In Denmark, e-mail consultations (e-cons) are now supplementing conventional consultations with doctors and raising questions related to self-governing technology from the patient perspective. Interestingly, old patients are the most frequent users of this kind of consultation. This article examines how e-cons affect old people’s relationships with and perceptions of their general practitioners (GPs) regarding trust, self-governance and indirect/direct power. This qualitative study is based on interviews with twenty patients between 66 and 83 years old. Applying a thematic analysis in which four salient themes were identified, the study demonstrates that the patients perceive the GP as powerful, knowledgeable and busy; this corresponds with the power relationship between disciplinary institutions and individuals. At the same time, many patients use e-cons as a technology of self-governance, thereby taking responsibility for their own health while still being able to contact the clinic. In this way, patients achieve the potential for self-management, while clinics maintain their institutional power.

Objective Video consultations enable a digital point of contact between the general practitioner and patient. With their medium-specific characteristics, video consultations may create novel conditions for the enactment of patient participation during consultations. Although numerous studies have explored patients’ experiences of video consultations, research explicitly investigating patient participation within this new consultation setting remains sparse. This qualitative study explores how patients participate during interactions with their general practitioner by drawing on the affordances of video consultations. Methods The data corpus comprises eight recorded video consultations (59 minutes and 19 seconds in total) between patients and their general practitioner, all subjected to reflexive thematic analysis yielding three themes illustrating concrete participatory use cases. Results We find that video consultations provide an accessible format for patients otherwise unable to attend a physical consultation due to physical and mental barriers. Moreover, patients participate by drawing on resources situated in their spatial setting to settle health-related questions of doubt arising during the consultation. Lastly, we posit that patients enact participation by visually communicating their impromptu engagement in decision-making and reporting to their general practitioner by making use of the qualities of their smartphone during their consultation. Conclusions Our findings illustrate how video consultations provide a communicative context in which patients may enact distinct forms of participation by drawing on its technologically contingent affordances during interactions with their general practitioner. More research is needed to explore the participatory opportunities of video consultations in telemedical healthcare services for different patient groups.

This article explores the incorporation of mobile applications in older people’s physical health management through the lens of Foucault’s concepts on self-governance. Based on ten interviews with older Danes, the article posits that physical health management practices constitute practices of self-governance, involving participants’ attunement to both physical activity and bodily phenomena, which are both facilitated and optimized through app-based self-tracking. The findings align the rationales driving participants’ efforts with the trajectory of the governmental concept of active ageing. Using apps thus becomes intertwined with participants’ efforts towards ageing successfully, consequently taking on a dual function: Apps strengthen the adherence to norms of conduct for achieving an optimal ageing process by allowing for ubiquitous self-monitoring and self-assessment. Simultaneously, I argue that apps may also act as a gatekeeper, as lacking the technical competencies to efficiently use apps hinders effective health management and thus clashes with efforts conforming to active ageing.

Background Video consultation was urgently introduced in general practice in connection with the COVID-19 pandemic, where a rapid implementation ensured patients’ continued access to their general practitioner (GP). With the Danish lockdown in March 2020, the use of video consultations in general practice increased drastically and then declined significantly shortly after as society gradually reopened. Today, only a small proportion of the total number of consultations in general practice is made up of video consultations, and there is great variation in the scope and use of video consultation among GPs and practice staff. Objective The aim of this paper is to present research findings from a qualitative, interdisciplinary project, investigating GP and patient experiences with video consultations during the first lockdown period in 2020, which might help explain the abovementioned tendencies in relation to scope and implementation variances. Methods The data corpus includes data generated through semistructured interviews with 27 patients and 15 GPs, as well as 8 video recordings of video consultations between GP and patient. Results The patients reported positive experiences with consulting their GP through video, valuing increased convenience and spatial flexibility and wishing for future use of video consultation as either a supplement or an alternative to physical consultation. Video consultation furthermore presented a new communicative context in which both patients and GPs enacted distinct forms of technologically facilitated participation. Conclusions To further the best use of video consultation in future general practice, organizational and individual factors such as renumeration, task delegation, time pressure, and professional identity need to be considered.