It has been suggested that joint teleconsultations can improve communication at the primary-secondary care interface. We examined data from a qualitative analysis of social interactions in teleconsultations between specialists and general practitioners. The primary interaction was between specialists and patients. The general practitioners mostly adopted a ‘back seat role’, listening and observing, but not becoming actively involved. Teleconsultations create a number of interactional difficulties, which are likely to impede implementation and sustainability.