Virtual care is now the access layer for specialty care, survey finds

For years, physicians have watched telehealth get talked about in pieces — a video visit here, a portal message there, a phone check-in tucked into an otherwise ordinary day. A new industry survey found that fragmented framing is outdated, and that patients stopped experiencing virtual care that way long ago.

Virtual Care in America: The Populus Report, released by Populus Health Technologies in partnership with DHC Group, PM360, and Researchscape International, surveyed 1,093 U.S. patients, 125 U.S. healthcare providers, and 63 pharma marketing professionals between February and March 2026.

The report's central argument is a redefinition. Rather than treating telehealth, patient portals, secure messaging and phone follow-up as separate channels, Populus frames them as one category: "the category of all digital environments — video, phone, text, email, patient portal, and the modalities yet to come — where a patient and a healthcare provider exchange clinical attention." Telehealth, in this view, is a tactic. Virtual care is the environment it lives in.

Follow-up and prescriptions lead; chronic care management is close behind

The provider survey found broad, cross-specialty comfort with virtual care for two tasks in particular: follow-up appointments and prescription refills or medication management, with appropriateness ratings ranging from 85% to 100% depending on specialty. Chronic care management trailed somewhat, at 68% to 80% across the specialties studied.

But those topline numbers obscure real variation once you look specialty by specialty, says Andrew Schulman, vice president of marketing at Populus. "Specialty-level differences are significant for clinicians to understand," he says, pointing to a set of contrasts in the provider data. Dermatology, for instance, "shows 100% appropriateness for follow-up and prescription management, but only 17% for mental and behavioral health — the sharpest specialty contrast in our data." General and family practice providers, by comparison, were significantly more likely than other specialties to see virtual care as appropriate for mental and behavioral health concerns (86%) and acute illness (59%).

Cardiology told a different story again. Providers in that specialty rated virtual care appropriate for follow-up at 95% and for chronic care management at 80% — numbers Schulman attributes to "a practice pattern organized around longitudinal management" rather than acute diagnosis. Endocrinology and gastroenterology showed similarly strong adoption for chronic care (76% and 75%, respectively) and prescription management (88% and 95%).

That specialty split isn't unique to the Populus data. A Health Affairs analysis of 2022 Medicare fee-for-service claims, covered by Medical Economics, found psychiatry logged the highest share of telehealth claims of any specialty — 44.6% for male physicians and 49.1% for female physicians — with neurology a distant second at roughly 12% to 16%. Dermatology, consistent with the Populus findings on clinical skepticism, posted the lowest telehealth claims share of any specialty studied, under 1% for both sexes.

The specialties where virtual care is "the access layer," not a convenience

The report's most interesting numbers concern patients who say they would have delayed or skipped care entirely without a virtual option. Across four specialties, majorities of patients reported exactly that: 78% in neurology, 75% in mental and behavioral health, 73% in OB/GYN, and 70% in cardiology.

"These are not convenience findings," Schulman says. "They describe a category of care that is now load-bearing for specialty access in the United States, particularly in areas with limited local specialist availability." He points to supporting provider data: 68% of clinicians say virtual care gives patients access to specialists who aren't locally available, and pharma marketers separately identified rural HCP reach as the clearest use case where virtual care outperforms traditional channels.

The driver, Schulman says, is structural rather than incidental. "The driver in all three specialties is access, not convenience," he says of cardiology, OB/GYN, and neurology specifically. "These are fields where patients face real barriers to seeing a specialist in person. Geography, wait times, transportation, and the episodic nature of symptoms in conditions like neurology that may not present during a scheduled appointment. Virtual care is filling a structural gap in the care system, not simply making an already-accessible experience easier."

Neurology stood out as the clearest case: with 78% of patients saying they'd have delayed or skipped care, it posted the highest rate in the dataset, which Schulman links to specialist scarcity and the geographic distribution of neurologists nationally. OB/GYN showed the highest patient recency of any specialty measured — 96% had used virtual care within the past six months — with patients using it most often for consultations and second opinions, suggesting it “is serving a decision-support function alongside in-person care rather than replacing it."

That access story squares with reporting Medical Economics has done separately on telehealth's role for higher-need patients. A February Annals of Internal Medicine analysis, also covered by Medical Economics, found telehealth users on Medicare were more likely to have physical or cognitive limitations, rate their health as fair or poor, and log substantially more outpatient visits overall than patients who saw clinicians only in person. "It's hard to imagine going back to a world where telehealth is a tiny fraction of all the health care that's delivered," Terrence Liu, M.D., assistant professor of internal medicine at University of Utah Health, told Medical Economics. Kyle Zebley, CEO of the American Telemedicine Association, told Medical Economics that telehealth use today is "exponentially greater than it had been prior to the pandemic," estimating that roughly one in four Medicare beneficiaries use it in a given year.

Skepticism has a specialty pattern too

The Populus data isn't uniformly optimistic. Roughly 45% to 50% of providers in dermatology and cardiology rate virtual care as less effective than in-person visits for their patients — a signal, Schulman suggests, that for conditions dependent on physical examination or hands-on diagnostics, "virtual care may accelerate access to an initial conversation without fully substituting for the in-person encounter that follows. The delay may be compressed but not eliminated."

Dermatology emerged as the specialty most worth watching on this front. It posted the highest administrative-task appropriateness in the entire study — 100% for follow-up and prescriptions — alongside the highest clinical skepticism, with 50% of dermatologists rating virtual care as less effective than in-person. "Adoption appears to be driven by workflow efficiency rather than clinical endorsement," Schulman says, "which is a different and potentially more fragile foundation."

Where pharma fits — and where it doesn't

For physicians increasingly encountering pharmaceutical content inside virtual care platforms, the report offers a rough map of what providers find acceptable. Post-visit resources and follow-up materials were the most broadly accepted format for pharma content, cited by roughly half of providers regardless of how much of their practice happens virtually. Pre-visit content and ongoing patient-portal education each drew support from about a third of providers.

Content delivered during the visit itself was far more polarizing. "Content delivered during the visit itself is significantly more acceptable to providers who conduct a high volume of virtual care — 42% of high-volume providers find it appropriate, compared to only 15% of providers who use virtual care for a minority of their interactions," Schulman says. Between 20% and 29% of providers said none of these moments are appropriate for pharma content — a stance Schulman says is more common among physicians newer to virtual care.

The distinction providers draw, according to Schulman, isn't really about frequency of exposure — it's about framing. "Our data shows that providers make a meaningful distinction between educational content and brand messaging," he says. "Providers who encounter pharma content regularly in virtual settings are more likely to view it as helpful; those who encounter it rarely are more likely to find it concerning."

A persistent equity gap

None of this growth has been evenly distributed. An analysis of more than 46 million patient encounters across a major health system from 2019 through 2024 reported in the Journal of General Internal Medicine found persistent disparities in virtual care access by age, race, income and geography — with the patients who could benefit most from virtual care, including older adults and those living far from medical facilities, often the least likely to actually use it. That gap sits uneasily alongside the specialty-access story in the Populus data: the same structural barriers driving patients toward virtual neurology and cardiology visits — geography, transportation, limited local specialists — are, for a subset of patients, also what keeps them offline in the first place.

For physicians weighing how much clinical real estate to hand over to virtual encounters, the numbers offer a fairly clear signal: virtual care has become a genuine access mechanism for several high-acuity specialties, providers remain split on where its clinical limits are and the patients most likely to need it aren't always the ones using it.