Table 6 What’s required from the consultation

Objective factors

I still very much 100% think your first appointment should be a face-to-face. I would want the first one definitely so I would know what the exercises were (a) that you showed me what to do, but also that I was doing them correctly. [3BF03]

I just don’t see how you can do it over the phone. Like I said, I think for follow-ups it’s not too bad, I don’t see how you could possibly do it only that, because I don’t see how you could ever assess someone for the first time without having a prod. But I’m not a physio, so I don’t know. [3BF07]

But if it involves physical aspects where you’re having problems, has it changed, how is your knee looking or feeling now, can we see it move, then no, you have to go in for a check. [3BF04]

Certainly, in a physio setting, somebody demonstrating how to do exercises or specific movements, I don’t know how the physio knows by virtual whether you’re actually doing them right or not. [3BF03]

I would want a physical face-to-face appointment if I’m having a specific problem or a new issue. I mean, I’ve been there long enough that they know my condition and that’s fine. [3BV03]

In fact XX, a couple of weeks ago or last week, did actually phone out of the blue for an update. Everything that has been said previously they’ve sort of said again and it worked very well over the telephone [3BV06]

It seems like I can do that over the internet much easier than I can in person. It feels like a waste of time, where this is quick. I can say what I need to, they can ask the questions, I can answer them, it takes 10/15 min out of my time, consultation over. [3BV01]

But if I’m just coming up to be told a couple of things by someone looking on a screen and then saying this and that and then that’s it – then it is really pointless. [3BV06]

At the moment the way my leg is I would be quite happy - if you were my physio today I would sit here and I would show you how far I can bend my knee backwards and what I can do with it. It’s not as swollen as it was et cetera, et cetera. I think that’s perfect [3BF01]

I could teach anyone how to stretch their calves or their hamstrings, because I have to because I’ve got a dodgy back. That is less specialist and that is just the standard exercises out of the book, I’d call them. [3BF04]

Interaction factors

I still think it’s an age thing because I think it’s a security blanket going to see XX. You’ve built up that trust and that rapport over the last 20-odd years and you know they are doing their best for you. [3BF01]

When you’re face-to-face, personally, I think you can engage better. You can see by people’s expressions, their movements, or their body language, which I don’t think you can always do when you’re on a virtual. [3BF03]

Whether you’re gaining the therapist’s attention, full attention, as in - compared to a face-to-face. You can see what they’re doing. I do worry that there was other things going on. They were using the phone, answering other calls, or writing other texts, because you only see a head above. [3BF03]

If I’ve had a telephone conversation, people can - it’s much easier to switch off what you’re saying or not hear clearly or misunderstand thing when you have a virtual one. [3BF04]

I think that in itself is a kind of therapy, really, because when you - no matter what you’re going through, if someone else can see and are empathising with you, you start to feel a little bit better. You start to feel, well, someone here is concerned about me. They’re going to try their best to help me. I find the - I just find video calling a bit cold. [3BF05]

I know things like Zoom has tightened up on their security. So maybe if they’re having more intimate type of examinations or having to remove clothing and all the rest of it, they might feel a bit uncomfortable doing that on a screen [3BV03]

I think the first appointment it’s always good to have virtually. The reason is that you can actually speak to your physio team and you can explain to them and they will be prepared, they will know that exactly. This patient, it’s their first appointment, you can speak to them virtually, they know exactly what the issues, what the problems are. They can have their own plan and let’s say the second appointment is face-to-face, so they know about you, they have a knowledge. Reading about you is one thing but speaking to you is another thing [3BV04]

XX would know my knee was fine. There’s that trust, isn’t there. XX - [he’ll go, it’s alright XX] your knee is not bad at the moment. Next time we’ll just do it - over the iPhones or whatever. I’ll go yeah, yeah cool. [3BF01]

If you’ve got a good rapport with them, and the patient gets confident that what they’re saying is true, then yeah, I think that [vc]'s a good option. [3BF03]

Plus it can sort of read wrong results into it, where if you’ve travelled for a long time and you’re really hurting when you get there, then you’re not really showing the true average day as well, so I don’t know. [3BV02]

They may have more success to have an interpreter within their own home and then they wouldn’t have to impinge on that person’s time, as well, to take them to the hospital with them [3BF09]