Boundary-work of primary care physicians using telemedicine technologies for communication.

Abstract

Implementing telemedicine technologies (TT) for patient-physician communication leads to the emergence of new structures of boundaries. Hence, boundary work theory can provide a useful lens for examining how primary care physicians (PCPs) experience TT. The objective of this research was to examine the experiences of PCPs in using TT in their communication with patients. During 2023 in-depth interviews were conducted with 20 Israeli PCPs: family physicians and pediatricians. The concept of boundary work emerged as a focal point, with three forms of boundary work identified in the PCPs' descriptions of their TT experiences: collaborative, competitive, and configurational. Interviewees described improved collaboration with patients who find it difficult to get to the clinic and better service for administrative issues. However, they reported constant power struggles to maintain their authority. They expressed concern about treatment failure and suggested that healthcare organizations reconfigure TT so that it can be used to provide optimal care. They suggested that healthcare organizations should instruct physicians how to best manage TT consultations and regulate its usage. This article demonstrates that while implementing TT in primary care has many advantages, it uncovers boundary work for maintaining power and authority that both PCPs and healthcare organizations should take into account in practice as well as in policy.