Table 2.

Subthemes related to Theme 2: ‘Challenges related to assessment, diagnosis, ‘hands on’ treatment, observation, communication, and technology’.

Subtheme	Illustrative quotes
Accurate assessment and diagnosis	I think if it'd been face-to-face, he would've been able to do a better clinical assessment. I have a couple of little sort of tender spots, which I think he would be able to determine as I've described and pointed them out to him. It's really not quite the same as him being able to examine me and assess it himself (P3); Maybe the assessment might be a bit harder to do online just because they can't physically look at the area, and do tests, and exercises (P7); So if I've just go for a run and felt my calf go, I'd need to go to him to assess it for me. So more for a diagnostic level, I'd rather him be present and be able to feel the swelling, feel the injury, feel exactly where it is instead of me trying to point and explain it on video (P12); I believe it would've been more useful if somebody could've had their hands on and felt around, or at least been able to work out a little bit more detail around the injury (P8).
Lack of hands-on treatment	I understand what alignment needs and how to do these exercises correctly. But for other people, if they've never done something like that and they're on telehealth, they might need someone to give them cues to fix their positioning and it's a lot harder to do that over the internet than it is for someone to get physical cue (P13); If you needed to do something which was hands-on, then you couldn't do that (P10); I have a physio that I see for my back and there's no point – I wouldn't even – he does manual manipulation and there's just no point in doing that remotely (P4).
Difficulty with observation	The scope to kind of observe is limited in telehealth unless you've got a really well-positioned camera or you can kind of move this around so that [the physio] is able to see what he needs to see (P11); I was doing the exercises on – with my laptop, moving my laptop around on the floor, on the chair that I was doing the exercises, and – I don't know. I just felt like he wasn't getting as complete a picture of what I was doing as he would've if we were in the same room (P4); I obviously much prefer face-to-face as its just easier to show him like spots that might be hurting and my technique for some exercises cause it can be hard trying to angle the camera and find a place to show him the whole body and things like that (P7); The hardest bit was trying to find an angle to set up my iPad so that [physio] could see me when I was doing the exercises and all that sort of thing (P5).
Understanding and communicating	You don't get the same information from a patient by talking to them on the phone or seeing a picture of them that you get by actually being there (P10); I find better being face-to-face. It just triggers more questions, triggers – I can actually feel more comfortable in showing him my exercises and where I'm having issues, where my knees hurt … I found it easier face-to-face than online in telehealth (P6); You can't see the facial expressions as well, so you can't really gauge whether or not he's totally understood what you're meaning … You feel like the person understands you more, just being physically there (P7).
Perceived as less personal typically but not always	I suppose the disadvantage is, that face-to-face, which is always nice to have human contact. But now, all I feel like is I'm talking to a screen. You don't get to feel the energy in the room, you don't get to feel that person's energy (P14); I'd like to speak to people, see people face-to-face …. I think it's just more personal if you're there, over telehealth (P5); I like technology, so I don't have a problem with technology. … You still get all the personal stuff. So, there's no issue around feeling close to the practitioner (P8).
Technology concerns	This Zoom business is quite complicated (P10); I think that the platform – that [the clinic] was not a very good platform … there were some issues with the browser that you needed to have in order to operate the software on a laptop … I would have preferred to have the consult on my laptop for some bigger screen real estate, I ended up having to use it on my phone because that's all I could make the software work on (P11); I don't know what the problem was, but initially when we started … something went wrong with it and [physio]and I ended up FaceTime-ing (P5); I was down in my shed, I wasn't in the house, so I was running off 4G, and I don't have very good connection here where I am (P5); I didn't have earphones so I didn't quite understand this whole process. I think it was the second time that I'd used it. His receptionist was fabulous in coaching me through it and she set it up (P6); The internet connection is also – wasn't the best for me here, so it was cutting in and out a lot. So, sometimes it was hard and I had to get him to repeat things (P7); [Technology] needs to be supported right through that entire chain of activities and so, not just around sort of booking the activity, but also paying as well (P11).