While telemedicine holds great promise for making health care more accessible and more cost-effective, there are still some interactions that doctors believe should not take place online or over the telephone.

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

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

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

The survey comes only several months after a team of researchers actually argued that phone consultations might be a better way to deliver potentially tragic news to patients. In an article for JAMA Oncology, University of Michigan researchers Naveen Krishnan, Angela Fagerlin, and Ted Skolaris highlighted studies that showed patients care most about the content of the message when receiving bad news, rather than the sense of emotional support they received from the doctor, including signs of affection and compassion, such as the physician holding their hand.

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

But it’s clear, according to the most recent survey, that many physicians believe the consolation a doctor can offer immediately following bad news is invaluable, whether or not the patients say so in a survey.

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

Instant Insights /

Doctors say telemedicine isn't good for giving bad news

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