# Choosing between virtual and in-person family physician care: a qualitative study

## TL;DR

This study explores how patients and family physicians decide between virtual and in-person care, especially for those with multiple chronic conditions.

## Contribution

The study integrates patient and physician perspectives to develop a framework for choosing care delivery modes in multi-morbidity contexts.

## Key findings

- Patients and FPs consider factors like visit reason, access impact, and technology when choosing care mode.
- Endorsing patient choice and involving clinical expertise are key in the decision-making process.
- Current clinical systems often fail to support preferred processes for virtual/in-person care decisions.

## Abstract

Virtual care accelerated to the forefront of family physician (FP) care following the COVID-19 pandemic and continues to play a significant role in patient care. The choice between virtual and in-person primary care must be sensitive to patients’ contexts particularly for those with multi-morbidity.

This study explored how to make the choice between virtual and in-person FP care for persons living with multi-morbidity that is acceptable to patients and FPs.

We conducted a constructivist grounded theory study to understand the processes patients and FPs employ when deciding on the mode of primary care delivery. We used individual interviews to understand the perspectives and expectations of patients with multi-morbidity (2+ chronic conditions) and FPs.

There were two main themes revealed in data analysis: Considerations in choosing mode of delivery (including reason for visit, impact on access, technological logistics, and reimbursement for virtual care) and Process for choosing mode of delivery (including endorsing the patient choice when possible and scheduling visits).

This paper integrated the experience of both patients and FPs to understand how to make the choice between virtual and in-person care. This understanding can support the future of FP care where diverse modes of delivery are employed, but currently technological barriers remain. Clinical scheduling systems that depend on telephone interactions between clinic staff and patients do not always support the process patients and FPs indicated they prefer; that is, one that respects patient preference and FP clinical expertise.