Patient Satisfaction with Physician–Patient Communication During Telemedicine

Abstract

The quality of physician-patient communication is a critical factor in treatment outcomes and patient satisfaction with care. To date, few studies have specifically conducted an in-depth evaluation of the effect of telemedicine (TM) on physician-patient communication in a medical setting. Our objective was to determine whether physical separation and technology used during TM have a negative effect on physician-patient communication. In this noninferiority randomized clinical trial, patients were randomized to receive a single consultation with one of 9 physicians, either in person (IP) or via TM. Patients (n = 221) were recruited from pulmonary, endocrine, and rheumatology clinics at a Midwestern Veterans Administration hospital. Physician-patient communication was measured using a validated self-report questionnaire consisting of 33 items measuring satisfaction with visit convenience and physician's patient-centered communication, clinical competence, and interpersonal skills. Satisfaction for physician's patient-centered communication was similar for both consultation types (TM = 3.76 versus IP = 3.61), and noninferiority of TM was confirmed (noninferiority t-test p = 0.002). Patient satisfaction with physician's clinical competence (TM = 4.63 versus IP = 4.52) and physician's interpersonal skills (TM = 4.79 versus IP = 4.74) were similar, and noninferiority of TM was confirmed (noninferiority t-test p = 0.006 and p = 0.04, respectively). Patients reported greater satisfaction with convenience for TM as compared to IP consultations (TM = 4.41 versus IP = 2.37, noninferiority t-test p < 0.001). Patients were equally satisfied with physician's ability to develop rapport, use shared decision making, and promote patient-centered communication during TM and IP consultations. Our data suggest that, despite physical separation, physician-patient communication during TM is not inferior to communication during IP consultations.

Teleaudiologia: comunicação profissional-paciente na programação e adaptação de aparelhos de amplificação sonora individuais via teleconsulta

“…Other research have also reported a lower number of patients utterances (9) and mastery of the professional on communication (10) during consultations.…”

“…This kind of counseling occurs in a very small proportion in health consultations as professionals worry more about getting information on psychosocial and biomedical content both in face to face consultations and in teleconsultations (10,26) .…”

“…The "social conversation" has the role of establishing rapport and showing the interest of the professional for the patient. Literature also shows which type of conversation isn´t frequent in medical consultations carried out face to face or at a distance (10) .…”

“…This scenario may present challenges to professional-patient communication, with the need for a greater use of communication repair strategies (9,10) , mostly for the hearing impaired.…”

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

“…Expansion of telehealth in VA is likely to enable timely access to care (Agha et al, 2009;Wakefield et al, 2004;Whited et al, 2002;Whited et al, 2004;Wilkins, Lowery, & Goldfarb, 2007) in several different ways. Clinical video telehealth can facilitate contact between distant patients and providers and is particularly useful for patients in rural or otherwise underserved areas who face transportation barriers, poverty, and limited access to specialty care .…”