While telemedicine holds great promise formaking health care more accessible and more cost-effective, thereare still some interactions that doctors believe should not takeplace online or over the telephone.

A recent survey of 309 doctors conducted by mHealth Intelligence and Aptus Health finds that 88 percent ofphysicians believe that a bad biopsy result should be delivered toa patient face-to-face, rather than by a less direct method, suchas text, email, phone or a video consultation.

“The very thought is abhorrent and the opposite of (a) caringphysician,” said one respondent, according to mHealth.

Granted, there are some inevitable exceptions to the rule. Somedoctors noted that delivering the results as quickly as possible ismore important than waiting for a face-to-face interaction if thepatient lives far away. And in some instances, patients wouldactually prefer to receive bad news over the phone, a preferencethat one doctor told mHealth is good to confirm beforehand.

The survey comes only several months after a team of researchersactually argued that phone consultations might be a better way todeliver potentially tragic news to patients. In an article for JAMAOncology, University of Michigan researchers Naveen Krishnan,Angela Fagerlin, and Ted Skolaris highlighted studies that showedpatients care most about the content of the message when receivingbad news, rather than the sense of emotional support they receivedfrom the doctor, including signs of affection and compassion, suchas the physician holding their hand.

“Telemedicine allows physicians to focus on content rather thannonverbal communication that patients may not appreciate at theinitial in-person visit,” said the study.

But it’s clear, according to the most recent survey, that manyphysicians believe the consolation a doctor can offerimmediately following bad news is invaluable, whether or not thepatients say so in a survey.

“Would a TV be the same as a handshake, a touch, being in thesame room?” said one doctor. “When discussing bad news, one needsto be prepared for different reactions, and it is hard to react 10miles away.”