Zocdoc Reports – The Healthcare Experience: 2022

Zocdoc appointment booking trends, and user and provider surveys, show how healthcare has evolved in the two years since the onset of the COVID-19 pandemic, and shed light on the highs and lows of delivering and receiving care during an unprecedented time

Data points to a pronounced preference, with the exception of mental health, for in-person care, and for the use of telehealth as one part of the overall continuity of care

NEW YORK, June 22, 2022 /PRNewswire/ — Zocdoc, the leading healthcare marketplace that makes it easy for people to find and book in-person or virtual care across +200 specialties and +12k insurance plans, today announced “The Healthcare Experience: 2022”, a comprehensive report that includes data from Zocdoc user and provider surveys, and an analysis of healthcare appointment booking trends beginning in May 2020 – the first full month Zocdoc facilitated video visit bookings – through May 2022.

To uncover insights regarding how users’ booking choices, and the perspectives of providers and users, evolved throughout the pandemic, Zocdoc conducted provider and user (“patient”) surveys, and analyzed aggregated appointment booking data. The results show four key insights, detailed below.

Prior to the pandemic, telehealth represented just ~1% of care. At its onset, amid stay-at-home orders and concerns about contracting COVID-19, many Americans turned to telehealth to safely get the care they needed; at telehealth’s peak, between March and August 2020, 13% of outpatient visits were conducted via telehealth. As Americans have emerged from the acute beginnings of the pandemic and adapted to a new normal, an overwhelming majority of patients are choosing to see their doctors in-person again.

In May 2020, 33% of all appointments booked via Zocdoc were telehealth visits. By May 2022, that number had declined significantly, to 17%. Excluding mental health, the only specialty which skews toward virtual care, just 9% of appointments in May 2022 were conducted virtually.

By specialty, the percentage of in-person appointments in May 2020, May 2021, and May 2022 was as follows:

• Primary Care Physician: 58% → 87% → 83%
• OB-GYN: 85% → 97% → 98%
• Dermatologist: 62% → 91% → 95%
• Dentist: 96% → 99% → 99%
• Optometrist: 92% → 100% → 100%
• Orthopedic Surgeon: 77% → 96% → 98%
• Podiatrist: 82% → 96% → 98%
• Chiropractor: 98% → 100% → 100%
• ENT: 64% → 95% → 98%
• Psychiatrist: 25% → 15% → 15%
• Ophthalmologist: 89% → 97% → 99%
• Gastroenterologist: 60% → 79% → 86%
• Urologist: 74% → 94% → 96%
• Pediatrician: 75% → 89% → 92%
• Allergist: 64% → 91% → 96%
• Cardiologist: 75% → 92% → 96%
• Neurologist: 52% → 86% → 92%
• Psychologist: 20% → 13% → 18%

Additionally, within this minority of virtual appointments, it is clear that patients using telehealth understand they may someday want or need to visit their provider’s office in person. Between May 2020 and May 2022, across all specialties excluding mental health, 81% of in-person appointments and 61% of virtual appointments were located less than 20 miles from the patient’s home address.

This is further evidenced when examining rebooking trends during the same timeframe. While 82% of first-time appointments with a new provider take place in person, those who meet a provider for the first time virtually often make an in-person follow-up appointment: a significant portion of the 18% of virtual appointments with a new provider eventually result in an in-person rebooking.

For patients who booked a virtual visit with a new provider via Zocdoc, and then rebooked an in-person appointment at the same practice using Zocdoc, there were three distinct groups of specialties with similar patterns of offline-online continuity of care:

• High likelihood of in-person rebooking: OB-GYN, Eye Doctors, and Dentists. 50-60% of people who booked a virtual visit with a new provider in these specialties booked a second, in-person appointment with that same practice.
• Medium likelihood of in-person rebooking: Dermatologists, Specialists, PCPs, and the average of all specialties excluding mental health. 30-45% of people who booked a virtual visit with a new provider in these specialties booked a second, in-person appointment with that same practice.
• Lower likelihood of in-person rebooking: Mental Health. Less than 5% of people who booked a virtual visit with a new mental health provider booked a second, in-person appointment with that same practice.

