Female, Behavioral Health Physicians Led Early Telehealth Adoption

Female, primary care, and behavioral health physicians were more likely to adopt virtual care early on during the COVID-19 pandemic compared to male and surgical specialty physicians, a study published in JAMA Network Open found.

While many health systems and practices transitioned to virtual care in response to the public health emergency, some individual physicians were slower than others when it came to telehealth adoption.

Massachusetts researchers focused on physicians at Mass General Brigham — a health system comprised of outpatient practice sites and 12 hospitals, including Brigham and Women’s Hospital and Massachusetts General Hospital — who conducted at least one virtual or in-person visit between October 1, 2019, and December 31, 2020.

The researchers used their databases to identify physicians’ age, gender, and specialty. Researchers also used the physicians’ birth years to categorize them by generation, including the Silent Generation (1928 to 1945), Baby Boomers (1946 to 1964), Generation X (1965 to 1980), and Millennials (1981-1996).

The study sample consisted of 3,473 physicians. Nearly half of the physicians were in Generation X (47 percent), 28 percent were Baby Boomers, 21 percent were Millennials, and 2.4 percent were in the Silent Generation.

Medical specialties were the most common specialty class, with 1,649 physicians, followed by primary care (807 physicians), surgical specialties (749 physicians), and behavioral health (248 physicians).

Out of all the physicians, 478 (13.8 percent) adopted virtual care before March 15, 2020 — the day of the public health emergency declaration in Massachusetts — and were dubbed innovators. Nearly half (45 percent) adopted virtual care during the first week of the public health emergency. Researchers classified these physicians as early adopters.

Just over a third of physicians (35.6 percent) adopted telehealth after the week of March 15, 2020, while 5.6 percent did not use virtual care at all as of December 31, 2020.

Primary care and behavioral health specialists were more likely to be early adopters compared to other specialty physicians. More than half of primary care physicians (64 percent) and 41 percent of behavioral health physicians adopted virtual care during the first week of the public health emergency. Additionally, nearly 10 percent and 30 percent of primary care and behavioral physicians, respectively, had adopted telehealth before the pandemic.

Behavioral health specialists may have been quick to implement telehealth due to the feasibility of using virtual care for conditions that do not require physical examinations. Physicians may have also transitioned quickly due to the increased need for behavioral healthcare services when the pandemic hit, researchers suggested.

Conversely, surgical specialty physicians were the least likely to have adopted telehealth before or during the first week of the public health emergency — 10 percent and 33 percent, respectively.

Female physicians were also more likely to be early adopters of virtual care compared to male physicians (51.2 percent versus 40.5 percent).

“Female physicians have previously been shown to have more patient-centered communication and to spend more time with their patients, and it is possible that their earlier transitions to virtual health care were a result of being more responsive to their perceptions of their patients’ needs with rapid changes early in the pandemic,” the researchers stated.

Additionally, Baby Boomers, Millennials, and Generation X physicians had higher rates of early telehealth adoption compared to older physicians in the Silent Generation. Millennial physicians were the most likely to have implemented telehealth prior to the pandemic.

Although the researchers hypothesized that technology barriers for older generations would be associated with lower levels of early adoption, Baby Boomers were just as likely as younger generations to implement telehealth early on, and the majority of physicians in the Silent Generation did end up using telehealth at some point during 2020.