A new study, from the University of Michigan, finds that what a doctor has behind them during a telehealth video visit can affect how a patient feels about them and their care. Even if the doctor is far from their usual clinic or exam room, they should make it look like they’re there, the study suggests.

Better yet, they should sit in an office with their diplomas hanging behind them or use a virtual background that looks like such an office. This is especially important if they haven’t seen the patient before, according to the study.

A home office with a bookshelf or a plain, solid-color background is also acceptable to patients.

However, if the visit takes place in a home environment with a kitchen or a bed in the background, doctors should use blurred or virtual backgrounds, the study suggests.

Background matters

The findings come from a survey asking patients to react to seven different backgrounds behind a model physician. They rated how knowledgeable, trustworthy, caring, approachable, and professional the physician appeared, and how comfortable they felt with that provider.

Patients also considered each background for a first or returning appointment with a primary care or specialty provider.

More than 1,200 patients who had seen providers at one of two health systems completed the surveys, and the researchers compiled their responses.

Strong aversion

The researchers were surprised by the strong aversion patients had towards kitchen and bedroom settings. Only 2% and 3.5% expressed a preference for these backgrounds, respectively.

In contrast, 35% favored an office with displayed diplomas, 18% preferred a physician’s office setting, 14% leaned towards a plain color background, and similar preferences were noted for a home office with a bookshelf or an exam room.

Moreover, significant differences emerged in the composite scores reflecting how patients perceived each background in terms of their comfort level with receiving care from the provider. Bedroom and kitchen backgrounds received markedly lower composite scores compared to the other five backgrounds.

Improving things

The authors suggest several immediate steps that providers can take to enhance virtual visits, such as conducting them from an office or exam room. Clinics could consider making unused clinical rooms available for providers conducting virtual visits during in-person clinic days.

Alternatively, providers can utilize virtual backgrounds to create professional settings that evoke the atmosphere of an office or exam room.

While the authors haven’t yet examined physicians’ perspectives on backgrounds behind patients during video visits, they believe this aspect could provide valuable insights.

The emergence of “Hospital at Home” and home-based primary care underscores the importance of considering patients’ settings during virtual visits, as these environments can offer clues about the role of physical and social factors in their health.

Furthermore, discussing visible elements from both the provider’s and patient’s virtual backgrounds—such as art or hobby-related items—can help foster rapport between them.

“This is a reminder that patients often do care about some of the details that providers and health systems may not have emphasized,” the authors conclude. “It’s important to remember that our words and our nonverbal behaviors are taken to heart by those we care for, and it behooves us to care about them as well.”