Suddenly Becoming a "Virtual Doctor"

Objective

In response to the COVID-19 pandemic, many psychiatrists have rapidly transitioned to telemedicine. A qualitative study was conducted to understand how this dramatic change in delivery has impacted care, including how telemedicine was provided by psychiatrists, barriers encountered, and plans for the future. The aim was to inform the ongoing COVID-19 response and pass on lessons learned to psychiatrists who are starting to offer telemedicine.

Methods

From March 31–April 9, 2020, 20 semi-structured interviews were conducted with outpatient psychiatrists practicing in states with significant early COVID-19 activity. Inductive and deductive approaches were used to develop interview summaries, and a matrix analysis was conducted to identify and refine themes.

Results

At the time of the interviews, all psychiatrists had been using telemedicine for 2–4 weeks. Telemedicine encompassed video visits, phone visits, or some combination of the two modalities. Although many continued to prefer in-person care and planned to return to in-person care after the pandemic, psychiatrists had largely positive perceptions of the transition. However, several noted challenges such as decreased clinical data for assessment, diminished patient privacy, and increased distractions in the home setting that impacted the quality of provider-patient interactions. Several psychiatrists also pointed that their disadvantaged patients lacked reliable access to a smart phone or computer as well as the Internet. Participants identified a number of promising strategies that helped them improve the quality of telemedicine visits.

Conclusions

The COVID-19 pandemic has driven a dramatic shift in how psychiatrists deliver care. Findings highlight that although psychiatrists express some concerns about the quality of these encounters, the transition has been largely positive for both patients and physicians.