Consulting on the telephone requires a different skill-set, relying on common sense and improvisation. Learning how to do this effectively is necessary to safeguard patients and your professional position, says GP and popular author Dr Tony Males
Document telephone consultations contemporaneously. Obtain and document a thorough history. Telephone consultations do not give a GP the opportunity to assess clinical signs.
Mr B, a 35-year-old businessman, consulted Mr L, a urologist, over the telephone requesting a vasectomy.
Mr P was a 17-year-old student who attended the Minor Injuries Unit at his local A&E department after a fight. He walked in and sat in the waiting area with a friend. The triage nurse offered him some analgesia but he refused it.
Three months after returning to the UK after a holiday in Gambia, Miss N, a 27-year-old care assistant, telephoned her GP practice for advice and spoke to Dr T. She told him that she was feeling generally unwell and slightly feverish and had noted that her urine was unusually dark.
Mrs B received a letter from the Child Health Department addressed to the Parents or Guardians of Jemima B. The letter said: “Jemima B born in … is due for her pre-school immunisation; please telephone your GP surgery and arrange an appointment with them.”
Mrs G, a 50-year-old baker, became unwell with what appeared to be flu. There was an outbreak of flu in the area at the time. Mrs G telephoned her GP surgery and spoke to a receptionist who told her to take bed rest, plenty of fluids and paracetamol.
Mrs B had one child and had been trying for a few years for another. She recently had a positive pregnancy test and was now about seven weeks pregnant. She suffered an abrupt onset of lower-abdominal pain one evening and telephoned the out-of-hours on-call service used by her GP practice.
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