Dos and don'ts of telephone consultations

Do

• Document telephone consultations contemporaneously.
• Obtain and document a thorough history. Telephone consultations do not give a GP the opportunity to assess clinical signs.
• Be able to justify any course of action that is taken.
• Be aware that visual body language cues are lost in the context of a telephone conversation.
• Inform the patient when recording a telephone consultation. There should be robust procedures in place for storage, retrieval and transcription of the call.
• Organise protected time and a confidential environment for telephone consultations.
• Be careful when contacting patients about results. To minimise the risk of a breach of confidentiality, consider either writing to the patient, or phoning their mobile telephone. If the patient is phoned at home and the call is answered by someone else, and the patient isn’t there, or there is an answer machine, simply leave a message asking them to phone Dr X, or another identified contact at the surgery.

Don’t

• Attempt to deal with complex matters by way of a telephone consultation.
• Leave messages on answering machines unless absolutely necessary. Be cautious; only do so if absolutely necessary. It is better to write to the patient or seek permission from the patient to text a message, via the patient’s mobile phone. Any contact or attempted contact with the patient should be recorded in the patient’s medical record.
"Any contact or attempted contact with the patient should be recorded in the patient's medical record"
• Leave any details when phoning patients about results, or discuss what it is about even if pressed to do so by a relative (unless you have prior permission to do so in this particular circumstance).

Further reading

• Males, T, Telephone Consultations in Primary Care, RCGP

Last updated: October 2009

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