Surgeon Personal Factors Associated with Care Strategies in Musculoskeletal Telehealth

Document Type : RESEARCH PAPER


1 Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA

2 Department of Orthopaedic Surgery, Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen at Groningen, The Netherlands


Background: Most surgeons used, or are currently using telehealth during the SARS-CoV-2 (COVID-19) pandemic.
We studied surgeon personal factors associated with relative use of telehealth during the worldwide height of the
Questions/Purposes: (1) Are there any personal factors/characteristics associated with use and utilization of telehealth?
(2) What are surgeon’s perspectives/ opinions with regard to use of telehealth for five common upper extremity
conditions in terms of future prospects and viability?
Methods: Hand and upper extremity surgeons in the Science of Variation Group (SOVG) were invited to participate in
a web-based survey. The first part of the survey focused on surgeon characteristics and work preferences. The second
part focused on care strategies during the pandemic and utilization of telehealth. The final part of the survey addressed
the care of five common upper extremity conditions during the pandemic.
Results: Ninety percent of surgeons used telehealth during the first few months of the pandemic, but only 20% of
visits were virtual. A greater percentage of telehealth visits compared to office visits was independently associated with
a policy of only seeing people with emergencies in person (RC: 0.64; CI 95%: 0.21 to 1.1; P<0.01). Surgeons found
it difficult to reproduce most parts of the physical examination on video, but relatively easy to make a diagnosis, with
both ratings associated with less belief that the physical exam is essential. Comfort in offering surgery by video visit
was associated with having young children, preference for remote meetings, and less belief that the physical exam is
Conclusion: Utilization of, and comfort with, telehealth is related to personal factors and preferences, acceptance of
a more limited physical examination in particular. Utilization of early adopters and training to increase comfort with the
probabilistic aspects of medicine could facilitate incorporation of telehealth into standard practice.
Level of evidence: N/a


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