For Camilo Garza, an ordinary spring Saturday took an unexpected turn. Engaged in yard work, he lost his footing on a low retaining wall, tragically landing on a garden stake. The steel stake, piercing his armpit, inflicted damage to nerves, muscles, and tendons, causing severe pain, though surprisingly, surgery wasn’t required.
This incident occurred in May 2020, during the initial surge of the COVID-19 pandemic, a time when in-person doctor visits were fraught with challenges. As Garza transitioned from hospital care back to UChicago Medicine for ongoing management, a significant shift had taken place in healthcare. UChicago Medicine, along with many other providers, had rapidly adopted virtual “telehealth” appointments, offering a remote care option for patients whose conditions didn’t necessitate physical presence.
For Garza, these Virtual Doctor Appointments with his primary care physician, Dr. Sachin D. Shah, proved to be remarkably convenient. “After my injury, mobility was a major issue,” Garza recounted. “I was essentially bedridden for weeks. The virtual appointments with Dr. Shah and others were a lifeline. Despite being in considerable pain, I could simply sit at my dining room table and connect with Dr. Shah remotely.”
He added, “While not exactly the same as face-to-face consultations, these virtual visits were incredibly effective and comprehensive. They were invaluable during a critical period when traveling to a doctor’s office would have been exceedingly difficult.”
Dr. Shah also noted benefits beyond mere convenience. He believes telehealth actually enhanced the quality of care Garza received. “Virtual doctor appointments significantly decreased the number of in-person visits required for Mr. Garza,” Dr. Shah explained. “This reduced barriers to care, improved his overall patient experience, and enabled us to deliver more efficient and continuous care throughout his recovery.”
Virtual Doctor Appointments: Expanding Access to Healthcare
Over just two years, virtual doctor appointments have become increasingly common across various healthcare settings. They offer a more accessible and convenient way for patients to connect with healthcare providers. These virtual consultations, combined with necessary in-person tests, procedures, and home monitoring systems, can significantly improve the patient journey.
Image of a doctor and patient having a virtual consultation on a laptop
Alt text: Doctor Sachin D. Shah conducts a virtual doctor appointment with patient Camilo Garza on a laptop, showcasing the ease of telehealth.
“Initially, many of Mr. Garza’s virtual doctor appointments focused on adjusting his treatment plan, particularly his pain management,” Dr. Shah mentioned. “While some aspects required in-person attention, these were minimal, perhaps only 10% to 20% of his total visits. This highlights the complementary role telehealth can play in modern healthcare delivery. A significant portion of patient care can be delivered just as effectively, and sometimes even more so, through virtual care options.”
For Garza, virtual appointments eliminated the need for travel during a period of significant discomfort. Since his initial injury, telehealth has continued to simplify follow-up care for his ongoing recovery and management of other health concerns, such as his blood pressure medication. Garza uses a home blood pressure monitor, allowing his physicians to remotely adjust his treatment without requiring in-person visits.
However, Dr. Shah emphasizes that the advantages of virtual doctor appointments extend beyond mere convenience; they are also crucial for healthcare equity.
“Offering virtual doctor appointment options can significantly reduce or even eliminate major obstacles people face when seeking medical care,” he states. “These barriers include transportation difficulties, time off work, childcare arrangements, parking issues, and associated costs. The logistics of getting to and from a doctor’s office can be a substantial burden, especially for individuals with disabilities, those with lower incomes, or elderly patients with limited mobility.”
Dr. Shah points out that the rapid expansion of telehealth options, particularly driven by increased insurance coverage, is a positive outcome of the COVID-19 pandemic. “Both patients and providers had been receptive to telehealth for some time, but the primary hurdle was insurance coverage,” he explained. “Before the pandemic, it was considered a niche service, often requiring out-of-pocket payments or offered as a premium benefit in select health plans. The pandemic spurred government healthcare plans to reimburse for telehealth visits, and commercial insurers followed suit. This shift in coverage dramatically accelerated the adoption of virtual care.”
