# GPs prefer to see patients face to face, says UK family doctors' leader



## Northerner (Mar 29, 2021)

Many GPs find telephone appointments with patients frustrating and want to see them in person because they fear they will otherwise miss signs of illness , the leader of Britain’s family doctors has said.

Prof Martin Marshall told the Guardian that remote consultations felt like working “in a call centre” and risked damaging the relationship between GPs and their patients.

Telephone and video appointments had proved useful during the Covid pandemic, when GP surgeries limited patients’ ability to come in for face-to-face appointments, he said.

However, while that helped limit the spread of coronavirus, “this way of working has been frustrating for some GPs, particularly when most consultations were being delivered remotely, who have felt like they’ve been delivering care via a call centre, which isn’t the job they signed up for.









						GPs prefer to see patients face to face, says UK family doctors' leader
					

Remote consultations feel like working ‘in a call centre’ and risk missing signs of illness




					www.theguardian.com


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## Toonpig (Mar 29, 2021)

Northerner said:


> Many GPs find telephone appointments with patients frustrating and want to see them in person because they fear they will otherwise miss signs of illness , the leader of Britain’s family doctors has said.
> 
> Prof Martin Marshall told the Guardian that remote consultations felt like working “in a call centre” and risked damaging the relationship between GPs and their patients.
> 
> ...


That has not been my experience not once have I been able to see a doctor in person. I even had to send a photo of my foot when I wanted advice about a nail loss. I understand co id has caused problems but we really need a face to face consultation  sometimes. It could be done with screens and face masks


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## Pumper_Sue (Mar 29, 2021)

I have left the practice I was with due to the outstanding lack of care. It was as rare as hens teeth to get an apt with anyone at this practice. 5 weeks for a phone apt!

As so desperately unwell I registered at another practice and saw my new GP today. The wow factor in care is unbelievable. Spoke to him on Friday morning he asked when I had last seen a GP and I said 15 months ago. His response was I need to see you so I can make an urgent referral, come see me Monday afternoon at 3.20. 
Just that one apt was worth changing surgery for.


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## mikeydt1 (Mar 29, 2021)

if my hospital was allowing f2f instead of dam phone appointments then i wouldn't be in the mess i am with the bowel thing.  my doctors new about the blood loss well before Xmas and wanted the bowel surgeons to see me god knows why they thought a telephone appointment was suitable, seriously.  

when i spoke to the bowel surgeon i told her there was something wrong but she acted pig headed, she was so big headed that she thought there was no need for another ct scan as i had a recent one the recent one to her was 2 years old!  don't things change in all that time? so this has brought her down a peg or two i call it incompetence to say the least.  i mean how the hell can they examine you down a phone line. i have been saying this on here over and over that the practice of phone calls can be dangerous in some circumstances.


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## Abi (Mar 29, 2021)

Phone consultations have limited roles. In some circumstances an examination is not needed.They are also useful for a review/ to discuss blood results and further plan if the patient has recently been seen F2F. Sometimes photos are suitable for dermatological conditions but sometimes not- if in "personal " area, or the person is not able to email a photo , or if the photo does not give a clear picture...
In some ways if secondary care ( hospital) clinicians are doing phone consultations first I feel more necessary to see patients so at least they have had a physical examination by someone ( for abdominal/ intestinal complaints)


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## Thebearcametoo (Mar 30, 2021)

Ours were already using a mix before covid. On the day appointments were triaged by phone with an appointment booked in by the GP that day if needed so they could deal with quick things without face to face but bring people in for a full consult (which was usually a double appointment) if it needed more. They had already added online contact forms where you can answer a load of questions and someone will either message you back or you’ll be told you have an appointment. Obviously in person consults have been limited with covid but I expect this blended system to continue. I’ve had a reasonable amount of success with remote systems but there is something about face to face where you can more easily say, and this is bothering me too about something you may not have made an appointment for but which may need some checking.


