Is Telehealth as Good as In-Person? What the Evidence Says
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The body of evidence on telehealth has grown substantially since 2020, but it is worth noting that research into remote consultations predates the pandemic by decades. Australia has a long history of delivering care across distance, from the Royal Flying Doctor Service to the early adoption of telephone consultations in rural general practice.
Patient Satisfaction
Multiple studies have found that patient satisfaction with telehealth consultations is consistently high. A 2022 systematic review published in the Journal of Medical Internet Research analysed over 30 studies and found that patient satisfaction scores for video consultations were comparable to, and in some cases higher than, those for in-person visits. Patients frequently cited convenience, reduced travel time, and shorter wait times as key factors.
In Australia specifically, data from the Australian Digital Health Agency's national survey found that the majority of patients who had used telehealth services reported being satisfied with the experience and said they would use telehealth again. The Australian Bureau of Statistics' Patient Experience Survey has consistently shown growing acceptance of remote consultations, particularly among younger adults and patients in regional and remote areas.
Clinical Outcomes
The question that matters most to clinicians and patients alike is whether outcomes differ. A Cochrane systematic review examining remote patient consultations found no significant difference in clinical outcomes between telehealth and in-person care for a range of conditions, including chronic disease management, mental health, and post-operative follow-up. The review noted that the quality of evidence varied across conditions, but that the overall direction was reassuring.
A 2023 study published in The Lancet Digital Health examined clinical outcomes for patients managing chronic conditions through a combination of telehealth and in-person visits. The researchers found that patients who received a hybrid model of care had equivalent or improved outcomes compared to those receiving exclusively in-person care, particularly for conditions like diabetes, hypertension, and chronic respiratory disease.
In Australia, the Medical Journal of Australia published research showing that telehealth consultations during the pandemic resulted in no measurable decline in the quality of care for common general practice presentations. The study noted that GPs adapted their clinical approach to suit the remote format, including more detailed verbal history-taking and proactive follow-up.
Chronic Disease Management
Chronic disease is one of the areas where telehealth has the strongest evidence base. The World Health Organisation has noted that digital health interventions, including telehealth, can support the management of non-communicable diseases by improving access to regular clinical review. For patients with diabetes, for example, regular check-ins with a GP to review blood glucose levels, adjust medication, and monitor for complications can be conducted effectively via video consultation when combined with home monitoring devices.
The Royal Australian College of General Practitioners (RACGP) has acknowledged that telehealth plays a legitimate role in chronic disease management, particularly for patients who face barriers to regular in-person attendance. Their guidelines note that telehealth should be part of a broader care plan that includes periodic physical examinations when clinically indicated.
Not all consultations require a physical examination. Many of the most common reasons Australians visit a GP are well suited to a video or phone consultation. Understanding where telehealth excels helps patients make informed decisions about how to access care.
Chronic Care and Medication Reviews
For patients already diagnosed with a chronic condition, regular reviews are essential. These consultations typically involve discussing symptoms, reviewing test results, adjusting medication doses, and planning the next steps in treatment. A GP who has access to a patient's full medical history can conduct these reviews effectively via telehealth, often with greater frequency than would be practical if every appointment required an in-person visit. This is particularly relevant for conditions like hypertension, type 2 diabetes, asthma, and high cholesterol, where the ongoing management conversation is more important than any single physical finding.
Mental Health
Mental health is one of the strongest use cases for telehealth. A systematic review published in JMIR Mental Health found that outcomes for telehealth-delivered psychological support and psychiatric consultations were equivalent to in-person care across a range of conditions, including depression, anxiety, and post-traumatic stress disorder. Patients in several studies reported feeling more comfortable discussing sensitive topics from their own home, without the added stress of travelling to a clinic or sitting in a shared waiting room.
In Australia, the uptake of telehealth for mental health consultations has been significant. Healthdirect data shows that mental health-related telehealth appointments have remained well above pre-pandemic levels, suggesting that patients and clinicians alike recognise the effectiveness of this format.
