Background Telephone consultations are common in supporting patients and caregivers in managing symptoms from cancer diseases and side effects from cancer treatment. In connection with telephone consultations, it may be a challenge that healthcare professionals have to rely on their auditory sense alone when they assess whether the problem can be solved over the telephone, or whether patients need an examination face to face. Objective To explore how healthcare professionals identify patients? essential concerns and assess serious conditions in calls to an oncological emergency telephone without face-to-face contact. Methods From a phenomenological-hermeneutical frame of reference, the analysis of three focus groups with a total of 16 healthcare professionals was guided by content analysis. Ethics The study follows the ethical guidelines for research. Results Two themes emerged. To identify patients in serious conditions, healthcare professionals kept focus on: (1) ?Reaching a mutual understanding without the clinical eye?. Before making a decision regarding a face-to-face examination, the healthcare providers were as follows: (2) ?Listening to an inner voice ? attention on clues and signs?. Limitations The transferability of the findings is limited to healthcare professionals who perform telephone-mediated care in a team of nurses and physicians. Conclusion Staying open for diverse perspectives and integrating nonanalytical as well as analytical illness scripts, healthcare professionals were able to identify patients that needed further examination face to face.