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

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.

Keywords

• primary health care
• general practise
• video consultation
• virtual care
• telemedicine
• consultation process
• qualitative research