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Marjorie Bekaert Thomas
Advances in health and medicine.
General Health Channel
Reported November 21, 2012

Online Doctor Visits: Helpful or Hurtful?


(Ivanhoe Newswire) – The conveniences of the internet seem to be never ending, and now it is even possible to do doctors’ visits online to avoid the hassle of driving to the office. However, are these online e-visits really as beneficial as being examined by a doctor in person? A new study from University of Pittsburgh School of Medicine and UPMC asked the same question and found that e-visits do in fact have certain benefits but could also lead doctors to over-prescribe antibiotics. 
The study, led by Ateev Mehrotra, M.D., Associate Professor in Internal Medicine at Pitt's School of Medicine and a researcher at the non-profit RAND Corporation, focused on four primary care practices at UPMC including e-visits. The researchers looked at 5,165 visits for sinusitis and 2,954 visits for UTIs between January 1st, 2010 and May 1st, 2011. 
Out of the sinusitis cases examined in the study, 9% were performed over the internet as were 3% of the UTI cases used in the study. 
Through e-visits the doctors cannot see the patients directly but they do have access to their medical records as well as the patients’ responses concerning their medical conditions. The doctors are also still able to prescribe medications. 
The results showed no significant difference between the number of patients who went in for follow-up visits for e-visits or in-person examinations. 
"Follow-up rates are a rough proxy for misdiagnosis or treatment failure, so the lack of difference should be reassuring to patients and physicians," Dr. Mehrotra was quoted as saying. 
The researchers did find that at e-visits for both sinusitis and UTI doctors were more likely to prescribe antibiotics, adding to the growing concern of antibiotic misuse leading to increased numbers of germs resistant to the drugs. 
"When physicians cannot directly examine the patient, they may be more likely to take a 'conservative' route and order antibiotics," Dr. Mehrotra was quoted as saying. 
The doctors were also less likely to order further tests such as urinalysis and urine cultures for the UTI cases during e-visits. 
However, e-visits do seem to have some benefits for patients; e-visits could potentially lower health spending according to Medicare reimbursement data. On average the data showed lower costs for e-visits than in-office visits even with the increased prescriptions. 
So if you can’t make it to the doctor’s office, doing it over the internet may be a good alternative; just make sure not to overdo it on the antibiotics. 
Source: Archives of Internal Medicine, November, 2012


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