Participants were between 54 and 88 years of age (17 females and 13 males). Key study findings are presented below:
Access to general practice services and management of health conditions
Participants on average reported 2-3 GP consultations (ranged from 0 to 6) either face-to-face or by telephone since COVID-19 commenced (an approximate three-month period). A small number of participants reported that they had postponed or stopped making new GP appointments for non-urgent medical issues.
Consultations by telephone were viewed as an enabling factor in accessing general practice care:
I’ve found the medical fraternity has really stepped up to the plate, as far as making available these [phone] appointments, and to keep going the regular health checks that they have with people. I’m pretty impressed… (female, 68 yrs. old)
Well, it hasn’t been the same obviously, but I haven’t felt as though I’ve been deprived… certainly on the doctor’s part they were available, I’ve always been accommodated. (male, 73 yrs. old)
Out of 30 participants, only two reported longer waiting time and less frequent GP consultations:
I’ve got to physically go there, they would only allow so many people into surgery, having to have the constant temperature [checks]. It’s all valid but all these extra things…that didn’t enable us to see him [GP] as frequently as we normally would have been before COVID. (male, 59 yrs. old)
Twenty-nine out of 30 participants felt that, although their health had been managed differently during COVID-19 it had been managed quite well:
I think my health has been managed very well. If I needed, I know that the doctors would be available at the end of the phone, just the way things have gone along, I haven’t had any big problems. (female, 80 yrs. old)
Three participants even noted an improvement in their health management:
I actually think it’s better… people are much more aware of health, cleanliness. We’ve had less cases of flu. People are more thinking about how we react with each other, the distance, it’s made us think about a lot more things and what it impacts on. (female, 68 yrs. old)
Experience of telehealth services
Twenty-five participants utilised telehealth (at least once) for GP consultations. Of the five who did not use telehealth, three did not need a GP appointment and two did need but preferred face-to-face GP consultations due to their health conditions.
Those who had a telehealth consultation were very positive about it:
If we needed something we rang there and he [GP] rang us on the phone. If it was something that he wasn’t sure about or needed to check out – an appointment given to us and we had to go in and come straight out. It was quite good, a new standard. (female, 77 yrs. old)
The availability of telehealth was viewed as potentially increasing the frequency of GP visits ‘In fact, I’m probably seeing him [GP] more now via the phone’ (female, 56 yrs. old), or saving travel time ‘It would save the person having to go into the surgery’ (female, 80 yrs. old).
Most felt that phone consultations were not rushed ‘business was done, what’s the point in hanging around. I didn’t need any more time than what I had from the doctor’ (female, 68 yrs. old).
Prescription renewal, discussing test results and simple follow-ups were the most common reasons for which telehealth was used:
It helps if we don’t necessarily have to go face-to-face all the time, but a phone call. A renewal of prescriptions you’ve been on for a long time, and you’re finding them working well. (female, 68 yrs. old)
It was just a three-monthly diabetes check-up so it was nothing that couldn’t have been done over the phone anyway. (male, 64 yrs. old)
The availability of telehealth was highly appreciated by one participant who was diagnosed with cancer and required cancer investigations and treatments:
I was extremely grateful for those phone calls. It is, of course, not as good as a face-to-face because they can't see how you're looking and how you're actually doing. Nevertheless, I would have been lost without the phone calls. I appreciated that hugely. (female, 77 yrs. old)
There were differing views however on the usefulness of telehealth for mental health issues. While one participant felt: ‘if you had mental health problems that would probably be a difficult one to talk about over the phone, you might need to speak to somebody.’ (female, 68 yrs. old), another participant stated: ‘I see the benefit in the mental health space for argument’s sake where people are able to talk…to just be there privately in your own room with your computer talking to the person, it does assist a lot’ (male, 59 yrs. old).
A few participants who normally paid an additional charge (gap fee) for face-to-face GP visits appreciated the no-additional fee services (bulkbilling) mandated by Medicare for telehealth services:
The GP appointments have been really good because they’re bulkbilling, also I’ve been able to get in easily for the phone appointments. Our doctor’s surgery, they’re charging us, and now we’re not being charged, that’s a relief. (female, 56 yrs. old)
Many participants believed that ‘familiarity of the doctor with patient’ was crucial in telehealth communication:
Because my doctor knows me, I could say, “I need antibiotics or prescription”, and he says, “Yeah, okay”… but if you are talking by phone with a doctor that hasn’t seen you or doesn’t know you. That’s a big difference, isn’t it? (female, 68 yrs. old)
Finally, despite an emphasis in policy documents on videoconferencing as the preferred mode of communication, participants in this study were only offered telephone consultations with their GPs. For older participants with lower digital literacy telephone conversation was more convenient’ I don’t get on with the computer, I’m a bit old-fashioned’ (female, 69 yrs. old), however a few mentioned that they would have preferred videoconferencing but this wasn’t offered:
If it was perhaps online, such as Microsoft Meeting or Zoom, I probably would appreciate that a bit better, some GPs are offering just a phone consultation, I don't think that's satisfactory. (female, 76 yrs. old)
Opportunity for face-to-face consultations
Participants appreciated that they were still able to have face-to-face GP appointments if needed. Of 30 participants, 26 had had a face-to-face consultation. The COVID-19 safety measures adopted by general practices, mitigated patient’s fear of contracting the virus and this was not viewed as a major barrier to attending in person to the practice.
I felt quite comfortable, they were not taking a lot of people in, it was very staggered…you weren’t sitting with a lot of people in a waiting room with everyone coughing and sneezing over you. The practice did it very well, I had no concern at all. (female, 80 yrs. old)
I preferred to go there, I found that when you see the doctor you can sit there, you can read his face and I guess he can read yours. I found by phone it was less personal, less invasive, less whatever. (male, 73 yrs. old)
Continuation of telehealth services
Participants felt that telehealth should be continued for issues that do not need physical contact:
Absolutely, if I’m just doing that 6 or 12-monthly blood test thing, I’d be more than happy for him to mail me the paperwork and ring up for a report - no dramas. It’s only when I have something that I feel I need to see him about. (male, 73 yrs. old)