Designing Virtual Primary Care: Desire or Dread? How Structural Forces Shape the Anticipation of Futures

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The COVID-19 pandemic changed many healthcare companies' priorities and dramatically accelerated the drive towards increasingly virtual health care. Grand Rounds Health*, a healthcare startup, decided the time is now to launch its virtual primary care offering. It was assumed that a rural, lower-socioeconomic population would be more eager for, and best served by, virtual primary care, given their greater geographic distance from clinicians and other assumed access deficits. However, ethnographic research revealed that it was the urban, higher-socioeconomic population who both reported far more favorable experiences with remote care and more eager anticipation of virtual primary care. This is partly due to different technological experiences and ecosystems, but more directly due to differing trust in and agency with institutionalized health care. Ultimately, this case study reminds researchers that our experiences are shaped and limited by our social positions, and that we cannot know if the framing of our inquiry is adequate. Article citation: 2021 EPIC Proceedings pp 91–107, ISSN 1559-8918,

Keywords: Ethnography, healthcare, social location, socioeconomic status

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