“I can't show them on the phone so it's what I say and I'm not saying a lot.” – The loss of nonverbal and visual cues during telephone consultations, equity of access and the impact on marginalised patients
A qualitative study
Bibliographic Data
| ID | 21258204 |
|---|---|
| Authors | Ada Humphrey (0000-0002-8007-061X, Imperial College London, corresponding author), C May (0000-0002-0451-2690, London School of Hygiene & Tropical Medicine), Steven Cummin (0000-0002-3957-4357, London School of Hygiene & Tropical Medicine), Steven Cummins, Fiona A Stevenson (0000-0003-2139-2309, University College London) |
| Year | 2025 |
| Volume | 8 |
| Pages | 100604 |
| Publication date | 2025-12-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | SSM - Qualitative Research in Health (JOURNAL) |
| Journal identifiers | ISSN: 2667-3215 • E-ISSN: 2667-3215 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.ssmqr.2025.100604 |
| OpenAlex | W4412462745 |
| Language | EN |
| References cited | 38 |
Background There has been an increase in the use of telephone consultations in General Practice in the UK during and since the COVID-19 pandemic. This results in a reliance on verbal communication alone due to the loss of non-verbal and visual cue. The consequences of this for inequities of healthcare in marginalised groups is underexplored This paper examines accounts of patients from marginalised groups of the impact of loss of non-verbal and visual cues during telephone GP consultations and effects on experiences of care. Design and setting: Ethnography and interview study (n=15) undertaken at three sites in London: a foodbank, a community development organisation, and a drop-in advice centre for migrants. Additionally, GPs (n=5) working at practices in London, Digital Health Hub staff (n=4) and staff at fieldwork sites (n=3) were interviewed. Method Ethnographic observation (n=84hrs) and semi-structured interviews (n=27). Interviews were conducted in-person and over the phone and data were analysed through reflexive thematic analysis. Results Analysis identified challenges in effectively conveying information during telephone GP consultations as a result of language barriers, health literacy, and concerns around sensitive disclosure as a result of a loss of non-verbal and visual cues. Additionally, GPs reported mitigation techniques employed during telephone consultations including increased use of questioning, referrals for additional tests, and converting to face-to-face consultations in an effort to improve equity
Advertising · Business · Linguistics · Nonverbal communication · Phone · Political science · Communication · Healthcare Systems and Technology · Patient Satisfaction in Healthcare · Patient-Provider Communication in Healthcare · Psychology
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Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups
The Virtual Clinical Encounter
Powers of Freedom
Conceptual and design thinking for thematic analysis
Associations of health literacy with socioeconomic position, health risk behavior, and health status
Quantifying the body
A policy analysis of the Expert Patient in the United Kingdom
Understanding Digital Health as Public Pedagogy
The digitally engaged patient
Tactics of material participation
Using thematic analysis in psychology
Administrative Burden
Understanding the promises and premises of online health platforms
Personal health technologies, micropolitics and resistance
Training to self-care
Normality and Pathology in a Biomedical Age
From State responsibility for education and welfare to self-responsibilisation in the market
Social Conditions As Fundamental Causes of Disease
Working with vulnerable groups in social research
The Datafication of Health
Participation in the medical consultation
Governing economic life
| Citation velocity | historical |
|---|---|
| Highly cited | No |