Table 4:

Participant themes regarding telemedicine primary care^*

PCP Themes	Example Quotes
Prefer in person visits
Physical exam necessary	“I also have several issues that I have put off until I can be seen as a virtual visit will not be of any help- are you going to get undressed and show a body part to the screen.” (Patient51)
In-person interaction helpful	“At my age there’s a certain positivity when seeing my PCP, which I did not get from the virtual visit. Comfort factor, I guess. I’m old… it’s nice to be seen.” (Patient29)
One-stop (vitals, blood work, testing can be done)	“My preference is an in-person visit because there is always blood work. The virtual visit is not a time and/or trip saver. It is an interim solution to in-person visits during the COVID 19 Pandemic.” (Patient47)
Higher quality	“Virtual visit cannot possibly offer the same high level of care as a traditional visit. Many details and questions are missed or forgotten because of contending with technical issues concurrently.” (Patient134) “Face to face visits are necessary so that the provider can examine or observe the patient and maybe detect a problem of which the patient is unaware or had forgotten.” (Patient25)
Annual Wellness Exams should be in person	“The virtual visit was completely satisfactory for an interim visit but not for an annual visit where the physician needs to examine the patient.” (Patient159)
Prefer telemedicine to remain an option
Hybrid model	“I’m happy to do some virtual and then alternate with in person visits.” (Patient37)
Ease of scheduling	“I am able to get an appointment faster than if it was for an in person visit.” (Patient122)
Useful for follow-up care, minor issues	“Virtual visits are quite satisfactory for routine matters. For non-routine matters I would prefer a traditional visit.” (Patient64)
Better with good doctor-patient relationship	“Since I have had this PCP for a while, I am comfortable enough raising issues/asking questions in person or virtually. If she was new, I might feel a little less likely to do so virtually.” (Patient145)
Prefer video to phone-only	“Video based is the closest thing to being there in person.” (Patient85)
Accessible	“I think it could be very useful if a patient has difficulty getting to the office - bad weather, mobility or illness problems, etc.” (Patient112)
Convenient	“Virtual visit will save a lot of time in terms of travel and waiting in the waiting room.” (Patient118)
Safer during a pandemic	“Maybe in an emergency, where somebody’s health would be compromised by going out.” (Patient93)
More focus/less interruption	“Quicker, easier and specific info given and received because there are no other interruptions. Recommend them for most of my problems, I am an old man with an ailing body…” (Patient189)
Easier to involve family	“My daughter attended a couple of appointments to take notes which was very useful.” (Patient143)
Briefer visit	“Feels there is more time pressure for calls; that doctor is more willing to spend extra time when in person.” (Patient96)
Technical challenges with telemedicine
Needs better processes	“A virtual reception room, to reassure the patient they have made the correct connections, would be reassuring.” (Patient126) “In the future I should have had my blood drawn a week or two before so that we can discuss the findings.” (Patient112) “If needed, send the pdf link to the Health Risk Assessment, prior to meeting.” (Patient84)
More training needed	“We believe that more care can be provided in this manner with appropriate planning and education.” (Patient33)
Need better technology	“Video for one is not good enough -- we all know how hard it is to take a picture that looks like life.” (Patient165) “It’s harder to hear the doctor.” (Patient115)
Too technologically challenging	“I’m not a computer person. The tech needed to use this virtual visit is beyond me.” (Patient133)
Too many different platforms	“Unfortunately I found that every practice uses a different program. It was very difficult to clarify what program I was supposed to use with each appointment.” (Patient174)
Plans not to use telemedicine
Not patient-centered	“There are times when I MUST have to see him face to face and a virtual visit would be totally unacceptable. I would change providers if it came to that.” (Patient43)
Perceives financial benefit to doctors/hospital	“I am very suspicious that the long term motivation to (get away with) virtual/phone doctor “visits” is driven by health care entities bottom line and am very concerned about that!” (Patient74)
Lower quality	“Do away with them. It is a ridiculous way to offer healthcare. An email would result in the same outcome.” (Patient38)

^*Codes were grouped into major themes which are highlighted in bold