Use of alternative consultation forms in Danish general practice in the initial phase of the COVID-19 pandemic – a qualitative study

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Background: Attempts to manage the COVID-19 pandemic have led to radical reorganisations of health care systems worldwide. General practitioners (GPs) provide the vast majority of patient care, and knowledge of their experiences with providing care for regular health issues during a pandemic is scarce. Hence, in a Danish context we explored how GPs experienced reorganising their work in an attempt to uphold sufficient patient care while contributing to minimizing the spread of COVID-19. Further, in relation to this, we examined what guided GPs’ choices between telephone, video and face-to-face consultations. Methods: This study consisted of qualitative interviews with 13 GPs. They were interviewed twice, approximately three months apart in the initial phase of the pandemic, and they took daily notes for 20 days. All interviews were audio recorded, transcribed, and inductively analysed. Results: The GPs re-organised their clinical work profoundly. Most consultations were converted to video or telephone, postponed or cancelled. The use of video first rose, but soon declined, once again replaced by an increased use of face-to-face consultations. When choosing between consultation forms, the GPs took into account the need to minimise the risk of COVID-19, the central guidelines, and their own preference for face-to-face consultations. There were variations over time and between the GPs regarding which health issues were dealt with by using video and/or the telephone. For some health issues, the GPs generally deemed it acceptable to use video or telephone, postpone or cancel appointments for a short term, and in a crisis situation. They experienced relational and technical limitations with video consultation, while diagnostic uncertainty was not regarded as a prominent issue Conclusion: This study demonstrates how the GPs experienced telephone and video consultations as being useful in a pandemic situation when face-to-face consultations had to be severely restricted. The GPs did, however, identify several limitations similar to those known in non-pandemic times. The weighing of pros and cons and their willingness to use these alternatives shifted and generally diminished when face-to-face consultations were once again deemed viable. In case of future pandemics, such alternatives seem valuable, at least for a short term.

TidsskriftBMC Family Practice
Udgave nummer1
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
We would like to thank all the participating GPs for their time and contributions. We would also like to thank our co-worker Anne M?ller, GP and researcher, who, as a member of the The Danish College of General Practitioners? corona?task force, has provided us with clarifications and elaborations on the status and guidelines in general practice. All three authors hold a PhD degree, are social scientists (in public health, sociology, and anthropology, respectively), and have several years of experience in qualitative health services research. At the time of the study, TDD and JHA were post-doctoral researchers, and TT was senior researcher.

Publisher Copyright:
© 2021, The Author(s).

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