This use of telehealth as a singular component of the overall care experience, which includes a combination of virtual and in-person interactions with providers, was also reflected in the Zocdoc user survey.

In response to the statement, “I believe I will utilize a combination of telehealth and in-person care in the future,” 77% of patient survey respondents indicated they either “agree” or “strongly agree.” An even greater majority of providers agreed that the future includes an interconnected on- and offline care experience: 83% of survey respondents said they “agree” or “strongly agree” that the future of healthcare will include a combination of telehealth and in-person visits for most patients and providers.

Despite the return to in-person care across every other healthcare specialty, mental health – which represents more than half of Zocdoc’s top 10 fastest-rising appointment booking reasons year over year – is an anomaly. It remains the only specialty in which the percentage of virtual care bookings remains higher than peak pandemic booking levels. In May 2020, 74% of mental health bookings were virtual. In May 2021, 85% of mental health bookings were virtual, and, in May 2022, that number rose to 87%.

Patients surveyed noted convenience, the comforts of home and a perception of increased intimacy as reasons they appreciate virtual visits with mental health providers. With regard to convenience, one patient said, “It is convenient, requiring less time off work and [it is] less expensive because I don’t need to pay for transportation,” while another stated, “I’m more likely to fit it in my schedule than if I need to travel for an appointment.” A third said, “I had already seen my doctor in person, and I simply needed a new prescription for the same issue, so I didn’t need to see her in person again.”

Addressing the benefits of at-home comforts and the perception of increased intimacy, one patient said, “Having my pet there made me feel calmer and I loved it,” and another stated, “My healthcare provider got to see how I truly look on a typical day – in bed with an IV hooked up. I think this helped her see the reality of my illness instead of the put together image I try to portray when I go in person.”

This ease of access to care for patients, and the ability for providers to deliver high-quality virtual care, has been crucial during a time when more than 40% of U.S. adults are reporting symptoms of anxiety and depression and providers are reporting a 93% increase in patients seeking anxiety resources.

By surfacing appointment availability in real-time, Zocdoc significantly accelerates access to care. The average U.S. patient seeking mental health care waits an average of 25 days to see a psychiatrist, with some waiting more than 90 days, and wait times for mental practitioners are growing overall.

This delay of access has significant consequences. According to National Council for Behavioral Health (NCBH) President and CEO Linda Rosenberg, referencing a recent study from the NCBH and the Cohen Veterans Network, “For every one day of wait time, you lose 1 percent of the patients — so if you have a 21-day wait, 21 percent of the patients seeking care just will give up and not show up.” On Zocdoc, the median number of days between a Zocdoc user booking a mental health appointment and attending that appointment is between 4-5 days for an in-person visit and 5-6 days for a virtual visit.

Since the onset of the pandemic, 30% of patient survey respondents indicated they’d had 6+ telehealth appointments, 50% have had 2-5, and 20% have had just 1 telehealth appointment. Of these respondents, 50% described their location as urban, 41% as suburban, and 9% as rural.

Convenience topped the list of reasons patients chose to use telehealth during the pandemic. When asked to pick up to three reasons virtual care had been useful since March 2020, 60% of patient survey respondents noted quick and easy access to providers; 56% enjoyed not having to take time off work or responsibilities to travel to appointments; 31% were able to access providers who are far away; and 30% said they could more easily have a follow-up or introductory appointment. Additionally, 15% of respondents said telehealth made managing their chronic illness easier, and 8% said they felt more comfortable sharing personal details via video than in-person. For those who specified another reason, avoiding exposure to COVID-19 was by far the most common write-in answer, cost savings was a close second, and the comfort offered by being able to interact with pets to reduce stress was third.

As one survey respondent said, “Having online appointments requires only an hour of time versus multiple hours, gas costs, and travel time and there’s no contact with the population so as to prevent possible covid infection.”

Providers agreed with convenience as a benefit of telehealth, with 57% appreciating ease of access to patients; 19% noting they could more easily fill their day with patient visits; 55% appreciating the flexibility to work remotely; 15% saying they can more easily conduct a follow-up or introductory appointment; and 43% noting they could serve patients in more rural or remote areas.