The result is a more streamlined and continuous care model. Patients can promptly update their physicians on their health status or request medication adjustments, while healthcare providers can quickly assess new information and respond effectively. This enhanced responsiveness facilitates timely treatment for a wide range of conditions, reducing the likelihood of minor issues escalating into more serious health problems.
The Looming Threat to Telehealth: Coverage Rollbacks
Despite the clear benefits of virtual doctor appointments for patients like Garza and countless others, there is growing apprehension about potential rollbacks in insurance coverage for these services as the pandemic recedes. For instance, many insurance plans have already ceased covering telephone-only consultations, although video visits often remain covered.
Image of a doctor talking to a patient on a video call on a tablet
Alt text: A doctor engages in a virtual doctor appointment via video call on a tablet, illustrating the visual aspect of telehealth.
“While approximately 80% of virtual doctor appointments are conducted via video and 20% via telephone, the reliance on telephone-only visits is significantly higher among our most vulnerable patient populations,” Dr. Shah highlighted. “When we examine patients aged 65 and older, Black individuals, and residents of Chicago’s South Side, we observe that less than half are able to utilize video visits, often depending instead on telephone-based consultations. Elderly patients, people of color, those with lower socioeconomic status, and individuals with limited English proficiency are disproportionately affected by the digital divide due to factors like inadequate broadband access, limited digital literacy, and lack of necessary technology.”
These underserved groups already disproportionately experience chronic diseases and face greater challenges in accessing healthcare. Requiring these patients to travel to clinics for minor check-ins and updates that could be efficiently handled via virtual doctor appointments places further strain on an already overburdened healthcare system and diminishes their ability to receive quality care.
At UChicago Medicine, Dr. Shah and his colleagues have gained valuable insights from their telehealth experiences over the past two years. A key takeaway is the significant impact of basic support for patients in facilitating access to virtual care.
“We are training our care team members to provide digital patient navigation support,” Dr. Shah explained. “This includes proactive check-in calls, sending video visit links just before appointments via text, guiding patients through connection steps, and even setting up devices during in-person visits. These measures are designed to reduce barriers to accessing virtual care.”
The Future of Virtual Healthcare
Recently, Dr. Shah and Garza shared their experiences and perspectives at a White House roundtable, advocating for the continuation of insurance coverage for virtual doctor appointments.
Garza emphasized the critical importance of access for those who face greater difficulties with in-person care. “Many of my family members live in a very remote area of south Texas,” he shared. “It’s about a 90-minute drive to access quality healthcare, especially specialist care. I’ve lost relatives my age or even younger, and I believe it’s partly due to the challenges they face in getting timely medical guidance. Driving hours for care is a significant barrier. If they could access the necessary medical information remotely through virtual doctor appointments, their health outcomes would undoubtedly improve. I am fortunate to have access to exceptional care at UChicago Medicine readily available, but unfortunately, this isn’t the reality for everyone.”
Image of Dr. Sachin Shah speaking at a roundtable discussion
Alt text: Dr. Sachin Shah participates in a roundtable discussion, advocating for the continued support of virtual doctor appointments.
Dr. Shah’s primary concern, with his patients in mind, revolves around whether insurance companies will deem virtual doctor appointment options valuable enough to maintain coverage, and the implications of their decisions for vulnerable populations.
“Will insurance companies cease coverage? That is the multi-billion-dollar question,” he stated. “I view virtual care as complementary, often replacing some in-person care rather than simply adding to costs. This is fundamentally a matter of health equity, especially for the communities we serve on Chicago’s South Side. By intentionally working to bridge the digital divide within our most vulnerable communities, virtual care can significantly improve healthcare access for underserved patients. Hospitals benefit from these options through increased flexibility and improved capacity for necessary in-person visits. And many patients greatly appreciate the flexibility virtual care provides.”
“For many individuals, virtual doctor appointment options can demonstrably improve the quality of care by fostering a more continuous relationship with their providers and care teams. Expanding virtual care options, when appropriate, can, in turn, free up in-person availability for patients requiring more complex care and procedures that must be performed in a clinic or hospital setting. We manage our finances online, book travel arrangements online—why shouldn’t healthcare be just as accessible? We can and should empower our patients with this level of access.”
