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2.5. Telephone consultations
It’s Telephone consultations can be cheaper and quicker than seeing patients face to face, but they carry risks. In the right circumstances, they can increase efficiency, improve access and boost patient satisfaction.
Benefits
- There is increased efficiency. • By talking to patients before they make an appointment, doctors can ensure they only see people who would benefit from a face-to-face consultation.
- Waiting times and appointment systems can be better managed, leading to greater patient satisfaction and lower staff stress levels.
- Patients have another channel through which to access primary care. This is particularly useful for people with reduced mobility or very little spare time.
- Telephone consultations can increase the opportunity for a patient to consult their preferred doctor, reinforcing the relationship, to the benefit of both parties.
Drawbacks
- Doctors rely on visual cues for diagnosis and these are absent in phone consultations. This could lead to a greater risk of wrong diagnosis.
- Phone calls are dependent on the setting, with both parties influenced by their surroundings and mood. Patients won’t necessarily share the full details of their health problem. Doctors won’t always interpret what they say correctly.
- People who don’t speak English as their first language are not always confident at self-expression. Decision-making is difficult for the GP. Involving interpreters is complicated and costly.
- While some patients appreciate telephone consultations, others regard it as a blocking tactic.
- Telephone consultations can result in higher phone bills – up to 25% higher.
- Not all conditions are suitable for phone management. Some will need a personal examination.
Costs
There are minimal costs involved in introducing a telephone consultation system. Phone systems need to be up to date, with increased capacity and more than one line into the practice. Computer systems should permit internal messaging and fast retrieval of patient records. Phone bills will rise in proportion to the increase in telephone consultations being made.
Telephone consultations by GPs in normal practice hours serve a variety of purposes:
In clinical management
- Assessing a new clinical problem and recommending appropriate action – such as a home visit, surgery appointment, hospital visit or self-care.
- Offering a second opinion or taking over management from a colleague.
- Giving advice – particularly when the patient is well known to the doctor.
- Multi-tasking, eg conducting a surgery while on call for emergencies.
- Following up a clinical problem.
In practice organisation
- Arranging repeat prescriptions or medical certificates.
- Giving the results of investigations.
- Fielding a complaint or other feedback.
- Speaking to third parties about a patient, eg relatives or social workers.
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