How do patients and general practitioners in Denmark perceive the communicative advantages and disadvantages of access via email consultations? A media-theoretical qualitative study.

ABSTRACT

OBJECTIVE: Email consultations have become part of everyday doctor-patient communication in many countries. The objective of this study is to investigate how patients and general practitioners (GPs) perceive the communicative advantages and disadvantages of access via email consultation drawing on a media-theoretical perspective. DESIGN: We analysed qualitative interview data from general practices in Denmark to identify salient themes. PARTICIPANTS: Our data set consists of semi-structured interviews with 30 patients and 23 GPs. The data were collected from February 2016 to September 2019. RESULTS: The following themes emerged (1) lower contact threshold, (2) accessing a new interaction space and (3) access to access. From the patients' perspective, email consultations provided more convenient contact with their GP. From the GPs' perspective, email consultations facilitated contact with patients whom they otherwise rarely saw, but also resulted in overuse and inappropriate use. Patients and GPs considered email consultations as inviting new interactions, facilitating also communication about emotional and sensitive issues. Both patients and GPs experienced email consultations as a way in which patients could achieve easier access to face-to-face consultations (access to access). CONCLUSION: Drawing on a media perspective, this study adds knowledge of how the potentials of the medium of email consultations are perceived by GPs and patients. Email consultations do not simply extend existing forms of contact and consultation (face-to-face and telephone); they produce a new communication space with its own possibilities which result in new practices. With increasing use of email consultations, there may be challenges involved in transferring GP-patient communication to the written medium.