Patients' Preferences for Synchronous Teleconsultation with a General Practitioner in Primary Care in Quebec: A Discrete Choice Experiment

This study aimed to elicit the preferences of Quebec adults regarding consultation modalities with a general practitioner (GP) and to examine how clinical and socioeconomic factors shape stated preferences for telephone and video modalities.

Participants were recruited via quota-based sampling to reflect Quebec's demographic profile (age, gender, and education) through a structured online survey conducted in 2025. The study employed a discrete choice experiment (DCE) featuring seven key attributes to elicit preferences for three synchronous consultation modalities: in-person, telephone, and video. Preferences and trade-offs were analyzed using mixed logit models. Willingness to pay (WTP) was calculated, and the influence of socioeconomic and clinical factors on the utility of digital care was examined. Finally, policy-relevant scenarios were simulated to estimate predicted choice probabilities and welfare implications.

A total of 1303 responses were analyzed. The most important attributes were total cost, patient-GP relationship and continuity of care, appointment availability, and consultation modality. In-person consultations remained the preferred option, with participants requiring compensation of 27.05 Canadian dollars (CAD) to accept a telephone consultation and CAD 29.37 for a video consultation in place of an in-person visit. The highest valuation was placed on continuity of care, with a WTP of CAD 45.43 to avoid consulting an unfamiliar GP without regular access to the patient's health record. Higher educational attainment was associated with significantly less negative preferences for video consultation. Scenario simulations showed that conditional choice probabilities exceeded 0.8 under ideal conditions, while in the best-case scenario, WTP was higher for in-person consultation (CAD 85.69) than for telephone (CAD 58.81) or video (CAD 56.62).

In-person visits remain the preferred option in Quebec. Telephone carried the smaller penalty and was valued consistently in the WTP-space model, whereas preferences for video varied more and were more favorable among respondents with higher education. Future service design should integrate virtual options without losing the continuity of care and affordability that patients value.