Why Telemedicine Is Now Essential in Oncology: Insights From Dr Phull

Telemedicine has quickly become a mainstay in oncology care, with oncologists among the most enthusiastic adopters of virtual visits. According to recent survey data from Doximity, 86% of oncologists who use telemedicine consider it an essential, daily part of their practice. For Hardeep Phull, MD, that statistic rings true.

In an interview with Targeted Oncology^TM, Phull, director of oncology at Palomar Health, shared how telemedicine has transformed access, improved patient experience, and redefined care delivery for patients with cancer while also offering surprising benefits for physicians themselves.

Targeted Oncology: Doximity recently conducted a survey of physicians regarding their use of telemedicine. Oncologists stood out for both their strong adoption and the significant value they’ve observed from virtual care. Why do you think telemedicine has found such a home in oncology?

Hardeep Phull, MD: That Doximity survey found that 86% of oncologists who use telemedicine say it is essential, not just a part of practice, but something we use daily. Most of us want it to be a permanent part of our practice[s]. About 89% of oncologists who use telemedicine reported that it improves access to care vastly. The majority also said it improves patients’ outcomes, and it improves their experience.

Imagine getting a new cancer diagnosis. You're scared, anxious, [and] unsure of what’s next. Being able to speak to someone quickly, get reassurance, [and] talk through the next steps—that's incredibly valuable. Most oncologists would agree it’s a wonderful tool to help reduce the fear surrounding cancer care.

The survey also showed that a quarter of oncology telemedicine users reported earlier diagnosis and intervention. Can you comment on that and other benefits you’re seeing?

One phrase I use a lot in my practice is, “Tissue is the issue.” You need a diagnosis. A scan might show a mass, or someone might feel a lump, but that’s not enough. If you’re a patient and you find something concerning, you don’t want to wait 8 weeks while your primary care [physician] figures it out. Sometimes, it’s just helpful to speak with someone quickly and to say, “Here’s what I think this could be. Let’s walk through the possibilities. Let’s get started.”

Sometimes the findings aren’t even cancer, and it’s a relief to clarify that early. Telemedicine lets us meet patients where they are, often at home, with family members present—even from out of state. That improves access and reduces anxiety.

Will it always get care done faster? It definitely gets access faster. Sometimes, it even speeds diagnosis. My telemedicine notes can justify and push for insurance approval for scans, biopsies, or tests. Referring doctors help move things quickly too, but when you're in the oncology system, things just move faster. So yes, I do agree with the survey that telemedicine improves diagnostics and speeds the path to treatment.

Can you share more about how you've integrated telemedicine into your practice?

Even before COVID, in our system, we had a mandated hour of telemedicine after lunch, from 1 to 2 pm. There were several patients who could not show up or were not showing up, and we labeled them as noncompliant. But in fact, people have lives. They have children to pick up, they have work, they live 2 hours away in the middle of nowhere and traffic is hard, or they are [older], and it is difficult to get on the freeway and get to the doctor.

I was an early adopter [of telemedicine], but COVID made it a mandate that it is a federal safety hazard to go see your doctor. [Telemedicine became the] front line. I started doing things I had never done before, like [checking in virtually] with patients receiving chemotherapy that same day. At first it was risky, but we got so good at it that it almost became second nature.

Five years later, we still use it the same way. It improves access [and] compliance and supports vulnerable populations. It’s also a good way to bring patients back into the office after a long time. I recently saw a patient I first met during COVID—5 years ago—only now in person. It was the right time to reconnect physically. So, telemedicine can actually help reengage patients and improve compliance.

How has telemedicine allowed you to expand access to care?

It has been huge. We have patients who live 2 hours away in a few rural areas around San Diego, and that's a long drive. It is not just the distance; it's the traffic. It's getting there and getting back, the stress of making it on time, and patients' blood pressures and heart rates are always high. They already have a cancer diagnosis that causes a lot of anxiety, and then they have to travel really far. [Telemedicine] is a good way to increase [access].

