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Research Articles

Physicians’ experiences of video consultation with patients at a public virtual primary care clinic: a qualitative interview study

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Pages 67-76 | Received 06 Jul 2020, Accepted 17 Jan 2021, Published online: 02 Mar 2021
 

Abstract

Objective

To describe physicians’ experiences of video consultation with new patients visiting a publicly owned virtual primary care clinic.

Design

In this qualitative study, data were collected from semi-structured individual interviews and analysed by systematic text condensation.

Setting

A publicly owned virtual primary care clinic in Region Västra Götaland, Sweden.

Subjects

Ten primary care physicians working at the clinic.

Results

Connecting with a patient over video could be either straightforward or deficient, depending on communication and the patient’s condition. Clinical experience, communication skills, and involving patients throughout the consultation and examination were crucial for assessments over video where patients were guided to perform self-examination. The flexibility of work and the regulated assignment online were positive for the physicians’ work situation and wellbeing. Providing video consultation within the same organisation as the patient’s regular health centre was considered to facilitate patient care and safety. Video consultation was considered suitable for some diagnoses and for some patients not able to reach a primary healthcare centre, though doubts were expressed about the healthcare and social benefits of this virtual care service.

Conclusion

For the physicians, video consultation induced changes in the basis for assessment of primary care patients. The limitations on informational exchange demanded an extended form of patient involvement founded upon consultation skills, clinical experience and new skills for virtual examination. Combining virtual care with traditional general practice has the potential to reduce the workload for the individual physician and ensure medical competence in virtual primary care. Video consultation experienced suitable in some situations, but easy access to it expressed problematic in terms of medical prioritisation in healthcare.

    KEY POINTS

  • Video consultation is suitable for primary care visits for some patients, but physicians’ experiences of this are rarely studied.

  • •Clinical experience and consultation skills are important for video assessment of primary care patients which involves physician-guided patient self-examination.

  • •Video consultation facilitates care in some situations and could benefit from the provider being connected to patient’s regular health centre.

  • •Virtual care offers a flexible way of working but challenges healthcare prioritisation from the primary care physician’s perspective.

Acknowledgements

The authors would like to thank the physicians for participating and sharing their experiences, the medical secretaries for the transcripts, the organisation of Närhälsan Online for providing information, and Lena Nordeman, associate professor, for valuable ideas and support.

Ethical approval

The study was approved by the regional committee for medical research ethics in Gothenburg (ref: 653-18). Participants provided written consent after having received oral and written information before entering the study.

Disclosure statement

None of the authors work at Närhälsan Online or with virtual care. The authors declare that there is no conflict of interests, and that they alone were responsible for conducting the research and composing this article.

Additional information

Funding

This research was made possible by grants from the Local Research and Development Council in Gothenburg and Södra Bohuslän.