Not just an information-delivery tool. An ethnographic study exploring Danish GPs’ perspectives on and experiences with the relational potential of email consultation

Abstract

Objective

To explore GPs’ perspectives on and daily experiences with the relational potential of email consultations.

Design

Qualitative study with data from participant observation and semi-structured interviews

Setting

General practice setting in Denmark

Subjects

Practice personnel from four clinics were observed and 16 GPs (seven women and nine men, between 35 and 70 years of age) interviewed. Field notes and interview data were analysed using an inductive thematic analysis approach.

Main outcome measures

Main themes and subthemes reporting GPs’ perspectives on and experiences with the relational potential of email consultations.

Results

The analyses showed that due to perceived interpretational shortcomings, the GPs generally experienced email consultation as unsuitable for communication about relational, socio-emotional and sensitive matters. In doctor–patient relationships founded on mutual knowledge and trust, the email consultation was however used as a supportive communication channel, as a way for the patient to express emotions and affect and for the GP to proactively show interest and compassion towards the patient.

Conclusion

Email consultations were highly context-variant. Within continuing relationships and in conjunction with face-to-face consultations, email consultation was used for supportive communication holding the potential for maintaining, strengthening and/or dissolving the GP-patient relationship. Therefore, email consultation is not simply an information-delivery tool but also holds more explicit relational potentials.

KEY POINTS

• Overall, the GPs perceived email consultation as unsuitable for non-medical, relationship-oriented purposes.

• Nonetheless, the GPs experienced that email consultations oftentimes comprised communication about relational and socio-emotional issues.

• Knowledge of the patient was a vital factor for the GP’s comfort in and acceptability of relational functions of email consultation.

• Email consultation is not simply an information-delivery tool as it holds the potential for maintaining, strengthening and/or dissolving the GP-patient relationship.