When medical consultations are not face-to-face: a pilot study of patient-centred care communication during coronavirus disease 2019.

Background: Patient-centred care (PCC) is essential to quality medical consultation. PCC communication refers to how PCC principles are reflected in doctor-patient interactions. Research has shown that a doctor's ability to communicate in a patient-centred manner is positively linked to patient satisfaction and improved health outcomes. However, previous studies have focused mainly on face-to-face communication and less is known about patient perceptions of PCC when medical interactions are not face-to-face such as online medical consultations (OMCs). This pilot study aims to explore patients' perceptions and experiences of OMCs.

Methods: Participants were recent university graduates from mainland China. Sixty-three participants completed an online questionnaire designed to gauge PCC communication, which included four validated communication measures: (I) patient health willingness to communicate (HWTC); (II) doctors' consultation and relational empathy (CARE); (III) patient perceptions of participation in health consultation (PPP); and (IV) doctors' communication assessment tool (CAST). Participants provided their modality preference when using OMCs. To gain a deeper understanding of quantitative data, two supplementary open-ended questions were included where participants provided feedback on their preferences for using OMCs and discussed the advantages and disadvantages of OMCs.

Results: Correlational analysis indicated that participants' perceptions of doctors' interpersonal and communication skills significantly correlated with perceived CARE (r=0.813, P<0.01) and with patient participation in health consultations (r=0.632, P<0.01). Supporting the quantitative results, the qualitative findings revealed that while participants appreciated the convenience of OMCs, they also felt that emotional care from doctors was lacking in the online format. Specifically, participants noted that nonverbal cues, rapport building, and other relational aspects were missing, which aligns with the quantitative data linking perceived doctor communication and empathy to patient satisfaction.

Conclusions: The findings suggest that more emphasis should be placed on training doctors to practice PCC communication in OMCs especially when the interactions are text-based. The results highlight that consideration must also be given to the interpersonal and emotional aspects of care that contribute to patient satisfaction with OMCs. Overall, this pilot study reinforces that PCC communication remains integral to quality medical interactions, regardless of whether they occur face-to-face or through an online format.