Medical diagnosis by phone might not be the answer

Medical diagnosis by phone might not be the answer. Picture: Supplied

Medical diagnosis by phone might not be the answer. Picture: Supplied

Published Nov 22, 2016

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As anyone who's struggled to make an appointment with their doctor will know, general practitioners are under tremendous pressure.

Indeed the problem is so great in some practices that patients must phone early in the morning to secure a slot that day or even for one week ahead.

A short-term solution is to recruit more GPs and to try to make sure that too many don't leave the profession because burn-out is rife.

However, according to reports, the NHS is looking at another answer: replacing traditional face-to-face consultations with phone chats with a GP.

Already, research suggests that one in ten consultations with a GP is over the phone. Shockingly, this follows another highly controversial initiative under which it was said that patients would get a three-minute phone consultation with a GP.

Only those deemed seriously ill would be able to see a GP face-to-face. These are dreadful proposals. A few minutes chatting to a GP by phone can never replace seeing them in the flesh.

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Such ideas fly in the face of everything that doctors are taught at medical school, about how more than half of all communication is non-verbal.

Today's medical students are sent on courses in how to read subtle but important body language clues. As always, the people I fear who would suffer most are the elderly and those struggling with their mental health.

These are the people who are most likely to be reluctant to bother their doctor, or feel anxious or embarrassed about discussing their problem. Forcing them to prove to an anonymous voice on the phone they're worthy of an appointment with their doctor is unreasonable and uncaring.

What's more, a phone consultation means there is never that key moment in the surgery, which doctors refer to as the door knob revelation.

This is when, after discussing an ailment, the patient is just about to leave the consulting room when, as they reach the door, they suddenly turn back and raise another symptom.

Often this is the problem that's been seriously worrying them - but they didn't think it was important enough or they were embarrassed to book an appointment for it.

Often it's a mental health concern, men in particular are reluctant to book a GP appointment just to talk about how they are feeling. Or sometimes it's a seemingly small thing such as a persistent, niggling cough that can turn out to be an indication of something much more serious, such as cancer.

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Or maybe its slightly more embarrassing, such as erectile dysfunction, and they've spent the whole consultation trying to pluck up the courage to mention it to their GP.

I am indignant about the phone consultation idea. It would be a sticking plaster hastily applied without any proper thought. Its cost-cutting dressed up as efficiency and we shouldn't accept being fobbed off in this way, says Dr Pemberton.

Daily Mail

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