While convenience is an important benefit, differences between provider and patient perceptions of care surfaced in the survey results. For example, 31% of patient survey respondents indicated it was “easier” or “much easier” to build a relationship with their provider via telehealth versus in-person. A number of patients indicated that the decreased level of formality in provider interactions, and the increased level of relatability that resulted, provided comfort. As one patient said, “I saw my provider’s dog in the background during our first session, which was fun and I think helped me connect with her.”

However,  just 7% of providers agreed. In fact, 37% of providers surveyed said it was “more difficult” or  “much more difficult” to build a relationship with patients via telehealth.

Questions of the ability to deliver quality care via telehealth also arose, with 58% of providers indicating it was “more difficult” or “much more difficult” to examine patients via telehealth compared to in-person. Just 3% said it was “easier” or “much easier” to do so. 25% of providers surveyed said it wasn’t possible to provide the type of care the patient expected via telehealth, while 15% of patients experienced the same.

As one provider said, “As a specialist, I am unable to do much for my patients [virtually]. We cannot take x-rays, perform ultrasound studies, do gait analysis, etc. We cannot dispense any of the durable medical equipment (DME) necessary to get the patient better. We are unable to take samples for pathology reports, apply casts, scan for orthotics, and many other things.”

Another said, “During the pre-vaccination phase of the pandemic, when in person was too dangerous, was the only time [telehealth] was helpful.”

Technology and connectivity issues also played a role in the delivery of virtual care, with differing opinions between providers and patients. While 58% of providers indicated they and/or their patient had connectivity issues or trouble with the tech set-up, just 30% of patients surveyed said they’d experienced these issues.

Many Americans have delayed or canceled health care since the pandemic’s onset – and we’re still catching up as a nation.

When asked to describe their approach to preventive care since the pandemic began, 63% of patients said they put off preventive care during the early stages of the pandemic. 24% said they put off preventive care during the early stages of the pandemic and have not yet caught up on scheduling those appointments. 22% stated they put off preventive care during the early stages of the pandemic and have made progress in catching up on scheduling preventive care appointments. 17% said they put off preventive care during the early stages of the pandemic and have caught up on preventive care appointments, and 38% of patients surveyed said their approach to preventive care appointments did not change during the pandemic.

But it’s not just preventive care that’s making a comeback. Across all specialties, the top 10 fastest-rising appointment booking reasons year over year* were:

• Sexually Transmitted Disease (STD) Testing (+300%)
• Relationship Struggles (+273%)
• Borderline Personality Disorder (BPD) (+266%)
• Confirmation of Pregnancy (+224%)
• Family Therapy/ Marriage Therapy (+216%)
• Flu (+193%)
• Comprehensive Eye Exam (+188%)
• Cognitive Behavioral Therapy (CBT) (+188%)
• Couples Therapy (+178%)
• Bereavement / Grief Counseling (+175%)

Excluding mental health, the top 10 fastest-rising appointment booking reasons year over year* were:

• Sexually Transmitted Disease (STD) Testing (+300%)
• Confirmation of Pregnancy (+224%)
• Flu (+193%)
• Comprehensive Eye Exam (+188%)
• Bad breath/Halitosis (+160%)
• COVID-19 RT-PCR Test (+154%)
• Cold (+154%)
• Acne Scarring (+136%)
• Sick Child Visit (+120%)
• Wellness Care (+119%)

Finally, within mental health, a majority of the top 10 fastest-rising appointment booking reasons year over year* are likely related to the ripple effects of the pandemic:

• Relationship Struggles (+273%)
• Borderline Personality Disorder (BPD) (+266%)
• Family Therapy/ Marriage Therapy (+224%)
• Cognitive Behavioral Therapy (CBT) (+187%)
• Couples Therapy (+177%)
• Bereavement / Grief Counseling (+175%)
• Stress Management (+153%)
• Therapy (+151%)
• Post-Traumatic Stress Disorder (PTSD) Counseling (+146%)
• Prescription / Refill (+140%)

With 81% of Americans having used video calling and conferencing during the pandemic, the public has gotten used to friends and colleagues noting, “you’re on mute,” and seeing or hearing pets, family and friends in the background of video calls. Healthcare appointments are no different.

