‘From disaster, miracles are wrought’: a narrative analysis of UK media depictions of remote GP consulting in the COVID-19 pandemic using Burke’s pentad

Abstract

During crises (major events characterised by uncertainty, urgency and threat), society must make sense of rapidly unfolding events. This happens mainly through narrativising—depicting a setting, characters and a meaningful sequence of events and actions unfolding over time. In the early months of the pandemic, UK general practice shifted from face-to-face consultations to a remote-by-default model (telephone, video or e-consultation). This shift was initially widely accepted by press and public, but support waned after a politician declared that the change would be permanent. We invoke Burke’s dramatistic pentad of act, scene, agent, agency and purpose to theorise findings from a detailed analysis of media coverage of the remote-by-default policy and reactions to it. We consider the 12 weeks from March to June 2020 (first lockdown, when remote-by-default services had just been introduced) and 1 week from late July 2020 (following the ministerial announcement). The initial introduction of remote consulting had strong narrative coherence in which all parts of the pentad were balanced: scene (a deadly virus threatening the country) aligned with act (lockdown, including avoiding face-to-face appointments unless essential), agents (the National Health Service and digital technology as heroic macro-actors), agency (general practitioners ‘deployed’) and purpose (to control the pandemic). The later period, however, was characterised by a mismatch between scene (a country emerging from lockdown and resuming normal life), act (imposition of the remote model), agent (a politician known for his enthusiasm for technology), agency (top-down directive) and purpose (modernisation). Whereas media narratives in the first period aligned with the genre of heroic adventure (suggesting a worthy battle, bravely fought), those of the second had characteristics of farce (something both comic and grotesque). We conclude that close reading of media narratives may surface potential misalignments between policy decisions and the context in which they must be implemented.

Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics

“…But they also warned of an uncomfortable "brave new world" characterized by fewer consultations overall, loss of continuity of care, threats to the clinician-patient relationship, inequalities of access, and clinical risks (6)(7)(8)(9). Lay media coverage of remote consultations mirrored this pattern, with an initial positive response followed by stories of inaccessibility, missed diagnoses and patients feeling "fobbed off " with phone calls (10,11). Whereas, politicians and the press emphasized the transformative potential of new technologies, most remote consultations before and during the pandemic occurred by telephone (3,(12)(13)(14)(15).…”

Digital educative public message: Health protocol awareness at pandemic COVID-19 periods (Instagram feeds @humasprovjatim)

“…Irdiansyah explained that the results of the pentad analysis will offer answers to the questions: What happened (act), when and where it happened (scene), who did it (agent), how it was done (agency), and why (purpose). Analysis of symbolic texts on these five points offers a way to determine why individuals in certain contexts choose communication strategies (Mroz et al 2021). In the end, the dramatic ratio was used to conclude what factors most influenced the health protocol awareness educational message during the COVID-19 pandemic on Instagram @humaspemprovjatim (Irdiansyah 2020, Mroz et al 2021.…”

COVID as a catalyst: medical student perspectives on professional identity formation during the COVID-19 pandemic

“…[27][28][29][30] In our study, physician heroics were communicated through forms of public media, a dynamic which has been noted previously. [31][32][33] We identified conflicts between personal identities (e.g., being a family member) and the notion that being a doctor means engaging in heroic selfsacrifice and even knowingly placing oneself in harm's way. Many of the situations students expressed anxiety around could be described as work-family conflicts, which is the sense of incompatibility between these two roles and also an experience closely associated with physician burnout.…”