We thank the author of the editorial comment for their insightful remarks and their enthusiastic response to our study. The COVID-19 pandemic certainly kicked adoption of telemedicine into high gear, and it will be fascinating to examine the extent to which the changes made over the past year are maintained in the coming months and years as the pandemic subsides.
We concur with the belief that andrology is a field well-suited to distance medicine. There are many populations that stand to gain from the widespread adoption of telemedicine. Certainly patients living in remote communities or those with impaired mobility may derive significant benefit from avoiding travel to in-person appointments. The andrology/infertility patient population is unique in certain respects from the average urology patient. Most importantly, these men tend to be younger, as indicated by our median patient age of only 48.5 years. With this difference comes certain considerations that are relevant to the acceptability of telemedicine in this population. While these men are less likely to be hindered by mobility or lack of social support when it comes to attending in-person appointments, absence from work is more likely to be an important factor for them. At the same time, young men may feel less comfortable discussing sensitive subjects such as erectile dysfunction or Peyronie's disease over videoconference or telephone compared to in an in-person appointment. This, in addition to the telephone vs video format, may explain why 27.1% of our study cohort said they would prefer future appointments to be conducted in-person instead of by telephone, which is higher than that reported in some other urologic studies assessing telemedicine acceptance.
It is clear that there is no single appointment modality that will be preferred by every patient. Each patient has unique preferences and values that will color whether face-to-face or telemedicine appointments are most appropriate for them. However, our study clearly demonstrates that a significant proportion of these patients prefer telemedicine appointments, in keeping with much of the telemedicine literature across various urologic subspecialties as well as other medical fields.
Sincerely,
Dr. Benjamin Shiff
Dr. Premal Patel