A year ago, non-emergency surgery at many hospitals ground to a halt, as hospitals tried to free up space for COVID-19 patients and prevent the spread of the novel coronavirus among patients, staff and visitors.

A new study looks at how surgeons in different specialties "pivoted" to hold their appointments with new patients via telehealth in those first months, and what happened as the year went on and the possibility of in-person care resumed. New patient visits may not require in-person care to discuss surgical options and what to expect before, during and after an operation.

The researchers studied statewide data from a large Michigan insurance company, and looked not only at trends within 2020 but also comparisons with 2019 new-patient visits for a wide range of surgical specialties. 

They found that 59% of 4,405 surgeons in nine specialties studied from January through September 2020 used telehealth for any type of patient care. But only 27% of the surgeons studied used telehealth options at least once for an initial visit with a new patient who had been referred to them.

Out of the more than 109,600 new patient visits in the entire study period, 6% were done via telehealth – compared with less than 0.1% of such visits conducted this way in 2019.

The study shows that 35% of new surgical patient visits in April 2020, and 17% of all new patient visits from March through early June, were done by telehealth. But for June through early September, telehealth use for new surgical patient visits fell back to 3% of the total but remained higher than before the pandemic.

Of the nine specialties, studied, urology and neurosurgery had the highest percentage of surgeons using telehealth. Lower rates were seen among patients who were from rural areas and those living in ZIP codes with lower median incomes.

The researchers also compared telehealth vs in-person new-patient visit rates for 2020 with those from the same period in 2019. This allowed them to calculate a "conversion rate" that shows which specialties were more likely to convert in-person visits to telehealth even though the volume of operations occurring was much lower for part of 2020.

Paper cited: "Use of Telehealth by Surgical Specialties During the COVID-19 Pandemic," JAMA Surgery. DOI: 10.1001/jamasurg.2021.0979