Americans have become accustomed to observing their doctors and other healthcare providers using telehealth video visits over the past four years. However, a recent study shows that the background that a doctor has during a telehealth visit can impact how the patient perceives them and their care.Even if the doctor is far from their regular in-person clinic or exam room, they should create the appearance that they are there, according to the study. Additionally, having a virtual background that resembles an office or sitting in an office with their diplomas displayed can be even better, especially when seeing a patient for the first time. Patients also find a home office with a bookshelf or a plain solid-color background acceptable. However, if the visit is conducted in a home environment with a kitchen or bed in the background, providers should use blurred or virtual backgrounds.
The study findings were derived from a survey in which patients were asked to evaluate seven different backgrounds behind a model physician. They were asked to assess the physician’s knowledge, trustworthiness, caring, approachability, and professionalism, as well as their comfort level with the provider. Patients were also asked to consider each background in the context of a first or returning appointment with a primary care or specialty provider.
The study, conducted by a team from the University of Michigan’s academic medical center, Michigan Medicine, and the VA Ann Arbor Healthcare System, is published in JAMA Network Open. More thanThe study surveys were completed by 1,200 patients who had appointments at either of the two health systems, and their responses were compiled by the researchers. Dr. Nathan Houchens, an associate professor of internal medicine at U-M and associate chief of medicine at VAAAHS, led the research. His previous work on how non-verbal factors such as attire and posture impact the patient-provider relationship inspired the new telehealth study. The rapid shift to virtual care during the early stages of the COVID-19 pandemic happened without specific guidance, prompting the need for the study.”Telehealth appears to be here to stay so it’s important to understand what patients prefer when it comes to the setting their provider is in,” says Houchens, a hospitalist who worked with U-M and VA general internist Jennifer Meddings, M.D., M.Sc. and others on the study.
He notes that during the first year of the pandemic, providers were urged to conduct telehealth visits outside of clinics if they didn’t need to go in, to reduce the chance of COVID-19 transmission.
But now, some clinics have created dedicated spaces for providers to sit in if they have telehealth appointments on days when they’re also seeing patients in person. Some o
Some of these spaces may be shared with other healthcare providers, so using a virtual background could help reduce visual distractions.
Houchens points out that as telehealth usage has increased and become a common way to receive care, there has been some advice on how to interact verbally over a virtual connection, known as “webside manner”. However, there is very little guidance available regarding the background for video visits.
Houchens and his colleagues were surprised by the strong dislike that patients had for kitchen and bedroom settings, with only 2% and 3.5% respectively saying they preferred these backgrounds.
The results showed that compared to an office with displayed diplomas (35%), a physician office (18%), a plain color background (14%), and a home office with bookshelf or an exam room, the bedroom and kitchen backgrounds received much lower composite scores from patients. The study also revealed significant differences in how patients rated the different backgrounds in terms of how they would feel about receiving care from the provider. Houchens, along with co-author Sanjay Saint, M.D., M.P.H., have previously conducted research on patients’ preferences.The article discusses the importance of physicians’ attire and workspaces during clinical encounters. The author suggests that these factors, although seemingly insignificant, can have a significant impact on the patient’s overall experience. According to the author, patients have certain expectations regarding the appearance of physicians’ attire and workspaces. The study mentioned in the article indicates that patients prefer what has been previously defined as traditional or professional attire and settings. The presence of diplomas and credentials serves to remind patients of the expertise they expect from their physician. Conversely, the author argues that a relaxed, informal home environment as the background can detract from the patient’s perception of the physician’s expertise. The team is currently analyzing the data to further understand the impact of these factors on the patient experience.Extracting additional data from the same research in order to evaluate other factors impacting patients’ telehealth experiences, such as their access to high-speed internet and their proficiency with necessary technologies.
However, at present, they recommend that healthcare providers take immediate actions to carry out virtual appointments from an office or examination room. Medical facilities may consider offering unused clinical spaces for providers to conduct virtual appointments during in-person clinic days.
Alternatively, creating virtual backgrounds that simulate professional settings is another option.
Houchens also points out that they have not yet researched how physicians can improve the virtual visit experience.Consider the environments visible in the backgrounds of patients during video visits, as they could offer valuable insights. The increasing popularity of “Hospital at Home” and home-based primary care means that patients with more serious conditions may have the option to virtually consult with their healthcare providers. Their surroundings can provide indications of how physical and social factors influence their health. Taking into account the visible elements in a provider’s and a patient’s virtual background, such as art and other personal items, could also help establish a better connection, states Houchens. This serves as a reminder that patients often appreciate attention to certain details from healthcare providers.health systems may not have prioritized,” he said. “It’s crucial to remember that the way we communicate, both through our words and our nonverbal actions, has a significant impact on those under our care, and it is our responsibility to show genuine concern for them.”
Meddings and Saint are part of the VA Center for Clinical Management Research and the U-M Institute for Healthcare Policy and Innovation.
Aside from Houchens, Meddings, and Saint, the authors of the study include Latoya Kuhn MPH, David Ratz MS, Jason M. Engle MPH of VA CCMR.
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