“A day in the life” – telemedicine in family medicine and its relationship with practicing physicians’ satisfaction

Introduction Telemedicine is widely implemented in primary healthcare. However, little is known about physicians’ attitudes toward the changes it brings about in their daily practices.

Objective To quantify the workload of the different types of physician-patient encounters and to assess the encounter type relation with family physicians’ satisfaction, and their perception of the quality of these encounters.

Methods In this cross-sectional nationwide descriptive study, physicians filled in a preliminary questionnaire and documented all doctor–patient interactions during a single workday. The questionnaire requested their personal details and data on clinic characteristics and workload in addition to posing questions regarding their attitudes toward different types of medical encounters. The primary outcomes were the perceived quality of the encounters and the physicians’ feelings at the end of each encounter.

Results Sixty physicians documented 2,025 encounters, of which 39% took place in person, 36% stemmed from online patient requests, 18% were telephone meetings, < 1% were video meetings, 3% were physician-initiated, and 3% consisted of other types of contact. Mixed effects logistic regressions were used to model the encounters’ evaluation. The OR for perceived medical quality was lower for non-face-to-face encounters: OR = 0.43 (CI 0.31–0.61) for telephone or video encounters and OR = 0.09 (CI 0.07–0.13) for online requests. The odds ratio (OR) for positive feeling at the end of the encounter decreased for non-face-to-face encounters: OR = 0.55 (CI 0.39–0.78) for telephone or video consultations and OR = 0.13 (CI 0.10–0.17) for online requests. Positive feelings were increased when the encounter modality was considered optimal OR = 7.35 (CI 5.14–10.52). There was a high correlation between the physicians’ feelings at the end of the encounters and their perceived medical quality, r = 0.82 (p < 0.001).

Conclusion Physicians prefer face-to-face encounters and rated their quality higher than that of telephone or video encounters. Physicians felt much less satisfied with other types of encounters.