[It is also great for patients] in between phases and in between treatments, or for those who missed a chemotherapy treatment because they were sick and they just want to check in. Sometimes they just want to check in, go over a recent hospital stay, or talk through their symptoms. They may be contagious with something like the flu and do not want to risk infecting others, but they still want to connect. Telemedicine makes that easy.

How do you envision telemedicine's role evolving to continue to support patients throughout their long-term journeys?

It’s here to stay. We’re doing this media interview on Zoom—Zoom’s not going anywhere. Same with telemedicine. There are so many platforms now, and it’s become a core part of care. It's almost a mandatory part of care that everyone, in some way, offers. I personally love the Doximity app for telemedicine. I adopted it early during COVID. It makes it easy for doctors to be able to call patients in a HIPAA-compliant way without using their personal phone number. It allows for billable visits, making the encounter legitimate from a medical and regulatory standpoint.

That said, telemedicine shouldn't replace in-person care. It's a valuable part of care, not a substitute. I mentioned earlier that I had patients I hadn’t physically met in years. At some point, it’s appropriate to bring people in. Human connection, face-to-face interaction, matters, especially in oncology. Telemedicine extends care, but it can’t replace touch.

What’s your top advice for other oncologists or health care systems looking to integrate telemedicine?

Most hospital systems by now have chosen their platform, often tied to their [electronic health record (EHR)]. Some use apps on personal devices. The key is to ensure it’s HIPAA-compliant and done responsibly. I’ve seen doctors doing telemedicine while driving. That’s obviously not safe. And I’ve seen patients join calls from their cars while driving, which I strongly discourage. There’s a right way to do it.

We have learned a lot since being pushed into telemedicine during COVID. Right now, there’s talk that the federal telehealth mandates could expire. If that happens, we risk going back to a pre-COVID model where telehealth was optional and limited. But telemedicine is not just a COVID-era necessity. It is a great idea that improves care. We should continue to use it—safely, wisely, and with appropriate regulation.

In oncology, we often talk about empathy and gratitude. Has telemedicine changed how patients connect with you emotionally?

In our field of oncology, we talk about empathy, [and] we talk about gratitude. I recently had a patient I’d only seen virtually for 5 years come in for the first time. They brought homemade baked goods. It was a simple gesture, but meaningful. They wanted to show appreciation in person.

You can thank someone virtually, but there’s something different about face-to-face human interaction. It can't be replaced—by AI or anything else—but it can be extended through telemedicine. You can form strong, authentic connections over video or phone, then deepen them in person. So, I support telemedicine but also see the irreplaceable value of in-person care. It's not either/or—it’s both.

What are the physician-side benefits of telemedicine in oncology?

There are many. First, it helps us reach patients who otherwise couldn’t come in. It captures missed opportunities, brings patients back into the system, and improves continuity of care. It also supports work-life balance. Burnout was a huge issue during COVID. Telemedicine visits are often shorter [and] more focused, and patients tend to keep things concise. That leads to high satisfaction on both sides.

For example, sometimes I couldn’t fit someone into my clinic day. Instead of adding them to the end of my schedule at 5:30 pm, I’d offer a 7:30 am or 9:30 pm virtual visit. You might think, “Why are you working at 10 pm?” But that was actually the best thing I did—for myself. I got home early, spent time with my family, had dinner, put my kids to bed, and then did a 20- or 30-minute visit. It gave me balance and allowed me to meet the patient’s needs.

During COVID, home visits via telemedicine were common for both patients and doctors. Whether that continues depends on evolving regulations, but the creativity telemedicine allows is powerful. It is a great way to prevent burnout, improve wellness, and break up the day. But if I did telemedicine all day? That wouldn’t be ideal either. Sitting too long, missing physical touch, those matter too. Human contact is part of healing. So again, it’s not about replacing in-person care. Telemedicine is just a great tool for what it’s great for.

REFERENCE:

From cancer diagnosis to survivorship: how telemedicine is strengthening the care continuum. News release. Doximity. April 18, 2025. Accessed July 9, 2025.https://tinyurl.com/35kyam9r