Telemedicine may help practitioners better reach their patients, but the convenience could come at a cost for the provider. In a qualitative study recently accepted in Nature’s Pediatric Research journal, pediatric doctors conducting telemedicine consultations report a number of medical and non-medical challenges that are not present during face-to-face encounters.

"It is clear that doctors working in this pediatric telemedicine service should have special qualities and skills beyond those required from standard physicians," lead author Dr. Motti Haimi of Clalit Health Services at the Children’s Health Center in Haifa, Israel, said in a statement. "Decision-makers should be aware of the challenges and special skills and training required to succeed in this setting.”

To explore how a telemedicine consultation may differ from standard care from the provider’s perspective, Haimi and colleagues interviewed 15 randomly selected pediatricians who had recently worked for Pediatrician Online of Clalit, the center’s telemedicine service offering urgent medical advice out of community clinic hours. Although the initial contact between doctors and parents consists of a telephone conversation, practitioners have access to the child’s medical records and can conduct a live video chat through a computer or device if necessary.

Through their qualitative analysis, the researchers identified a number of recurring challenges cited by the pediatricians. These consisted of concerns regarding the difficulty of diagnosing at a distance, having to treat patients with whom they were unfamiliar, having to work alone, technological obstacles, and the urgency and volume of calls they received. Pediatricians also expressed difficulty stemming from a clash between satisfying parents and maintaining appropriate standards of care.

"To overcome the problems mentioned above, the physicians in this study used different strategies, including use of intuition, their experience, and taking protocols,” Haimi said in a statement. “They confessed that they used non-medical or contextual factors to make decisions in this high-stress environment.”