Direct-to-Consumer Telemedicine Substitutes for 45% of In-Person Doctor Visits
Direct-to-consumer telemedicine (DCT) services are increasingly substituting for traditional in-person doctor consultations, with a significant portion of these online visits replacing rather than adding to overall healthcare utilization.
The Economic Journal · 2026
Key Findings
- 0145% of direct-to-consumer telemedicine consultations replace in-person visits.
- 02The remaining 55% of DCT consultations represent new utilization, not replacements.
- 03The increase in volume due to DCT may be close to cost-neutral.
- 04There is no evidence that the quality of care deteriorates with increased use of online consultations.
Application
Design takeaway
When designing healthcare services, consider the potential for new digital offerings to substitute for existing in-person services, rather than solely adding to demand, and focus on seamless integration.
How to apply
When developing or refining telemedicine platforms, analyze user behavior to understand the proportion of users who are substituting existing in-person visits versus those seeking new care. Use this data to inform marketing, pricing, and operational strategies.
Project actions
- 01When researching a new technology or service, consider how it might replace existing solutions rather than just add to them.
- 02Look for data that shows actual behavior changes, not just potential use.
Method & Evidence
Variables
Strengths & Limitations
Strengths
- +Utilizes a robust quasi-experimental design (fuzzy difference-in-discontinuities) to establish causality.
- +Provides quantitative evidence on the substitution effect of telemedicine.
Limitations
The study's focus on a specific demographic and region might limit its universal applicability. The definition and measurement of 'new utilization' could be further explored.
Reliability & validity
The use of a difference-in-discontinuities design strengthens internal validity by exploiting a natural experiment. External validity may be limited by the specific context of the study.
Think critically
If 55% of DCT consultations represent new utilization, what are the implications for healthcare systems and the potential for increased overall demand and costs, despite the substitution effect?
Design Principles
"Digital health solutions should be designed to complement and substitute for traditional care pathways, optimizing resource utilization and patient access."
Understanding the substitution effect of new service delivery models like DCT is crucial for businesses in the healthcare sector. It informs strategic decisions regarding resource allocation, pricing, and the potential impact on market dynamics and overall healthcare costs.
What This Means for Your Design
Online doctor appointments are replacing nearly half of in-person doctor visits for young adults, meaning people aren't just going to the doctor more often, they're switching how they get care.
How to use in your project
- 1.This research can be used to justify the design of a hybrid service model, arguing that digital components can efficiently substitute for some in-person interactions.
Add to My Project
Quick Cite
(2026). An App Call a Day Keeps the Patient Away? Substitution of Online and In-Person Doctor Consultations Among Young Adults. The Economic Journal. https://doi.org/10.1093/ej/ueag016 Retrieved from https://designdex.org/study/4da5aac0-99b0-4dc1-a67a-7d4d5735c14a/direct-to-consumer-telemedicine-substitutes-for-45-of-in-person-doctor-visits
Paragraph starter
Research indicates that direct-to-consumer telemedicine services can significantly substitute for traditional in-person consultations, with approximately 45% of online visits replacing prior in-person appointments. This suggests that innovative digital health solutions can be designed to optimize resource allocation and patient access by offering efficient alternatives to established care pathways.
Source
The Economic Journal
An App Call a Day Keeps the Patient Away? Substitution of Online and In-Person Doctor Consultations Among Young Adults
journal · 2026
View sourceQuestions about this research
- What does the research say about direct-to-consumer telemedicine substitutes for 45% of in-person doctor visits?
- When designing healthcare services, consider the potential for new digital offerings to substitute for existing in-person services, rather than solely adding to demand, and focus on seamless integration. Evidence: The Economic Journal (2026).
- Why does "Direct-to-Consumer Telemedicine Substitutes for 45% of In-Person Doctor Visits" matter for design?
- Understanding the substitution effect of new service delivery models like DCT is crucial for businesses in the healthcare sector. It informs strategic decisions regarding resource allocation, pricing, and the potential impact on market dynamics and overall healthcare costs.
- How can designers apply this research?
- When designing healthcare services, consider the potential for new digital offerings to substitute for existing in-person services, rather than solely adding to demand, and focus on seamless integration.
- What were the main findings?
- 45% of direct-to-consumer telemedicine consultations replace in-person visits.. The remaining 55% of DCT consultations represent new utilization, not replacements.. The increase in volume due to DCT may be close to cost-neutral.. There is no evidence that the quality of care deteriorates with increased use of online consultations.
- What research method was used?
- Fuzzy difference-in-discontinuities analysis.
- How strong is the evidence?
- Evidence strength is rated Strong effect, based on a 2026 journal from The Economic Journal.
- What should I do differently in my next project?
- When developing or refining telemedicine platforms, analyze user behavior to understand the proportion of users who are substituting existing in-person visits versus those seeking new care. Use this data to inform marketing, pricing, and operational strategies.
- What are the limitations?
- The study focused on young adults in Sweden, and findings may not be generalizable to other age groups or geographical regions. The 'new utilization' aspect warrants further investigation into its drivers and implications.
- Is there evidence that in-person doctor affects design outcomes?
- A substantial portion of online doctor visits are replacing in-person appointments, suggesting that telemedicine is not solely increasing overall healthcare demand and may not significantly increase costs. Understanding the substitution effect of new service delivery models like DCT is crucial for businesses in the hea Source: The Economic Journal (2026).
- Where does this doctor visits research apply?
- Healthcare sector, specifically primary care and direct-to-consumer telemedicine services. It sits within commercial production research on designdex.org.
Related research topics
in-person doctor design research · evidence on in-person doctor · does in-person doctor improve design outcomes · doctor visits studies for designers · in-person doctor and doctor visits findings · commercial production research evidence