Most patients prefer physician’s office backgrounds during video visits

New research reveals that most telehealth patients prefer a traditional physician’s office setting background for video visits.

The study, published in JAMA Network Open, assessed patient preferences for visual backgrounds during video visits. As telehealth use escalated in the wake of the COVID-19 pandemic, the study authors noted there was little time to train physicians on ‘webside manner’ or determine best practices for video visits.

Now that telehealth is increasingly ingrained in healthcare delivery, researchers from the University of Michigan Medical School (U-M) and Veterans Affairs Ann Arbor Healthcare System (VAAAHS) set out to identify optimal visual background elements during telehealth visits. They conducted a survey between February 22 and October 21, 2022, polling 1,213 adults, 18 years or older, who had completed an in-person or virtual outpatient visit within the prior year at either institution.

The survey included photographs of a model physician in different environments, and participants were asked to select their preferred environment. The researchers calculated a composite score based on how knowledgeable, trustworthy, caring, approachable, and professional the physician appeared to the respondent and how comfortable the physician made the respondent feel. The scores ranged from one to ten, with higher scores indicating greater preference.

The physician's office displaying diplomas scored highest for all physician types. Over one-third of survey respondents (35 percent) preferred the background of an office with displayed diplomas. Approximately 18 percent of patients said they preferred a physician’s office, 14 percent preferred a plain color background, and another 14 percent preferred a home office with a bookshelf or an exam room. Only 2 percent preferred a kitchen as a background setting, and 3.5 percent preferred a bedroom.

“Patients have expectations of what physicians’ attire and workspaces should look like. This study showed that patients prefer what have been previously termed traditional or professional attire and settings,” said co-author Sanjay Saint, MD, MPH, the George Dock professor of internal medicine at U-M and chief of medicine at the VAAAHS, in a press release. “Diplomas and credentials remind patients of the expertise they expect a physician to have, and conversely, something is lost when the background conveys a relaxed, informal home environment.”

Thus, researchers concluded that health systems should prioritize telehealth visit environments that display a traditional office or examination room environment.

The research builds on survey results published by a University of Michigan Medical School research team in 2018, which showed that what physicians wear during clinical encounters matters to patients. The survey polled 4,062 patients at ten major medical centers between June 1, 2015, and October 31, 2016.

More than half of the survey respondents (53 percent) indicated that physician attire was important to them during care, with 44 percent saying their physician should wear formal attire with a white coat and 26 percent scrubs with a white coat.

While the clinical evidence backing video-based telehealth use is growing — with one 2023 study showing that live video telehealth and in-person care quality were similar across health outcomes and utilization — it is important to note that various non-clinical factors influence patient perceptions of the care modality.

“This is a reminder that patients often do care about some of the details that providers and health systems may not have emphasized,” said lead researcher Nathan Houchens, MD, an associate professor of internal medicine at U-M and associate chief of medicine at VAAAHS, in the press release. “It’s important to remember that our words and our nonverbal behaviors are taken to heart by those we care for, and it behooves us to care about them as well.”