Remote GPs miss vital clues

I’VE BEEN very worried to hear that in some areas as many as 80 per cent of consultations with GPs are happening remotely. Sure, for the young and generally fit who need a simple prescription, a phone call might work. But that’s not the majority of people who want to see their doctor. The nature of a phone appointment means it tends to be brief and to the point — but this is what worries me. What about people with complex complaints? Many of those with mental health problems who are presenting for the first time make appointments for something else — they come on the pretext of having a physical complaint when, in fact, they are depressed, anxious or suicidal. Phone appointments miss what’s sometimes called the door-knob diagnosis. This is when a patient comes to see a GP about one thing, but, just as they’re set to leave and have their hand on the door-handle, they mention a key symptom. Working out that there’s more going on than first meets the eye is what GPs are so good at — yet this is precisely what is lost over the phone.

■ Children who spend just two hours in front of the TV per day are more likely to grow up being addicted to gambling, cigarettes, cannabis or alcohol, according to a shocking study, which has caused concern among parents. But i suspect this may be an example of ‘confounding factors’ — variables that can skew the result and lead us to false conclusions. So it might be that parents who let their kids watch lots of TV have confounding factors that are the actual risk for their children developing addiction in later life, such as poverty or addiction in the family. Watching TV for long periods isn’t great. But i doubt that a few hours a day is in itself going to turn your child into an addict.