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## Northerner (Mar 31, 2021)

I fell ill at the beginning of the year and had phone appointments - probably would have wanted them anyway as I didn't feel well enough to leave the house. For most things I prefer face-to-face as it feels much more like a 'complete' consultation - I'm a phone-phobic introvert who often forgets to mention things on the phone that would be more likely to occur to me in person


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## Robin (Mar 31, 2021)

Northerner said:


> I fell ill at the beginning of the year and had phone appointments - probably would have wanted them anyway as I didn't feel well enough to leave the house. For most things I prefer face-to-face as it feels much more like a 'complete' consultation - I'm a phone-phobic introvert who often forgets to mention things on the phone that would be more likely to occur to me in person


I hate phone consultations. I find it difficult to process information quickly enough, and formulate a good reply on the phone, for some reason. I think face to face, you pick up nuances of meaning from peoples facial expressions, and also if you need time to formulate a reply, assuming a face that shows you’re thinking about what’s being said prompts the other party to wait for an answer, whereas on a phone, if there’s a pause, the other party starts saying 'Are you still there?'


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## grovesy (Mar 31, 2021)

My surgery has been phone appointments first with a Dr. For a couple of years, and at the beginjng of last year this put me off contacting them for longer than I normally would. Though have to say when I did contact them twice in 3 days , I was seen face to face within 30 mins of initial call with the Dr. I was have abdominal discomfort.


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## JJay (Mar 31, 2021)

Hate phone appointments. Always feel rushed and end up not saying everything I meant to, even if I write it down first.


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## rebrascora (Mar 31, 2021)

I'm not keen on phone appointments for the reasons mentioned by @Robin and @Northerner but I find the online referral system brilliant and was how I came to be diagnosed diabetic. It means I can sit down at my leisure and compose a message which includes all the relevant information without getting flustered or distracted perhaps by something the doctor says if I am face to face.... I get to say everything I need to tell them uninterrupted. I appreciate it is not for everyone, but for me, going down to the doctors is stressful (white coat syndrome) and I am not comfortable speaking on the phone and I take time to process information and if there is a strong accent, it can be awkward if not downright embarrassing trying to understand each other, but the written word via email seems an ideal means of reporting stuff or seeking advice and then the doctor can triage and assess whatever treatment or tests or examinations need to be done from there. It works brilliantly at my surgery. I sent my email off on the Sunday night. The GP assessed it first thing on Monday morning and I had a blood test booked for later that afternoon with the nurse. Got the result back the next day. Not had to see a GP for my diabetes yet!

I did have a telephone consult with my diabetes specialist in October and I was dreading it because he is of Asian origin and I have difficulty understanding him in person sometimes let alone on the phone but actually it went exceptionally well and I didn't struggle at all. Having LibreView really helped though.


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## grovesy (Mar 31, 2021)

Mine does not do e-mail consults.


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## SB2015 (Mar 31, 2021)

I was pleased to have a video call rather than nothing with my consultant and DSN in August, and I have a face to face one next week.   My training for the new pump was all through video calls which have worked better than I expected, and possibly been more readily available with this system.

I have had phone consultations with my GP which have not been too bad as they have followed an email in which I had had time to make sure I included all that I wanted.  I was also asked what I wanted to get out of the appointment and what I had already done so far.  This focused my mind beforehand, gave the GP all the info I wanted to, and made our call effective.  BUT I have been at the same practice for many many years, had the same GP for over 20 years and know all the the staff.  I do not know how I would feel if I did not know the person calling and he didn’t know me.

I definitely think a mix is needed.


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## Christy (Mar 31, 2021)

Our practice has provided great care for my family when required. So far we've always been able to get through on the phone same day. Nurse triage call 1st then advice/face to face appointment or call with doctor.  Again advice and/or visit to practice. Great care with social distancing and PPE. Not ideal circumstances for patients or doctors but very happy with our care. By the sounds of it we're lucky which is a real shame.


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## SueEK (Mar 31, 2021)

I work for 12 GPs and every one of them wants to go back to seeing patients face to face. They know there is a place for phone consultations but as one said to me ‘we pick up a lot of unrelated problems when a patient is sitting opposite you’. Certainly if they feel a patient should be seen face to face they arrange for them to come in. They can’t win really


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## trophywench (Mar 31, 2021)

grovesy said:


> Mine does not do e-mail consults.


