Examining patients

SIR – My 40 years in hospital medicine ended recently and had seen many changes, most of which were positive. But what of the future?

The clinical consultation – history and examination – has always been the foundation of managing a patient. Examination is impossible for most conditions using video consultation. Exploring and allaying a patient’s worries may be facilitated by personal contact excluded by technology.

This “modern alternative”, as NHS England calls it, may appear attractive for the under-resourced NHS and to satisfy the zeitgeist of instant gratification, but is not without risk.

Wouldn’t the £45 million earmarked for its rollout be better spent on more human beings, not computers? Dr John Trounce

Hove, East Sussex

SIR – If only I could see my doctor for 9 minutes 22 seconds (report, November 9). Our GP practice in Surrey now allows just five minutes per appointment, and you are meant to discuss one problem only in that time.

You may book a double appointment, if they can fit it in, to talk about several concerns, for which multiple appointments will then be needed, with the ensuing wait at the surgery, apart from the journey of five miles in each direction.

You will have to get up before 7.30am to try for an online booking, or attempt to phone at 8am, when, however quickly you push the recall button, you are always in a queue and probably have missed that day’s slots. But they won’t then book you in for the following day; you have to go through the same procedure the next day and the next until you have dealt with all of your issues.

Many people won’t bother, and end up at the hospital A&E, which wouldn’t have been necessary if the GP had dealt with the illness when it first occurred. Valerie Thompson

West Horsley, Surrey