The video window: How video consultation technology reveals and redefines the art of medicine in Danish specialist practice.

In the contemporary landscape of technologically mediated healthcare, video consultations introduce a dynamic interplay of challenges and opportunities. Taking the notion of 'the art of medicine' as an analytical frame, and drawing on interviews with medical specialists as well as participant observation of video consultations with patients (carried out between February 2022 and January 2023), this article investigates how video consultation technology changes the practices of medical specialists in the Danish healthcare system. Informed by post-phenomenology, we approach video consultations metaphorically as 'windows' between medical specialists and patients, unveiling three pivotal dimensions characterizing these changes. First, the shift from a physical to a virtual consultation room requires a reevaluation of the authoritative nature of the clinic, emphasizing the need for negotiating and staging the clinical space online. Second, while video consultations limit doctors' ability to rely on traditional non-verbal cues such as body language, they offer glimpses into patients' home environments, exposing the influence of social preconceptions on medical evaluations. Third, the adoption of video consultations introduces new conditions for doctors' use of senses, accentuating the importance of reflecting on the roles of different sensory impressions in the art of medicine. Our study illuminates how video consultation technology simultaneously expands and constrains the engagement between medical specialists and patients. Despite their inherent limitations, video consultations bring medical specialists closer to some of the intricacies of patients' lives. This proximity offers new insights and renders visible the roles of caregivers and relatives in the patient's care. The metaphor of 'the video window' encapsulates this tension between distance and closeness in video consultations, portraying the patient as both fragmented and socially situated. Our study extends beyond traditional patient and provider satisfaction evaluations, providing nuanced insights into how video consultations reconfigure the art of medicine.

Medical specialists' use and opinion of video consultation in Denmark: a survey study.

BACKGROUND: The COVID-19 pandemic accelerated the use of telemedicine which is seen as a possibility to reduce the pressure on healthcare systems globally. However, little research has been carried out on video as a consultation medium in medical specialists' practice. This study investigated the use of and opinion on video consultation among specialists in Denmark. METHODS: An online survey on use of video consultation, as well as relevance of and opinion on video consultation, was distributed to all 963 medical specialists in private practice in Denmark throughout May and June 2022, resulting in 499 complete answers (response rate: 51.8%). Data were analysed using descriptive and logistic regression analyses, and data from open text fields were analysed using thematic network analysis. RESULTS: Among the respondents, 62.2% had never used video consultation, while 23.4% were currently using video consultation, most particularly among psychiatrists. A total of 47.3% found video consultation medically irrelevant to their specialty, especially radiologists, plastic surgeons, ophthalmologists and otorhinolaryngologists. According to the specialists, video consultation was most suitable for follow-up consultations and simple medical issues, where the patient had an established diagnosis. In these cases, mutual trust remained present in video consultations. Better access for the patients and fewer cancellations, especially for psychiatrists, were highlighted as benefits. IT problems were reported as obstacles hindering optimal use of video consultation. CONCLUSION: The political aspiration to digitization in healthcare systems should be rooted in professionals' and patients' perceptions and experiences with video consultation which emphasize that it is not a standard tool for all consultations.

Interpreter services for immigrants in European healthcare systems: a systematic review of access barriers and facilitators.

BACKGROUND: Language barriers have been identified as a key access barrier to healthcare services for immigrants. The aim of this study was twofold: to investigate immigrants' and healthcare professionals' experiences with barriers and facilitators of interpreter services, and to examine the influence of barriers to interpreter services on the quality of care from immigrant and healthcare professional perspectives. METHODS: We searched PubMed, Embase, The Cochrane Library, Scopus, SocINDEX and PsycINFO, resulting in 1425 studies. A total of 21 original quantitative, qualitative and mixed methods studies published between 1996 and 2021 were assessed as eligible for inclusion. RESULTS: Identified barriers included: lack of immediately available interpreter services, cost, lack of knowledge about availability, and attitude towards interpreter services. Facilitators included: a high number of interpreters in the requested language, awareness among healthcare professionals and patients of the patient's rights to interpreters, and a positive attitude towards use of interpreter services. Regarding quality of care, language barriers created safety risks for the patients, made patients feel unsafe, or delayed patient contact with the healthcare system. CONCLUSION: Immigrant patients and healthcare professionals experience barriers in using interpreter services due to restrictive policies regarding user fees and limitations to entitlement to interpreters, a limited number of qualified interpreters and lack of knowledge. Medical encounters with unaddressed language barriers can put patients at risk and reduce quality of care for immigrants, which calls for strengthening formal and informal access to interpreters.