Of the providers surveyed regarding their experiences while providing telehealth, 36% have seen a patient’s pet, 31% have seen a patient’s family member or roommate, and 42% have seen patients outside their home.

Of the patients surveyed, 14% said their pet appeared in the background, 6% indicated a family member or roommate appeared in the background, 3% noted a family member or roommate did something distracting or funny on video, and 21% said they joined a call outside their home.

Sometimes, these interactions led to deeper understanding. As one provider said, “As a mental health professional, seeing an individual’s home provides great insight into their worldview.”

Other times, the circumstances of a virtual visit make it harder to deliver or receive care. Notable situations shared by providers include:

• A patient plucking their eyebrows during an appointment, not realizing the video was on
• Patients taking video calls while using the restroom
• A cat jumping on a client’s head during hypnosis
• A patient dialing in while rollerblading on the beach
• Kids interacting with their parents calls, from playing peekaboo, to speaking with the provider, and beyond

Distractions don’t just come from patients. Providers are also humans with real lives that don’t always lend themselves to perfect video interaction. Notable situations shared by patients include:

• Mistaking a provider’s frozen video for an impressively focused, intense gaze
• An unmade bed as a provider’s backdrop
• A provider conducting a video appointment from his car
• Seeing a therapist’s cat lick itself for 45 minutes straight
• Meeting a provider’s “really cute!” pet parrot

The physical limitations of virtual care created issues for many. One patient said, “My telehealth appointment was a failure. I had to go to the clinic, as the doctor couldn’t treat me without an exam,” and another said, “[Sometimes I] need to talk to the physician or other medical person face-to-face, including taking [blood] pressure, and other physical exams where hands on the patient are involved…for podiatry issues, I want the podiatrist to inspect my foot with his hands.”

Many concluded that telehealth was primarily useful as a triage or regular check-in tool when a physical examination wasn’t important. One patient said, “[Telehealth should be] triage-only. It’s a lot more convenient, since I don’t have to physically be somewhere for a doctor’s appointment and I can schedule them during my workday during a lunch break or something. I’m not chronically sick and I usually know what’s wrong with me when I need to see a doctor (psychiatric check-up, prescription refills, etc.). I probably wouldn’t use telehealth for more serious things or if I need a diagnosis.”

Insights from Zocdoc appointment booking trends, and user and provider surveys, reveal American patients’ desire for choice and connection in their healthcare experience. They do not want telehealth to be the only way they interact with healthcare professionals; they prefer in-person care, and hope to use a combination of virtual and in-person care in the future. They want the convenience of virtual care for narrow, specific circumstances, such as screenings and prescription refills. They also want ongoing relationships with providers, and to get high quality care, whether in-person or virtually. The insights also show the importance of providers offering choice and focusing on creating a seamless continuity of care experience regardless of appointment location.

For more information, contact press@zocdoc.com.  If you are interested in working with Zocdoc to streamline scheduling, and improve Americans’ access to care — in-person or virtually — you can learn more at zocdoc.com/join.

If you are interested in sharing a story about your healthcare journey, to help Zocdoc drive regulatory and legislative changes that put patients first, please visit https://www.zocdoc.com/about/patient-stories/.

Zocdoc is a leading digital healthcare marketplace for in-person or virtual care. Each month, millions of people use our free service, via Zocdoc.com or the Zocdoc app, to find in-network doctors, instantly book in-person or virtual appointments, read reviews from verified users, get reminders for upcoming appointments and preventive checkups, and more. With a mission to give power to the patient, Zocdoc’s platform delivers the accessible and simple experience they expect and deserve.

* The “top 10 fastest-rising appointment booking reasons” reflects the most popular visit reasons booked from January-May 2022, compared to that same time period in 2021.

Contact
Sandra Glading
sandra.glading@zocdoc.com 

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