DoH PLANS For Phone Consultations "Could Be Flawed", Warns MDDUS, UK

Main Category: Primary Care / General Practice
Article Date: 02 Feb 2009 - 5:00 PDT

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Reported government plans to push for more GP phone consultations as part of its Saving Carbon, Improving Health strategy may be flawed, because the effectiveness of such consultations is questionable and they could disadvantage some patients, warns the Medical and Dental Defence Union of Scotland (MDDUS) today (Friday, 30 January 2009).

"We know very little about what goes on in telephone consultations, and even less about the quality of advice given compared with face-to-face consulting," said Dr George Fernie, senior medico-legal adviser at the MDDUS.

"Some studies suggest that phone consultations are briefer and more cost-effective than consulting in the surgery or at home. However, one trial of GP phone triage found that patients were 50 per cent more likely to re-consult within two weeks than those seen face to face.

"Patients who haven't got a phone, are hard of hearing - nearly half of the over-70s - or don't have English as a first language may be disadvantaged," adds Dr Fernie. "The service might appeal to housebound patients and those who are geographically isolated, though."

There may be benefit in recording phone consultations wherever possible, to ensure that if challenged, GPs can provide evidence that they gave full and sufficient advice, says MDDUS.

Adds Dr Fernie: "Perhaps the most disconcerting part of phone consulting is that you can't informally examine the patient, as you can face to face. If a sick child makes a dive for the toy box in your surgery, he probably hasn't got meningitis. How can you tell that over the phone?"

MDDUS is a medical defence organisation providing access to professional indemnity and expert medicolegal advice for doctors, dentists and other healthcare professionals throughout the UK.

MDDUS

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