Reciprocal dynamics between patients’ choice of place and how they experience video consultations: A qualitative study

Abstract

Objective To analyse the reciprocal dynamics between patients’ choice of place and how they experience video consultations (VCs) with the general practitioner. Methods Qualitative, semi-structured interviews with 27 Danish patients were conducted over a period of 9 months, from February to October 2020. Interviews were analysed using thematic analysis. The analysis was guided by Nelly Oudshoorn's concept of technogeography of care. Results The following three themes were identified in the data: VC-home dynamics: balancing boundaries; VC-workplace dynamics: logistical considerations; and VC-body image dynamics: on-screen exposure. Conclusions Taking human geography and science and technology studies as our analytical point of departure, we used the concept of technogeography of care and demonstrated how the reciprocal dynamics between patients’ choice of place and how they experience VC made boundaries fluid and complex between different contexts and places, such as the home, the workplace and the clinic. These boundaries were negotiated differently by the patients depending on their need for privacy, convenience and support. Additionally, VC reconfigured patients’ and general practitioners’ roles, increasing patients’ responsibility in securing an appropriate health care setting.

What are patients’ first-time experiences with video consulting? A qualitative interview study in Danish general practice in times of COVID-19

“…Literature relating to VC user experiences in primary care both before and during the pandemic present mixed and highly context-dependent results 3–6. Generally, quantitative and qualitative studies, reporting on patient satisfaction of VC in primary care, point towards high satisfaction (compared with physical or telephone consultations) and high interest in future use, especially among patients with non-critical conditions, mental illness and chronic conditions, who report increased convenience in terms of time saved (avoiding travel-time and waiting time) and of consulting with the practitioner from a place of one’s own choosing (mostly the home) 4 6–9.…”

“…Literature relating to VC user experiences in primary care both before and during the pandemic present mixed and highly context-dependent results 3–6. Generally, quantitative and qualitative studies, reporting on patient satisfaction of VC in primary care, point towards high satisfaction (compared with physical or telephone consultations) and high interest in future use, especially among patients with non-critical conditions, mental illness and chronic conditions, who report increased convenience in terms of time saved (avoiding travel-time and waiting time) and of consulting with the practitioner from a place of one’s own choosing (mostly the home) 4 6–9. While some patients have reported VC to be their preferred consultation type for selected health conditions, indicating that needs for patient-centred care and rapport-building have been satisfactorily met through a VC, others have reported to prefer physical consultations due to technical challenges, privacy issues and loss of the ‘personal’ feel of a physical encounter 4 10.…”

Collaborative domestication

“…First, family members were found to infl uence the domestication process: As explained in the objectifi cation phase, one of the obstacles patients experienced during video consultations was the presence of family members. Th e challenge of securing doctor-patient privacy and confi dentiality resembles fi ndings from a study on video consultations in general practice (Lüchau et al, 2021) and from studies on video consultations done in the context of psychology, where a therapist needed to know whether a third person (family member or friend) was present during the consultation (Rasmussen et al, 2017;Tarp & Nielsen, 2017).…”

General Practitioners’ Experiences of Professional Uncertainties Emerging from the Introduction of Video Consultations in General Practice: Qualitative Study

“…During the COVID-19 pandemic in Denmark, video consultation technology was rapidly implemented in general practice and made available to all patients via the mobile app Min Læge (“My Doctor” in Danish) as an alternative to face-to-face consultations. Moreover, Danish health authorities encouraged patients to use video consultations to decrease the transmission of COVID-19 [ 7 , 8 ]. From the beginning of the pandemic in March 2020 to December 2020, 2.6% of all general practice consultations in Denmark were video consultations (not including email and telephone consultations) [ 9 ].…”