Medication Management and Prescriptions
Prescription renewals, medication reviews, and discussions about side effects are consultations that frequently do not require a physical examination. A GP who knows a patient's medication history can review their current regimen, order follow-up blood tests, and issue scripts via telehealth. This reduces the burden on patients who might otherwise need to take time off work or arrange transport to a clinic for a straightforward medication conversation.
Follow-Up Appointments
Post-consultation follow-ups are another area where telehealth is highly effective. After an initial assessment, whether in-person or online, a follow-up appointment to discuss test results, check on recovery, or adjust a treatment plan can almost always be done remotely. This improves compliance with follow-up schedules, because the friction of attending another in-person appointment is removed.
Rural and Remote Access
For Australians living outside major metropolitan centres, the question of telehealth versus in-person care takes on a different dimension. In many regional and remote communities, the nearest GP clinic may be hours away. Specialist services may require travel to a capital city. In these settings, telehealth is not a convenience — it is often the only practical way to access timely care.
The Australian Digital Health Agency has highlighted the role of telehealth in reducing geographic barriers to healthcare, noting that patients in rural and remote areas were among the highest adopters of telehealth during and after the pandemic. For these communities, the alternative to a telehealth appointment is often no appointment at all.
It would be irresponsible to suggest that telehealth can replace all in-person care. There are clinical scenarios where a physical examination, a procedure, or hands-on assessment is necessary for safe and accurate care.
Physical Examinations
Some conditions require a clinician to listen to heart and lung sounds, palpate the abdomen, examine the skin, check reflexes, or assess range of motion. While a video consultation can provide useful visual information, it cannot replicate the diagnostic information gained from a stethoscope, otoscope, or direct palpation. Conditions that present with lumps, rashes requiring close inspection, abdominal pain, or musculoskeletal injuries often warrant an in-person visit.
Procedures and Diagnostic Imaging
Any consultation that may require a procedure, from a skin biopsy to wound care to joint injection, needs to happen in person. Similarly, diagnostic imaging such as X-rays, ultrasound, and blood collection requires a patient to attend a physical location. A thoughtful GP will identify early in a telehealth consultation whether a patient needs to be seen in person and facilitate that transition promptly.
Acute Emergencies
Telehealth is not appropriate for medical emergencies. Chest pain, difficulty breathing, severe allergic reactions, signs of stroke, serious injuries, and other acute presentations require immediate in-person emergency care. Any responsible telehealth service will make this clear to patients and have protocols in place to direct patients to emergency departments or to call 000 when the situation demands it.
Paediatric Assessments
While telehealth can work well for many paediatric consultations, particularly follow-ups and behavioural health discussions, some assessments in young children benefit from in-person examination. Ear infections, throat assessments, growth monitoring, and developmental checks often require direct clinical evaluation.
Complex New Presentations
When a patient presents with a new, complex, or unclear set of symptoms, an in-person consultation allows for a more comprehensive assessment. The GP can perform a full physical examination, observe the patient's gait and demeanour, and conduct point-of-care testing if available. For these first-contact presentations, in-person care often provides a more complete clinical picture.
The most evidence-supported approach is not telehealth versus in-person care. It is telehealth and in-person care, used together based on clinical need. This is sometimes called a hybrid model, and it reflects how modern general practice is evolving in Australia and internationally.
A hybrid approach means that a patient might have a telehealth consultation for a routine medication review, an in-person visit for an annual health check that includes a physical examination, and another telehealth follow-up to discuss the results. The mode of consultation flexes around the clinical question, not the other way around.
The RACGP has endorsed this flexible approach, noting that the decision about whether a consultation should occur via telehealth or in person should be a clinical one, made collaboratively between the GP and the patient. Their position statement on telehealth recognises it as a permanent and valuable part of Australian general practice, not a temporary pandemic measure.
What makes a hybrid model work well is continuity of care. When a patient sees the same GP or a small team of clinicians over time, the clinician builds a deep understanding of the patient's health history, preferences, and circumstances. That continuity means the GP knows when a telehealth consultation is appropriate and when the patient needs to come in. It also means the patient trusts their GP's judgment on that question.
Research from the Australian Institute of Health and Welfare supports the link between continuity of care and better health outcomes, including fewer hospitalisations, lower emergency department use, and higher patient satisfaction. The hybrid model, when anchored to a continuous care relationship, brings together the best of both formats.
