Telephone consulting in primary care: a triangulated qualitative study of patients and providers

McKinstry, Brian; Watson, Phillip; Pinnock, Hilary; Heaney, David; Sheikh, Aziz

doi:10.3399/bjgp09x420941

Cited by 110 publications

(139 citation statements)

References 16 publications

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“…30 However, the small number of examples in the present data of doctors and patients successfully consulting at length by telephone about complex continuing problems, support the researchers' previous finding that it is a medium that could be used more frequently for the care of patients with long-term conditions. 31 The doctors in the study sample who are consulting by telephone do not elicit additional concerns from patients nor, with a few notable exceptions, do the patients introduce additional problems by making use of recognised communicative strategies such as mention of more than one concern at the beginning of consultations. 32 This supports the evidence from the recent triangulated focus group study which shows that both doctors and patients consulting by telephone expect to pursue limited agendas.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Comparison of face-to-face and telephone consultations in primary care: qualitative analysis

Hewitt¹,

Gafaranga²,

McKinstry³

2010

Br J Gen Pract

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There is evidence that telephone consultations in general practice are typically shorter than face-to-face consultations and that fewer problems are presented in them. AimTo compare the communicative practices of doctors and patients in face-to-face and telephone consultations, in order to understand the contrasts between the two consulting modes. Design of studyConversation analysis. SettingEight NHS GP surgeries in Scotland. MethodTranscription and conversation analysis of 32 face-to-face and 33 telephone consultations. ParticipantsEighteen GPs and 65 patients. ResultsThere are no underlying contrasts between the communicative practices used in face-to-face and telephone consultations. Telephone consultations are typically used by patients to deal with a limited range of single-issue concerns, whereas a wide range of different problem types is dealt with in face-to-face consultations. Most telephone consultations for new problems lead to a face-to-face meeting rather than a diagnosis, making them shorter than equivalent face-to-face consultations. Interaction in telephone consultations is continuous and orderly, but in face-to-face consultations there are periods of silence that facilitate the introduction of additional topics, including social speech and rapport building. Doctors on the telephone are less likely to elicit additional concerns than in face-to-face consultations, and ask fewer questions when patients present self-diagnosed problems or describe problems with treatment. ConclusionDoctors in general practice do not substantially change their communicative behaviour on the telephone. Telephone consultations are shorter and include less problem disclosure than face-to-face meetings, partly because they are typically mono-topical and partly because of intrinsic differences between the two channels.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Comparison of face-to-face and telephone consultations in primary care: qualitative analysis

Hewitt¹,

Gafaranga²,

McKinstry³

2010

Br J Gen Pract

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“…Detailed analyses of the clinician-patient interaction using conversation analysis have found that, compared with traditional face-to-face consulting, telephone consultations have a more linear format and tend to focus on a narrow range of preplanned themes, with fewer opportunities for the patient to raise ad hoc issues. 34,35 One study combined telephone consulting with video consultation to support patients receiving palliative care and reported that the combination offered both practical support and reassurance. 45 …”

Section: Telephonementioning

confidence: 99%

“…Telephone contact is used variably for assessment and triage of acute problems; [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] general practice consultations; [34][35][36][37][38][39][40] to offer health education; 41,42 and to offer support for those with chronic illness 43,44 or those in need of palliative care. 45 The literature on telephone consultations consists largely of small and heterogeneous primary studies, most of which had practical challenges or methodological flaws.…”

Section: Telephonementioning

confidence: 99%

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Shaw

Wherton

Vijayaraghavan

et al. 2018

Health Serv Deliv Res

148

186

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 13/59/26. The contractual start date was in March 2015. The final report began editorial review in July 2017 and was accepted for publication in November 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Depar...

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“…(Katz et al, 2008) In terms of safety, more than 70% of clinicians and 60% of patients were concerned that clinicians would be more likely to make a wrong/inaccurate diagnosis in telephone consultation compared to face-to-face consultations. (McKinstry et al, 2009) Challenges with telephone consultations include the lack of nonverbal clues, no direct observations and examinations, lack of active listening as the physician might be engaged in his own activities at time of call and talking to family members. Mobile phone cameras and audio recording can have the potential to compensate for the lack of observations.…”

Section: Safety Concernsmentioning

confidence: 99%

Telemedicine in Primary Care

Antoun¹

2012

Primary Care at a Glance - Hot Topics and New Insights

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Telephone consulting in primary care: a triangulated qualitative study of patients and providers

Cited by 110 publications

References 16 publications

Comparison of face-to-face and telephone consultations in primary care: qualitative analysis

Comparison of face-to-face and telephone consultations in primary care: qualitative analysis

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Telemedicine in Primary Care

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