The obscured face in video consultations: a qualitative analysis of patient experiences

Elisabeth Assing Hvidt, Frida Greek Kofod, Johannes Van Den Heuvel, Michael Scheffmann-Petersen

Keywords: Video consultations, general practice, phenomenology, Levinas, Buber, ethical telecare

Background:

Video consultations represent a relatively new way of delivering face-to-face consultation in the context of general practice. In Denmark, video consultations have since 2025 become a mandatory service in general practice. We lack knowledge about how video-mediated consultations affect the possibilities for communication about vulnerable issues.

Research questions:

The aim of the present analysis is to examine how video consultations influence patients’ experiences of their ability to communicate their emotions, needs, and vulnerabilities, as well as the GPs’ ability to respond to these.

Method:

The empirical base consists of 43 semi-structured interviews with patients (23 women and 20 men), aged between 17 and 81 years old, who have used video consultation as part of their treatment for various health issues in general practice. Emmanuel Levinas’ theory of "the face" was used as an analytical and interpretative tool.

Results:

The analysis showed that in video consultations, patients experience a digital obscuring of the face, i.e., of their emotions, needs and vulnerabilities. This complicates the GP’s ability to perceive their vulnerability, making it challenging to recognize the patients’ needs. Moreover, this obscuration hinders the patients’ capacity to connect to their own vulnerabilities, which can lead to a diminished awareness of their own suffering. On the other hand, this mechanism might help those patients who wish to obtain shielding from their face and from difficult emotions.

Conclusions:

We conclude that significant relational and ethical dimensions of care within the doctor-patient relationship in general practice are challenged in video consultations. We propose integrating Buber’s dialogical principles with the present Levinasian analysis as it may offer a promising approach to enhancing relational dynamics in video consultations.

Points for discussion:

How do we enhance relational dynamics in video consultations?

Are video consultations suitable for addressing and discussing vulnerable issues?

What characterises the communicative situations in which vulnerabilities have been successfully addressed in video consultations?

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