Why do telephone consultations work?

Since the pandemic occurred in early 2020 there has been a radical change in GP and nurse consultations. The continuing requirement for 1-meter physical distancing means that waiting rooms cannot be the busy places that they once were. But we’re just as busy, if not more so. It’s just that we spend most of that time on the telephone.


How is it possible to do the job as well as previously?

Non-urgent advice: The diagnostic process

Most of the skill in making a diagnosis or figuring out the issues that require attention involves talking and listening. Usually a diagnosis is apparent with a good clinical history. Examinations and tests are normally about verifying that diagnosis rather than making it.

Should an examination or a test we can perform in the surgery be required, it is a straightforward matter for somebody to come in to the building. However, the benefit of being able to do much of the work on the telephone means that patients do not have to take time away from work or travel unnecessarily to see us. People seem to like that. Though for some it may be more difficult (e.g. language barriers and learning difficulties).

Non-urgent advice: Photographs

The ability to take good quality photographic images and send them to the practice by email to a dedicated account is new for us too.

Good lighting and something such as a measuring tape to illustrate size is really helpful and also provides a record for the clinician and patient as the condition evolves. We often send a good image with a referral letter to a specialist.

Non-urgent advice: What of the future?

It is likely that we will continue to offer a large proportion of telephone appointments for the convenience that it offers people. We hope to offer easier access to face-to-face consultations once vaccinations are complete and the necessary restrictions during the pandemic have relaxed.

However, do consider if a telephone conversation with your doctor or nurse of choice would be the best option for you in the first instance. And remember, you can book them in advance, not just same day.


Evidence

There remains conflicting evidence about how good telephone consultations are both for doctors and nurses and for patients too.

Below you can find a link to a British Medical Journal review article from 2017 by Prof Brian McKinstry (who used to be a local GP in Blackburn).