Family physicians’ perspective on risks and benefits of remote patient consultations during the state of emergency due to COVID-19 epidemic in Latvia: qualitative study in primary care

The study aimed to identify and analyze the risks and benefits of remote patient consultations in primary care from family physicians’ perspective during the emergency due to COVID-19 epidemic in Latvia in Spring 2020. Qualitative face-to-face or online, semistructured interviews with 19 family physicians were conducted from September to December 2020. A purposeful maximum variation sampling was used. Interviews were recorded and transcribed. Thematic analysis revealed three themes related to benefits and risks of remote patient consulting. The study was carried out in the frame of the project VPP-COVID-2020/1-0011 of National research programme to lessen the effects of COVID-19. The 1st theme ‘remote consultation as integral part of primary care’ indicated benefits of higher effectiveness and increased autonomy of physicians in deciding on the form of consultation. Identified risks were patients being hesitant to call the doctor and not capable to use more advanced communication technologies. The 2nd theme ‘remote evaluation of patients’ health needs’ emphasized benefits of physicians ability to remotely solve health needs that did not require a visit, in the same time risks of underestimating the seriousness of patient’s health issue was of great concern. The 3rd theme ‘change in the physician-patient relationship’ revealed benefits of increasing patients’ responsibility and involvement, and promoting the potential of patient empowerment. In the same time risk of doctors’ burnout due to stress related to new communication forms and blurred lines between remote consultations and personal life was identified. Findings indicate potential gains of remote consultations by creating more efficient, autonomous and health literacy promoting communication between physician and patient. Managing identified risks – patient capability to use technologies, physician competence of remote health evaluation and ability to separate work from personal life - are crucial in order to protect both patients’ and physicians’ wellbeing and health.