Management of diagnostic uncertainty in teleconsultation by General Practitioners (GPs) in primary care
Abstract
Introduction Diagnostic uncertainty is ubiquitous in general practice. General practitioners perceive it more frequently during teleconsultations, where the clinical reasoning process is altered, the physician physician-patient relationship is disrupted, and physica l examination is limited or absent. In 2020, general practitioners feared that teleconsultations would increase diagnostic unce r- tainty, yet no study had explored how diagnostic uncertainty is managed in this context. Objectives To identify the sources and consequences of diagnostic uncertainty and to explore how general practitioners man- age diagnostic uncertainty in teleconsultations. Methods An inductive qualitative study based on semi semi-structured individual interviews was conducted using an interview guide. Sampling began through networking, then was purposive as interviews progressed until data saturation was reached. Two researchers performed an inductive thematic content analysis. Results : Fifteen interviews approached data saturation. Diagnostic uncertainty was greater in teleconsultations and generated negative emotional experiences among general practitioners, including worry, frustration, and dissatisfaction. Inappropriate conditions for teleconsultations and difficulties in identifying or interpreting symptoms via video contributed to this uncer tai nty. In response, general practitioners adapted their diagnostic approach by adopting a more exhaustive process, which some- times led to over over- or under under-prescribing and the arrangement in in-person consultations. They also involved patients by explicitly expressing their diagnostic uncertainty , instructing them on warning signs, and providing guidance based on symptom evolu- tion. Conclusion : To manage diagnostic uncertainty in teleconsultations, general practitioners modified their usual reasoning pro- cess, tended to over over-prescribe, and arranged in in-person consultations. While the exhaustive diagnostic approach compensates for uncertainty, it may also be more resource resource-intensive and less aligned with evidence evidence-based medicine.
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BibTeX
@article{courtin2026management,
title = {{Management of diagnostic uncertainty in teleconsultation by General Practitioners (GPs) in primary care}},
author = {Marion Courtin and Hadrien Prelaud and William Mirat and Julien Le Breton and Florian Caselli},
journal = {French Academic Journal of Primary Care},
year = {2026},
month = sep,
doi = {10.46298/fajpc.19491},
url = {https://hal.science/hal-05763541v1},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Management of diagnostic uncertainty in teleconsultation by General Practitioners (GPs) in primary care
AU - Marion Courtin
AU - Hadrien Prelaud
AU - William Mirat
AU - Julien Le Breton
AU - Florian Caselli
PY - 2026
DA - 2026/09/25
JO - French Academic Journal of Primary Care
DO - 10.46298/fajpc.19491
UR - https://hal.science/hal-05763541v1
AB - Introduction Diagnostic uncertainty is ubiquitous in general practice. General practitioners perceive it more frequently during teleconsultations, where the clinical reasoning process is altered, the physician physician-patient relationship is disrupted, and physica l examination is limited or absent. In 2020, general practitioners feared that teleconsultations would increase diagnostic unce r- tainty, yet no study had explored how diagnostic uncertainty is managed in this context. Objectives To identify the sources and consequences of diagnostic uncertainty and to explore how general practitioners man- age diagnostic uncertainty in teleconsultations. Methods An inductive qualitative study based on semi semi-structured individual interviews was conducted using an interview guide. Sampling began through networking, then was purposive as interviews progressed until data saturation was reached. Two researchers performed an inductive thematic content analysis. Results : Fifteen interviews approached data saturation. Diagnostic uncertainty was greater in teleconsultations and generated negative emotional experiences among general practitioners, including worry, frustration, and dissatisfaction. Inappropriate conditions for teleconsultations and difficulties in identifying or interpreting symptoms via video contributed to this uncer tai nty. In response, general practitioners adapted their diagnostic approach by adopting a more exhaustive process, which some- times led to over over- or under under-prescribing and the arrangement in in-person consultations. They also involved patients by explicitly expressing their diagnostic uncertainty , instructing them on warning signs, and providing guidance based on symptom evolu- tion. Conclusion : To manage diagnostic uncertainty in teleconsultations, general practitioners modified their usual reasoning pro- cess, tended to over over-prescribe, and arranged in in-person consultations. While the exhaustive diagnostic approach compensates for uncertainty, it may also be more resource resource-intensive and less aligned with evidence evidence-based medicine.
SN - 3130-334X
ER -