Abby Health is an online-first clinic, and that distinction matters. Online-first does not mean online-only. It means that the default starting point for a consultation is online, because for the majority of general practice presentations, that is the most convenient and clinically appropriate format. But when a patient needs in-person care, Abby's clinicians identify that need and refer accordingly.
This approach is grounded in the same evidence outlined above. Abby Health does not position telehealth as a replacement for all in-person care. Instead, the clinical team makes judgments about each consultation, guided by RACGP standards and the patient's individual circumstances.
Continuity of Care
One of the most important things that distinguishes Abby Health from other online services is its commitment to continuity. Patients are encouraged to see the same GP over time, building a long-term relationship that mirrors the traditional model of having a regular family doctor. This is reflected in Abby's rebook rate: 71 per cent of patients return to see the same clinician. That figure matters because it means the majority of patients are building ongoing care relationships, not receiving one-off transactional consultations.
Continuity of care is not just a patient experience metric. As the evidence shows, it is associated with better clinical outcomes. When a GP knows a patient's full health story, they can make more informed decisions about what can be managed via telehealth and what requires in-person assessment.
The Role of Abby AI
Abby AI, Abby Health's medical AI, plays a supporting role in every consultation. It surfaces a patient's medical history, past consultations, symptoms, and relevant risk signals so that the clinician starts each appointment informed. This is particularly valuable in a telehealth setting, where maximising the clinical value of the consultation time is important.
Abby AI does not diagnose, prescribe, or make clinical decisions. It is a decision-support tool that helps clinicians prepare for the consultation and ensure nothing in the patient's history is overlooked. The result is a more thorough conversation, even in a fifteen-minute video appointment.
Scale and Accessibility
With more than 300 clinicians available seven days a week, 365 days a year, Abby Health provides access to GP care that many Australians struggle to find through traditional clinics. For patients in rural and remote areas, for those who cannot take time off work, and for those who have been unable to find a regular GP accepting new patients, an online-first model removes barriers that would otherwise delay or prevent care.
That scale does not come at the cost of quality. Abby's clinical governance is overseen by a Clinical Director who sits on the AMA NSW Council, and the clinic's patient ratings reflect the standard of care delivered: 4.8 on Trustpilot, 4.8 on Google, and 4.9 on the App Store.
Ready to see a GP online?
Is telehealth covered by Medicare in Australia?
Yes. Medicare rebates for telehealth consultations with GPs were made permanent by the Australian Government. This means that eligible patients can access bulk billed telehealth appointments in the same way they would access bulk billed in-person consultations. Eligibility for bulk billing depends on the provider and the patient's circumstances.
Can a doctor prescribe medication during a telehealth appointment?
Yes. GPs are able to prescribe medication during a telehealth consultation, including issuing electronic prescriptions that can be filled at any pharmacy. There are some medications and clinical scenarios where a GP may determine that an in-person consultation is required before prescribing, and this is a clinical judgment made on a case-by-case basis.
Is telehealth suitable for mental health consultations?
Research consistently supports the use of telehealth for mental health care. Video consultations allow for meaningful therapeutic conversations, and many patients report feeling more comfortable discussing mental health concerns from their own home. Telehealth mental health appointments are covered under Medicare, and GPs can create and review Mental Health Treatment Plans via telehealth.
When should I choose an in-person appointment over telehealth?
If your consultation is likely to require a physical examination, a procedure, diagnostic imaging, or a blood test, an in-person appointment is the better choice. If you are experiencing a medical emergency, go directly to your nearest emergency department or call 000. For most other consultations, including medication reviews, follow-ups, mental health support, and chronic disease management, telehealth is clinically appropriate.
How does Abby Health decide when to refer a patient to in-person care?
Abby Health's clinicians are trained to identify when a consultation requires in-person assessment. During a telehealth appointment, if the GP determines that a physical examination, procedure, or in-person investigation is needed, they will advise the patient accordingly and facilitate a referral or recommend attending a local clinic or hospital. The clinical judgment always takes priority over the mode of delivery.
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