BACKGROUND Internet hospitals, an innovative approach to outpatient service delivery via the Internet, are rapidly developing in China, especially in the current ongoing COVID-19 epidemic, with adequately fulfilling people’s demands for health services. However, despite a number of studies regarding internet hospitals, there has been little research that further evaluates the effect of internet hospitals on physician-patient relationship during outpatient visits. OBJECTIVE The purpose of our study was to examine whether the use of internet hospitals improves physician-patient relationship and to find out the difference in physician-patient relationship between internet hospital users and nonusers (offline hospital users) during outpatient visits. METHODS We developed a questionnaire based on the patient-doctor relationship questionnaire (PDRQ-9), a widely used tool for measuring the physician-patient relationship, to survey physician-patient relationship. The random sampling technique was used to include respondents who used medical services in offline physical or internet hospitals in the past 12 months. Chi-square tests were employed to compare the different categorical characteristics between internet hospital users and nonusers (offline hospital users). T tests were used to test the significance in continuous variables between user scores and nonuser scores in physician-patient relationship. Multiple linear regression was performed to determine whether the use of internet hospitals during outpatient visits was associated with physician-patient relationship. RESULTS A total of 505 valid responses were received from patients, and 25.7% (130/505) reported that they had sought for medical services in internet hospitals in the past 12 months. Internet hospital users gave significantly lower scores than nonusers in total physician-patient relationship scores (t503=-2.610, P=.010), and the 5 items of “My physician helps me” (t503=-4.176, P CONCLUSIONS The use of internet hospitals could not improve but decrease the physician-patient relationship during outpatient visits. Internet hospitals as an important supplement to conventional physician-patient relationship, policy makers should pay attention to the improvement of physician-patient relationship when devoted to the development of internet hospitals.