Is Telemedicine Sufficient for New and Follow-up Patient Visits in Hand Surgery? Our Surgeons' Perspectives

Abstract Despite the effectiveness of telemedicine in various clinical settings, the role of physical examination and X-rays is crucial for assessing upper extremity issues. This study evaluates the adequacy of telemedicine for the evaluation and treatment of hand surgery patients. Seven surgeons from the Division of Hand Surgery at our institution completed surveys after each patient visit, including both initial and follow-up telemedicine and in-person visits. Data were analyzed using chi-square tests. Surgeons reported that about two-thirds of virtual initial visits were inadequate for evaluation and treatment, with a significant decrease in diagnostic confidence compared to in-person visits. X-rays were needed in 30.53% of these virtual initial visits. Additionally, virtual initial visits more frequently required follow-up, in-person appointments (86.6 vs. 28.8% for in-person visits, p < 0.001). For follow-up visits, no significant difference was found in the need for future in-person appointments (42.00% in-person vs. 35.29% virtual, p = 0.533). Comparing initial and follow-up virtual visits, follow-ups were rated as more adequate (86.27 vs. 37.5% for initial visits, p < 0.001) and required fewer future appointments (35.29 vs. 86.6%, p < 0.001). X-rays were necessary in only 5.88% of virtual follow-ups, and the most common reason for classifying virtual follow-up visits as accessory was the inability to provide injections. Although in-person visits are essential for comprehensive evaluation, particularly for new patients, virtual visits may be adequate for follow-up care, especially when physical exams and interventions are not required. Further research is needed to clarify the utility of virtual visits in different clinical scenarios. Survey, Level IV