Patient and Clinician Perceptions about Remote Video Visits for Musculoskeletal Problems: A Qualitative Study

Document Type : RESEARCH PAPER


1 Dell Medical School Austin, The University of Texas at Austin, TX, USA

2 Department of Psychiatry, Dell Medical School Austin, TX, USA


Background: An understanding of patient and clinician opinions about remote video musculoskeletal consultations
might help determine how to increase appeal and utilization. The purpose of this study was to evaluate perceptions of
remote video musculoskeletal consultations. Our research questions was what are patient and clinician facilitators and
barriers for the use of remote video consultations?
Methods: Prior to the COVID-19 pandemic 27 English speaking adult patients seeking ambulatory care for a
musculoskeletal problem, and 10 English-speaking musculoskeletal clinicians were interviewed using a guide.
Interviews were audio-recorded, transcribed, and coded using applied thematic analysis.
Results: Patient and clinician incentives for remote video consultations included increased convenience, lower costs,
less waiting time, and a better experience. Patient and clinician barriers to remote video consultations included concerns
about familiarity with technology, lack of personal interaction and physical examination, inability to perform procedures,
difficulties with reimbursement (clinicians), as well as technical, logistical, and privacy issues.
Conclusion: This qualitative study performed prior to the pandemic found that adoption of remote video consultation for
musculoskeletal problems may improve with seamless, efficient, and effective care, at an affordable price, particularly if
the human connection is similar to what occurs in person.
Level of evidence: Not applicable


