US Early and Midcareer Pediatricians’ Experiences with Telehealth in 2021

Frintner MP, Fiks AG, Gottschlich EA, Ray KN

Presented at the 2022 Pediatric Academic Societies Annual Meeting

Background: Telehealth use for patient care surged as a result of the COVID-19 pandemic. It is unclear how use varies across types of pediatric practice and practice area.

Objective: Compare pediatricians’ experiences with telehealth in 2021 by specialty (primary care vs subspecialist) and practice area.

Methods: We analyzed national data collected in 2021 from the American Academy of Pediatrics Pediatrician Life and Career Experience Study (PLACES), a longitudinal cohort study of early to midcareer pediatricians. Participants were asked if they used telehealth in the past month. Using a 4-point scale, participants rated the effectiveness of telehealth visits. Of 1355 participants, 937 completed the survey (69%), June-August 2021. Analytic sample included post-trainees providing primary or subspecialty care, n=666 (mean age=42 yrs). Chi-Square examined variations in experiences by specialty (primary care vs subspecialist) and practice area (inner city, urban, suburban, rural).

Results: 65% reported using telehealth for patient care in the past month (median monthly telehealth visits=10). Primary care pediatricians (78%) were more likely than subspecialists (46%) to report telehealth use in the past month, p<.001.

Among participants using telehealth, 73% used it for sick, 71% for chronic disease management, 64% for mental health, and 36% for new patient visits. Primary care pediatricians were more likely than subspecialists to report telehealth for sick and mental health visits and less likely for chronic disease management and new patient visits (Figure 1). Telehealth visit type varied by practice area. For example, 82% of participants in suburban, 78% in rural areas, and 49% in both urban and inner city areas used telehealth for mental health visits (p<.001).

Among those using telehealth for specific visit types, nearly 9 in 10 rated mental health and chronic disease telehealth visits as moderately or very effective (Figure 2). Subspecialists were more likely than primary care pediatricians to rate new patient visits as moderately or very effective (59% vs 31%, p<.01). Little variation was found for practice area.

Conclusion: Most primary care pediatricians and about half of subspecialists used telehealth for patient care in the summer of 2021, across suburban, rural, inner city, and urban areas. Chronic disease management and mental health visits were among the most common telehealth visit type and rated as most effective.

Figure 1. Percentage of PLACES pediatricians using telehealth for patient care in past month by specialty

Figure 2. Percentage of PLACES pediatricians reporting telehealth effectiveness by patient visit type