Doctor-patient communication in telemedicine consultations: insights from an interview study with patients in Singapore

Abstract

Doctor-patient communication is a critical aspect of health care, but it can be affected by patients’ characteristics such as their level of health literacy (Matusitz & Spear, 2014; Sim et al., 2016). Many studies have documented changes in doctor-patient communication in video consultations, but fewer have explored in-depth patients’ perceptions of doctor-patient communication during telemedicine encounters, especially in the Asian context (Agha et al., 2009; Gordon et al., 2020; Liu et al., 2007; Miller, 2001). Drawing from Miller’s (2002) model of doctor-patient communication in telemedicine, this study sought to address the research question: How do patient characteristics and the technology-mediated context affect patients’ perceptions of doctor-patient communication in video consultations? Semi-structured in-depth interviews were conducted with 26 users of video consultations with general practitioners in Singapore. Audio recordings of the interviews were transcribed verbatim and analyzed via thematic analysis (Braun and Clarke, 2006). Patients’ perceptions of doctor-patient communication in video consultations are influenced by their level of health literacy and whether their needs and expectations are met. Patients with low health literacy face difficulties describing their concerns and symptoms accurately and adequately and view video consultations negatively as a business-like exchange lacking personal touch when their needs and expectations were not met. This study has contributed insights from Asia to explain differences in perceptions of doctor-patient communication in video consultations. Findings point to the importance of developing tailored strategies for low health literacy patients and of understanding and meeting patients’ needs and expectations to ensure quality doctor-patient communication in telemedicine.