Mr Mark Phillips, Consultant Hand & Wrist Surgeon at London Sports Orthopaedics explains how switching to video consultation has benefited his patients & why he’s going to continue with them in the future.
The lockdown that came as a result of the Coronavirus pandemic has meant I’ve been forced to do a lot of my consultations by video link. Something that until recently, I thought would be impossible for a Consultant Hand & Wrist Surgeon. There have however been some surprising benefits.
1. Reduced stress, expense and carbon footprint
My specialist interest is treating musicians with hand & wrist conditions. Very few surgeons in the UK want to work in this specialised area. That means that patients were often prepared to travel a long way to see me, which I’ve been feeling guilty about.
Patients no longer have to travel to see me in clinic. With this comes a number of benefits. No travel time or travel costs; reduced carbon footprint and much less stress.
2. More convenient & time efficient
One of the things I’ve noticed about video consultations is how more important it is to be on time for the consultation. It’s quite dispiriting to be sitting, waiting, looking at a computer screen and I appreciate that patients would feel uncomfortable if in a virtual waiting room. So, I’ve made an extra effort to make sure that my appointments run to schedule.
I’ve also found that video consultations are more time efficient. My consultations in clinic are usually 30 minutes, but much of this is bringing a patient in from the waiting room and settling them in. There may be hats and coats that need to be taken off; bags and umbrellas to be stored, not to mention the hand washing and desk cleaning.
With a video consultation, I’ve found that’s it’s possible to take a very detailed history; do an examination and come up with a plan, all within 15-20 minutes. For those patients who are time poor, having a shorter consultation time is regarded as a real benefit.
3. You can see the patient in their own environment and provide multidisciplinary expertise
The next great advantage of video consultations that I’ve discovered, is that other specialists can be brought into the consultation as required. I frequently work with hand therapists and for the musicians I look after, I sometimes require the help of an instrument technical educator to talk about technique work arounds.
The musical educators I work with are all registered with BAPAM (bapam.org.uk) and have a great experience of therapeutic technique education in people who have clinical symptoms. Some of these technique adaptations are beyond my field of expertise and they are fascinating to learn about, for both me, and the hand therapist. The overlap of knowledge is growing all the time and we are learning from each other.
Some of these specialists are not located near my practice, but with video consultation this doesn’t matter anymore. Indeed, it means I can work with some of the very best people from around the country and indeed around the world should it be necessary. My network is growing all the time. Of course, patients don’t even need to be in the UK to have one of these consultations.
We formerly had to bunch our patients together so that we could see three patients at the BAPAM offices in Chancery Lane. This was by necessity, because each of us would have to travel and we would have to carefully select the patients for this clinic. This is no longer necessary. We simply have to find an appropriate appointment slot that all of us can attend. This is usually just a very brief break in our day, and afterwards everybody can go back to what they were doing previously.
For patients who have problems related to an interface, for example a musical instrument or even a workstation, we can for the first time see the patient in their own environment. This is particularly helpful when it’s difficult to bring the musical instrument or the workstation into the consulting room – e.g. harp, church organ or even a cockpit!
In conclusion
In March of this year, I thought that it would be impossible for me to see patients with hand & wrist conditions using video consultations. I’ve been surprised and heartened to see that not only is this possible, but also has many real benefits to patients that I’d never thought of before.
After the lockdown is over, my plan is to continue to offer video consultations as an option for specific patients (particularly musicians and those who live a long way away from London) and by doing so:
• Reduce patient’s stress, expense & carbon footprint by cutting out travel
• Offer shorter, more time efficient consultations for patients, particularly for those who are time poor
• Increase the use of multidisciplinary clinics to provide enhanced diagnosis & treatment options
If you have any tips or advice on how video consultations are working well for you and have benefited your patients, then please get in touch by emailing phillips.admin@sportsortho.co.uk
Mark Phillips, Consultant Hand & Wrist Surgeon
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