Physicians’ ability to clinically evaluate patients remotely in Finnish healthcare organisations

Abstract Background Teleconsultations can support early symptom detection and treatment, offering public health value if physicians can effectively assess and diagnose patients remotely. Insights into physicians’ experiences are key to improving the quality and reliability of remote care. This study examined their perceptions and the factors linked to finding remote evaluations challenging. Methods A nationwide cross-sectional Physicians’ Working Conditions and Health 2024 Study was conducted. The outcome was the perceived effect of teleconsultations on clinical evaluations, categorised as ‘more challenging’ versus ‘no difference from in-person’. We used binary logistic regression to assess associations of organisational factors and consultation type with the outcome, adjusted for career factors. Results Among teleconsulting physicians (N = 1,264), 71.4% found remote evaluations more challenging than in-person evaluations; 28.6% reported no difference. In the multivariable model, working in health centres (OR = 1.69, 95%CI=1.16-2.46) or private clinics (OR = 1.75, 95%CI=1.20-2.55; vs hospitals), and higher understaffing (OR = 1.77, 95%CI=1.52-2.06) were associated with greater odds of finding remote evaluations challenging. Insufficient line manager support for teleconsultations (OR = 3.72, 95%CI=1.88-7.37) and conducting initial (vs follow-up) consultations remotely (OR = 2.50, 95%CI=1.86-3.37) were also associated. Conclusions Physicians working in primary care and understaffed units may face particular difficulties in remote patient evaluation despite these being the settings where teleconsultations could especially improve access to care. We recommend: 1) strengthening nurse- or AI-led triage systems to identify patients with symptoms needing in-person physician evaluation and 2) developing line manager support for adapting to remote evaluations. These actions may sustainably improve timely care and physician wellbeing, but further research should assess their full public health impact. Key messages • Teleconsultations can promote preventive care, but physicians find remote evaluations challenging, especially in primary care, with limited staffing and support, and during initial consultations. • Improved triage and support from line managers could enhance the quality of physicians’ remote evaluations, potentially contributing to more timely, effective care and better working conditions.