Mr Ian McDermott, Consultant Orthopaedic Surgeon, explains his thoughts on remote consultations
Over the last few years, particularly because of the recent various government-imposed lockdown periods, the medical profession has changed significantly in many ways.
Since 2020 we have seen a huge rise in remote consultations via telephone and video (ZOOM) calls as opposed to proper face-to-face consultations, with new and existing patients much preferring to have a remote consultation due to the flexibility it provides around their busy lives.
A few years ago, many of us might have been quite strongly against such a thing; however, events have forced us down a different path and we have adapted, remote consultations have now become a fairly standard and regular part of many doctors’ practices.
From my perspective as a Consultant Orthopaedic Surgeon in the private sector, I see significant numbers of complex knee cases from around the UK and also from abroad. The use of remote video consults has ended up becoming a useful tool and has expanded what we are able to offer our patients, and whilst there are certainly not insignificant limitations, remote tele-consults do also offer several various positives.
The negatives of remote consultations are that:-
- Sometimes, if the internet connection is not working fast enough, the quality of the call can be affected, which can significantly hamper things, the connection is one of the most important components in a consultation.
- Amazingly, I have had several patients who for some reason have felt it appropriate to dial in for a tele-consult from a mobile phone from their car. On one occasion, one patient even dialled for a video consultation from their phone whilst they were walking around a shopping centre! Clearly, this is wildly inappropriate, in terms of concentration, clarity and confidentiality (which I politely explained to the patient at the time).
- Next, with a remote tele-consult one loses a significant proportion of the non-verbal communication that can so often be so very important in gaining a full and deep understanding of a patient’s feelings and exactly where they might be coming from.
- Finally, one cannot perform a clinical examination of a patient’s knee via just a video link, and clinical examination is a key part of clinical diagnosis.
Where remote consultations have, however, become particularly useful nowadays:-
- For those patients requiring just a quick follow-up, in terms of checking on their progress, particularly if the patient does not live locally (as this can avoid hours of travel).
- For those who have already been seen in the clinic and clinically examined, who have been sent for imaging, and who then need a discussion about the findings of their imaging and a discussion about their potential options (assuming their case is simple).
- As a form of triage for patients who live far away, and particularly for those patients potentially coming from abroad, where some people want to have a preliminary discussion about their knee issues before them then potentially travelling to the UK for a proper face-to-face appointment if it looks like this is going to be needed (i.e. assuming that it is felt appropriate for us to take on their case).
Personally, I would always prefer a proper face-to-face appointment with a patient in my clinic, as this still very much remains the gold standard. However, for the purposes of triage, and for more routine follow-ups, particularly for patients who do not live close to our clinic, remote tele-consults have certainly become a fairly integral part of our overall offering for our patients nowadays.
Making the most out of your remote consultation:
- Firstly, to get the most out of your consultation, make sure any report, referral or imaging you have that is about your condition, has been directly sent to the secretary before your appointment. This allows the consultant time to review your case just before your appointment.
- Ensure the room you are in is quiet, has a good WIFI connection and is private.
- Make sure you can access our clinic(s), should you need to go for further tests, scans or an in-person follow-up.
If you personally have any particular or strong feelings about this subject, then please feel free to contact us and we will potentially be able to add your comments to this blog, to further improve the whole discussion.