1. Armfield NR, Bradford M, Bradford NK. The clinical
use of Skype—For which patients, with which
problems and in which settings? A snapshot review
of the literature. International Journal of Medical
Informatics. 2015; 84(10):737-42.
2. Buvik A, Bugge E, Knutsen G, Småbrekke A,
Wilsgaard T. Quality of care for remote orthopaedic
consultations using telemedicine: a randomised
controlled trial. BMC health services research. 2016;
3. Benger JR, Noble SM, Coast J, Kendall JM. The safety
and effectiveness of minor injuries telemedicine.
Emergency medicine journal. 2004; 21(4):438-45.
4. Sharareh B, Schwarzkopf R. Effectiveness of
telemedical applications in postoperative follow- 
up after total joint arthroplasty. The Journal of
arthroplasty. 2014; 29(5):918-22.
5. Dietsche E. 82% of consumers do not use telehealth,
survey says.
6. Thranberend T. Video Consultations. An Effective
Tool for Outpatient Care - Acceptance among Doctors
Is Key to Leveraging Usage. 2015.
7. Guest G, MacQueen KM, Namey EE. Applied thematic
analysis. Sage publications; 2011.
8. Cook NL, Hicks LS, O’Malley AJ, Keegan T, Guadagnoli
E, Landon BE. Access to specialty care and medical
services in community health centers. Health Affairs.
2007; 26(5):1459-68.
9. Felt-Lisk S, McHugh M, Howell E. Monitoring 
local safety-net providers: do they have adequate
capacity? Health Affairs. 2002; 21(5):277-83.
10. National Health Expenditures 2016 Highlights.
pdf, 2018.
11. Marsh JD, Bryant DM, MacDonald SJ, Naudie
DD, McCalden RW, Howard JL, et al. Feasibility,
effectiveness and costs associated with a webbased
follow-up assessment following total joint
arthroplasty. The Journal of arthroplasty. 2014;
12. Marsh J, Hoch JS, Bryant D, MacDonald SJ, Naudie D,
McCalden R, et al. Economic evaluation of web-based
compared with in-person follow-up after total joint
arthroplasty. JBJS. 2014; 96(22):1910-6.
13. Müller KI, Alstadhaug KB, Bekkelund SI. Acceptability,
feasibility, and cost of telemedicine for nonacute
headaches: a randomized study comparing video
and traditional consultations. Journal of medical
Internet research. 2016; 18(5):e140.
14. Bradbury A, Patrick-Miller L, Harris D, Stevens
E, Egleston B, Smith K, et al. Utilizing remote
real-time videoconferencing to expand access to
cancer genetic services in community practices:
a multicenter feasibility study. Journal of medical
Internet research. 2016; 18(2):e23.
15. Polinski JM, Barker T, Gagliano N, Sussman A,
Brennan TA, Shrank WH. Patients’ satisfaction
with and preference for telehealth visits. Journal of
general internal medicine. 2016; 31(3):269-75.
16. McGrail KM, Ahuja MA, Leaver CA. Virtual visits and
patient-centered care: results of a patient survey
and observational study. Journal of Medical Internet
Research. 2017; 19(5):e177.
17. Dixon RF, Stahl JE. A randomized trial of virtual visits
in a general medicine practice. J Telemed Telecare.
2009; 15(3):115-117.
18. Kontos EZ, Emmons KM, Puleo E, Viswanath K.
Communication inequalities and public health
implications of adult social networking site use in
the United States. Journal of health communication.
2010; 15(sup3):216-35.
19. Chou WY, Hunt YM, Beckjord EB, Moser RP, Hesse BW.
Social media use in the United States: implications
for health communication. Journal of medical
Internet research. 2009; 11(4):e48.
20. Beckjord E, Rutten LF, Squiers L, Arora N, Volckmann
L, Moser R, et al. Use of the internet to communicate
with health care providers in the United States:
estimates from the 2003 and 2005 Health Information
National Trends Surveys (HINTS). Journal of medical
Internet research. 2007; 9(3):e20.
21. Kontos E, Blake KD, Chou WY, Prestin A. Predictors
of eHealth usage: insights on the digital divide from
the Health Information National Trends Survey
2012. Journal of medical Internet research. 2014;
22. Gordon NP, Hornbrook MC. Differences in access to
and preferences for using patient portals and other
eHealth technologies based on race, ethnicity, and
age: a database and survey study of seniors in a large
health plan. Journal of medical Internet research.
2016; 18(3):e50.
23. Nundy S, Razi RR, Dick JJ, Smith B, Mayo A, O’Connor A,
et al. A text messaging intervention to improve heart
failure self-management after hospital discharge in
a largely African-American population: before-after
study. Journal of Medical Internet Research. 2013;
24. Bartlett EE, Grayson M, Barker R, Levine DM, Golden
A, Libber S. The effects of physician communications
skills on patient satisfaction; recall, and adherence.
Journal of chronic diseases. 1984; 37(9-10):755-64.
25. Czaja SJ, Charness N, Fisk AD, Hertzog C, Nair SN,
Rogers WA, et al. Factors predicting the use of
technology: Findings from the center for research
and education on aging and technology enhancement
(CREATE). Psychology and aging. 2006; 21(2):333.
26. van Houwelingen CT, Ettema RG, Antonietti MG,
Kort HS. Understanding older people’s readiness for
receiving telehealth: Mixed-method study. Journal of
medical Internet research. 2018; 20(4):e123.
27. Chumbler NR, Li X, Quigley P, Morey MC, Rose D,
Griffiths P, et al. A randomized controlled trial
on stroke telerehabilitation: the effects on falls
self-efficacy and satisfaction with care. Journal of
telemedicine and telecare. 2015; 21(3):139-43.
28. Emme C, Mortensen EL, Rydahl‐Hansen S, Østergaard
B, Svarre Jakobsen A, Schou L, et al. The impact
of virtual admission on self‐efficacy in patients
with chronic obstructive pulmonary disease–a
randomised clinical trial. Journal of Clinical Nursing.
2014; 23(21-22):3124-37.
29. Hansen MM. A feasibility pilot study on the use
of complementary therapies delivered via mobile
technologies on Icelandic surgical patients’ reports
of anxiety, pain, and self-efficacy in healing. BMC
complementary and alternative medicine. 2015;
Volume 9, Issue 3
May 2021
Pages 330-337
  • Receive Date: 10 July 2019
  • Revise Date: 01 April 2020
  • Accept Date: 05 April 2020
  • First Publish Date: 01 May 2021