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"People contact their GP to ask about throat lozenges"

When technology makes doctors more accessible, it can lead to lower quality for patients and increased pressure on already stressed doctors, says Magnus Wanderås.

One in five consultations in Norwegian general practice is now digital.
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Presented by: University of Agder
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It has become easier to contact your GP. With just a few keystrokes, you can start an e-consultation where you can discuss what's on your mind. 

You can also ask your doctor for an appointment via video or phone if you prefer not to visit the clinic.

This development accelerated during the Covid-19 pandemic and has stabilised at a high level.

“One in five consultations in Norwegian general practice is now digital, which means either via phone, video, or a written e-consultation,” says Magnus Wanderås.

He has worked as a GP and has researched the topic at the University of Agder. 

In his research, he interviewed 24 GPs about how they perceive remote consultations have changed the general practitioner service.

Remote consultations are doctor's appointments via video or phone. It can also include written inquiries that the patient can initiate themselves, for example through Helsenorge, the official website providing information and access to health services for residents of Norway.

Follow-up appointments are necessary

These remote consultations are faster than in-person visits. They make it possible for GPs to see more patients. At least in theory.

Remote consultations are likely one of the reasons why the number of consultations has increased by 13 per cent since before the pandemic.

It doesn't help that nearly one in five of all those who have digital consultations still need an in-person appointment afterwards to resolve the issue.

“A GP I spoke to said that going to the doctor should be a bit special. It shouldn't be like going to the store and buying soda,” says Magnus Wanderås.

“Before Covid, there was hope that remote consultations could ease some of the pressure on GPs, but it's likely that instead, they have led to considerable double usage of doctor's appointments,” says Wanderås.

Ask about throat lozenges

Increased accessibility can lead to some people contacting the doctor about things they perhaps shouldn't seek medical advice about.

“A GP in the study mentioned a patient who sent an e-consultation to ask which throat lozenge the doctor would recommend for a cold,” says Wanderås.

At the same time, it is not easy for GPs to distinguish between serious and less serious enquiries in their inbox. 

Several describe checking e-consultations late at night to ensure there are no life-threatening conditions hidden among them.

'It's like having a direct line to the GP, and it's like asking already tired and conscientious GPs to become burned out,' says one of the doctors in the study.

Doorknob questions

Another of the doctors interviewed says:

'Most of what we do involves people skills. And we get these skills when we interact with people. These interactions make up perhaps 90 per cent of everything we do. Medicine is only a small part of it.'

“Some things can be handled digitally, and that's perfectly fine. But the more we move to digital platforms, the less room there is for doing good medical work,” says Wanderås.

It's about physical examinations, non-verbal communication, and what the researcher calls doorknob questions – the important issues patients often bring up right at the end of the appointment. 

Several GPs noted that some patients reveal the real reason for their visit as they are about to leave.

“That's when they could raise concerns about, for example, alcohol problems, after initially visiting the doctor for a sore elbow. This space disappears with digital consultations,” says Wanderås.

Want to oblige doctors to use video

The day before the interview with Wanderås, the Norwegian government proposed several measures (link in Norwegian) to increase the accessibility of GPs, among them an obligation to offer video consultations.

Wanderås is sceptical of such a requirement.

He emphasises that most GPs have already found a good way to work with digital consultations and that they should retain the freedom to find their own ways of working.

“This is a field where it's difficult to have definitive opinions. My interviews with 24 doctors are by no means enough to draw conclusions. There are probably GPs who think that digital consultations work perfectly,” he says.

Still, he reminds us that new technology must be used wisely.

“Innovation is not always the same as progress. If we see that the technology is not having the effect we hope for, the wisest course may be to take a step back,” he says.

Reference:

Wanderås, M. Going remote in general practice: Investigating the transformation of healthcare delivery enabled by remote consultations, Doctoral dissertation at the University of Agder, 2025.

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Read the Norwegian version of this article on forskning.no

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