I have to admit that the concept of being treated for minor, recurring conditions (such as sinus or urinary tract (UT) infections) sounds appealing to me. There’s no calling for an appointment, no trying to fit the appointment into my schedule, no getting dressed to go out when I least feel like it and no waste of travel and wait time. In addition, some doctor offices charge less for the e-visit than for a visit in the office. What’s not to like?
A recent study looked at whether e-visits were as effective as the traditional office visit in treating sinus and UT infections.
For the new study, researchers compared all e-visits and office visits for sinus infections and UTIs at four primary care practices in Pittsburgh, Pennsylvania, between January 2010 and May 2011. Over 90 percent of appointments for both conditions were in-person office visits, out of a total of more than 8,000.
Dr. Ateev Mehrotra from the RAND Corporation and University of Pittsburgh School of Medicine and his colleagues found a similar proportion of patients – seven percent or less in each case – had a follow-up visit for the same condition within the next three weeks. That suggests misdiagnosis and treatment failure weren’t any higher with e-visits.
However, people with both conditions who had e-visits were more likely to be prescribed antibiotics than those who had in-person appointments. The effect was especially strong for UTIs: 99 percent of those people who had an e-visit received an antibiotic, compared to 49 percent with an office visit.
With over-prescribing of antibiotics becoming a critical problem in this country (Antibiotics–What You Need to Know? and Shared Decision Making: Reducing Use of Antibiotics) the increased incidence of prescribing antibiotics with e-visits is alarming. Something to think about if your primary care doctor offers e-visits.