专业的执业外科医生进行了一项全国范围的调查。该调查基于实施决定因素框架,包括多项选择题和自由回答问题,涵盖人口统计学、提供者、患者和组织因素。
结果:共有 170 名外科医生做出了回应(24%的回应率)。总体而言,67%的外科医生表示他们的实践缺乏实施视频访问的动力。此外,69%的人不同意将视频访问作为术前手术咨询的唯一手段,即使有相关的病史、实验室和影像学检查。近 43%的人表示需要进行体检,而 58%的外科医生表示视频访问比面对面访问带来更大的医疗事故风险。其他障碍包括技术限制、计费和护理质量问题。尽管如此,41%的人认为视频访问可以改善某些患者的治疗效果,而 60%的人表示愿意仅在简单手术后的咨询中使用视频访问。
结论:外科医生认识到视频访问对某些患者的潜在益处。然而,他们认为存在障碍包括需要进行体检、技术限制、护理质量问题和医疗事故风险。
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