Phone consultations must not undermine good doctor-patient relationships

I share the concern of your correspondent, Brian Weddell, that despite the relaxation of lockdown measures such as the reopening of pubs and restaurants, “Scotland’s GPS are still not seeing the majority of their patients in their surgeries” (Letters, 13 August).

Since March this year, the majority of GPS have assessed most of their patients’ health needs at least initially only by telephone consultation and, in the main, their patients have been banned from entering their surgeries. These measures were instigated by the Scottish Government on a temporary basis to protect GPS and their staff from catching Covid-19.

At the present time, however, there seems to be no end to most patients not being able to have face-to-face contact with their GP. Indeed, it seems possible that the Scottish Government is viewing this changed model of working for primary care staff as being a new postcovid normal.

Initially it would appear that anecdotally some GPS found assessing their patients’ medical needs by telephone consultation unsatisfactory. Indeed, one doctor divulged that in making a diagnosis he found it helpful to be able to see the whites of his patient’s eyes!

As time has progressed, however, many GPS would seem to be finding consultation by telephone a much more satisfactory way of managing their ever increasing workload.

GPS insist that if they are concerned about patients they will immediately ask them to come to their surgery or if necessary do a home visit to assist their diagnosis; ask them to send a photograph of a body part or see them by video link. One doctor said phone consultations allowed them to swiftly redirect a patient complaining for example of back pain to another health professional such as a physiotherapist. Another thought valuable time could be saved by advising patients to buy a blood pressure machine to enable them to take their own blood pressure and yet another admitted he no longer felt so “burned out” after working a shift.

As a lay person and a septuagenarian not used to having had only remote contact with a GP, I can envisage certain problems which could arise from telephone consultation. These would include: a patient being deaf; having a memory problem or complex illnesses; feeling not confident or tongue-tied using a phone or an older patient having difficulty taking and sending a self photo.

For reasons of efficiency, many hard-pressed GPS will find it helpful if phone consultation continues indefinitely. If this happens, however, I feel that it is vital that this changed working model does not eradicate completely good doctorpatient relationships which even today are still important to many people.

SALLY GORDON-WALKER

Caiystane Drive, Edinburgh