Most of us have become familiar with the idea of the virtual medical appointment: GP Dr Paul Carroll explains the pros and cons for patients and doctors alike …
We have all got used to conducting more of our lives in front of a screen so it doesn’t come as a surprise that the experience of a virtual consultation with a GP – by voice call or video – is mostly a good substitute for a face-to-face consultation.
We say mostly because, of course, there are exceptions.
From conducting approximately 95 per cent of appointments in person pre-lockdown, GP practices have flipped their business model, finding that only a small number require a direct physical examination whilst we are still under level 5 restrictions. “While how we work has changed during this pandemic, what we do has not,” says Dr Paul Carroll of Churchtown Medical. “We have redesigned how we work around patients.” For his practice this means an easy and efficient virtual consultation service with patients booking via the surgery and connecting to a video consultation using a browser or via an app. For him and his colleagues at Churchtown Medical, the last year has established the efficacy of the vast majority of video consultations.
“I think before lockdown we would have been concerned that there was more clinical risk involved in not having the patient come to the surgery, “Dr Carroll tells Positively THE GLOSS. “But we have found that if you have the right set-up a good call or video is both effective and efficient. It’s still a time-limited encounter but also still a one-to-one consultation, with an opportunity for a virtual examination if required. The bonus is that the patient is relaxed at home, there’s no time spent getting coats off or helping someone onto the table, it’s convenient and user-friendly.”
The process is helped by patients not having to take time off work or find parking or having to wait with a bunch of strangers for their turn. “The dynamic is different, they are less stressed. What often used to be a two-hour experience (including time off work, and travel and waiting times) is now achieved in 15-20 minutes.”
He is quick to emphasise that a video call is sometimes more revealing than an in-person meeting involving wearing PPE, two-metre distancing and face masks. “On a video call free of these constraints, you can read a patient’s facial expression (and they can see yours), pick up on nuances and tune in much more closely.”
Dr Carroll still sees patients face to face if, in his judgement, the call or video encounter sparks a concern. “There are certain complaints, for instance, pains in the chest or abdomen, when I need to physically put a hand on the tummy. Or if a lump needs to be investigated, or a sore throat examined. GPs are trained to pick up on cues and can sense if something doesn’t feel right.” It’s always patients-first and in these instances, the patient will be invited in at no extra charge.
For those patients who are nearing end of life, Dr Carroll continues to attend with a combination of house calls and virtual consultations. “In many ways, for their families in these circumstances, the virtual consultation is a godsend, involving minimal disruption and upset.”
The revised prescriptions protocol introduced in April 2020 is the single biggest change for good for GPs in terms of their time and convenience for patients. “This has totally changed our lives: we can now send a prescription with three clicks to a patient’s pharmacy, no handwritten signature required. We have an electronic record, the pharmacy has a record so it’s safer and much more convenient than before.”
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