Is telemonitoring an option against shortage of physicians in rural regions? attitude towards telemedical devices in the North Rhine-Westphalian health survey, Germany

We assessed the knowledge and attitude towards telemedicine in the population of North Rhine-Westphalia (NRW), Germany, in a population-based telephone survey.Out of 2,006 participants, 734 (36.6%) reported an awareness of telemedical devices. Only 37 participants (1.8%) have experience in using them. The majority of participants were in favour of using them in case of illness (72.2%). However, this approval declined with age. These findings were similar in rural and urban areas. Participants who were in favour of telemedicine (n = 1,480) strongly agreed that they would have to see their doctor less often, and that the doctor would recognize earlier relevant changes in their vital status. Participants who disliked to be monitored by telemedical devices preferred to receive immediate feedback from their physician. Especially, the elderly fear the loss of personal contact with their physician. They need the direct patient-physician communication.The fear of being left alone with the technique needs to be compensated for today's elderly patients to enhance acceptance of home telemonitoring as support for remaining doctors either in the rural areas or cities.In rural regions of Germany, a shortage of physicians exists. Especially, general practitioners (GPs) are struggling to find successors [1]. Up to 15,000 general practitioners would be needed to guarantee today's level of ambulatory care by GPs (n = 60,374) in 2020-2025 [2]. Also in North Rhine-Westphalia (NRW), Germany, there are rural regions where GPs are retiring without finding a successor. Since physicians' practices better persist in urban areas, distances to see a doctor are increasing. Waiting lists for appointments are extending. These challenges caused concern among patients and mayors of remote towns or villages. Citizens started to sign petitions for the preservation of the ambulatory practices in their municipalities [3]. They posted calls via Internet [4] and television [5] to find a new doctor for th