Abstract Background Social distancing and lockdowns were implemented during the first period of the COVID-19 pandemic.Primary care physicians needed to adapt quickly to deliver remote care/telemedicine.Methods A cross-sectional, 47-item online Google Survey was distributed through the Israel Association of Family Physicians (IAFP) mailing list between March 31-May 5, 2020.
The questionnaire included demographics, physician characteristics, and information on usage and perceived telemedicine quality.Sampling weights by sex and age groups were applied.Results One hundred fifty-nine primary care physicians (10.
6% of registered Cashews IAFP members; 63.5% women; mean age 53.4 ± 10.
4 years and median professional experience 21.3 years) replied to the survey.The majority (59.
7%) of the participants performed a mixture of in-person along with phone counseling.About 40% had no former telemedicine experience.The majority indicated that telephone and video formats were inferior to in-person consultation (68%, 57.
1% online and phone, respectively).The overall counseling quality grade (on a 1–10 scale,)median (IQR)) was 6.2 (3) for telephone and 7(2) for video.
While 66.9% reported experiencing no challenges, 10% had technical problems, 10% interpersonal problems, 5.6% scheduling difficulties, and 7.
5% other difficulties.Majority of 56.6% physicians indicated they prescribed more antibiotics,16.
4% sent more blood tests, 24.5% referred more to experts, and 49.7% referred more to imaging in comparison to usual counseling.
Higher phone quality score was significantly associated with physicians who indicated not prescribing more antibiotics during the pandemic (OR = 0.30, 95%CI 0.134–0.
688, p = 0.004).Higher online tool quality score was associated with physicians who indicated not sending more blood tests during the pandemic (OR = 0.
06 95%CI 0.008–0.378, P = 0.
003).Conclusions Our findings suggest telehealth holds considerable promise for counseling in the primary care setting.However, interpersonal challenges raised by physicians should be understood in-depth to develop tailored training and further examine it in randomized trials while integrating patient-reported outcomes.
Finally, further research on utility, cost, and cost-efficiency during remote counseling with follow-ups, medical prescribing, and additional referrals is needed.