Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark.
Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark.
Soc Sci Med. 2024 Jun;351:116965. doi: 10.1016/j.socscimed.2024.116965. Epub 2024 May 11.
In the contemporary landscape of technologically mediated healthcare, video consultations introduce a dynamic interplay of challenges and opportunities. Taking the notion of 'the art of medicine' as an analytical frame, and drawing on interviews with medical specialists as well as participant observation of video consultations with patients (carried out between February 2022 and January 2023), this article investigates how video consultation technology changes the practices of medical specialists in the Danish healthcare system. Informed by post-phenomenology, we approach video consultations metaphorically as 'windows' between medical specialists and patients, unveiling three pivotal dimensions characterizing these changes. First, the shift from a physical to a virtual consultation room requires a reevaluation of the authoritative nature of the clinic, emphasizing the need for negotiating and staging the clinical space online. Second, while video consultations limit doctors' ability to rely on traditional non-verbal cues such as body language, they offer glimpses into patients' home environments, exposing the influence of social preconceptions on medical evaluations. Third, the adoption of video consultations introduces new conditions for doctors' use of senses, accentuating the importance of reflecting on the roles of different sensory impressions in the art of medicine. Our study illuminates how video consultation technology simultaneously expands and constrains the engagement between medical specialists and patients. Despite their inherent limitations, video consultations bring medical specialists closer to some of the intricacies of patients' lives. This proximity offers new insights and renders visible the roles of caregivers and relatives in the patient's care. The metaphor of 'the video window' encapsulates this tension between distance and closeness in video consultations, portraying the patient as both fragmented and socially situated. Our study extends beyond traditional patient and provider satisfaction evaluations, providing nuanced insights into how video consultations reconfigure the art of medicine.
在当今技术介导的医疗保健环境中，视频咨询带来了挑战和机遇的动态互动。本文以“医学艺术”为分析框架，通过对医学专家的访谈以及对 2022 年 2 月至 2023 年 1 月期间与患者进行的视频咨询的参与观察，探讨了视频咨询技术如何改变丹麦医疗保健系统中医学专家的实践。受后现象学的启发，我们将视频咨询隐喻为医学专家和患者之间的“窗口”，揭示了描述这些变化的三个关键维度。首先，从物理咨询室到虚拟咨询室的转变要求重新评估诊所的权威性，强调需要在线协商和构建临床空间。其次，虽然视频咨询限制了医生依赖传统非言语线索（如肢体语言）的能力，但它们让我们瞥见了患者的家庭环境，揭示了社会成见对医学评估的影响。第三，视频咨询的采用为医生使用感官创造了新的条件，强调了在医学艺术中反思不同感官印象的作用的重要性。我们的研究阐明了视频咨询技术如何同时扩大和限制医学专家与患者之间的互动。尽管存在固有局限性，但视频咨询使医学专家更深入地了解患者生活的复杂性。这种接近为患者护理中的护理人员和亲属的角色提供了新的见解，并使这些角色可见。“视频窗口”的隐喻包含了视频咨询中距离和亲近之间的这种紧张关系，将患者描绘成碎片化和社会定位的。我们的研究超越了传统的患者和提供者满意度评估，深入了解了视频咨询如何重新配置医学艺术。
