Does Telemedicine Affect Physician Decisions? Evidence from Antibiotic Prescriptions

Telemedicine has long been of interest to the U.S. general public. Yet, despite the advent of high-speed internet and mobile device technology, telemedicine did not reach its full potential until the COVID-19 pandemic spurred its unparalleled adoption. This sudden shift in the setting of healthcare delivery raises questions regarding possible changes in clinical decision-making. Using a unique set of patient-provider encounter data from the U.S. in 2020 and 2021, we examine the effect of telemedicine on antibiotic prescription errors for urinary tract infections. After accounting for potential endogeneity issues using provider fixed effects and an instrumental variable approach, we find a significantly lower likelihood of prescription errors with telemedicine relative to in-person encounters. We also find heterogeneous effects by a provider's patient volume and the patient-provider relationship.