Nor ours.


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## mikeydt1 (Mar 31, 2021)

i have just got a very good example of why f2f is important.  quite a while ago i had a doctor trying to diagnose shakiness of my hands and decided over the phone it was something called BET benign essential tremor.  roll on a few months i have some help coming in and when they were helping me with washing my legs they noticed that my right leg was getting shaky something i have not experienced.

i happened to mention this through a phone call to my doctors and have now had a request for a f2f so that the same doctor can see what is going on to decide what might be happening.

luckily i am under a neurologist for something else so if the doctor wants there is all ways the option to refer

the above clearly shows the need for f2f appointments.  

i have all ways said that phone appointments have their place but there are times when doctors do need to see what is going on in person.


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## Leadinglights (Mar 31, 2021)

We can e-mail the doctor but they won't e-mail back. If you need a blood form they will send a text with a link code and then you can print yourself. Last time they sent me a link code for somebody else but didn't seem particularly concerned that it had happened. 
Once you get through the portcullis of the reception then the Dr responds fairly promptly with a phone appointment. Though the system of having to phone at 8am to get a slot and can't book in advance makes getting any sort of appointment difficult as of course everybody is trying to phone at 8am and by the time you get through all the appointments are gone for that day so you are back to square one and same old same old the next day.


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## Gwynn (Apr 1, 2021)

I just rang our doctors reception to try to get an appointment for an infection that is not clearing up. It too 28 minutes to get through and then I was told that they are not seeing patients!!! 

I was advised to take a photo of the infected area and send it to them. Then someone may phone me later in the day.

So what are you supposed to do if you need a doctor to see you to make a proper assessment and take appropriate action? 

A&E is not a good option as they must be maxxed out and that was not advised by the receptionist.

I am not feeling very happy about this. 

So why can I see a diabetic nurse but not a doctor (or a nurse) for the infection? Very frustrating.


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## Jodee (Apr 1, 2021)

My surgery is only seeing emergency patients.  For my diabetes check in past year I have only had my blood glucose levels checked which was done at the doctors surgery by the phlebotomist.

I've not had a retinol scan for coming up 2 years now as I never got my annual one in 2020.

Dentist also not seeing anyone except in emergencies, although with lock down easing I may phone see if I can get a check up before the next lockdown, which is they things look to go with the behaviour of some folk.


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## Gwynn (Apr 1, 2021)

Update:

From a bit depressed 5his morning to really impressed right now!!!

I felt a bit let down not being able to see a doctor f2f today.

The receptionist asked for a photo of the infection. (Horrible idea). My phone refuses to send photos!!! However, I decided to stop being cowardly and to tackle the tech problem head on. Fixed it after some faffing about. Took 5he photo and sent it off to them.

I thought that that would result in nothing. Expectations zero.

How wrong I was. Within 20 minutes a doctor rang me, he had seen the photo (but not read the text I had also sent with the photo describing all the things he went on to ask about). He said that he understood the problem and prescribed something for it. Within 30 minutes of that I had the prescribed medication.

I think the problem is simply not knowing how the new system will work leading to worry, panic, frustration, fear. 

NHS 12/10

Gwynn 0/10 but a bit relieved smile and something learned.

And lets be honest, the NHS came through pretty smartish. No fuss and a good result.


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## Lanny (Apr 1, 2021)

rebrascora said:


> I'm not keen on phone appointments for the reasons mentioned by @Robin and @Northerner but I find the online referral system brilliant and was how I came to be diagnosed diabetic. It means I can sit down at my leisure and compose a message which includes all the relevant information without getting flustered or distracted perhaps by something the doctor says if I am face to face.... I get to say everything I need to tell them uninterrupted. I appreciate it is not for everyone, but for me, going down to the doctors is stressful (white coat syndrome) and I am not comfortable speaking on the phone and I take time to process information and if there is a strong accent, it can be awkward if not downright embarrassing trying to understand each other, but the written word via email seems an ideal means of reporting stuff or seeking advice and then the doctor can triage and assess whatever treatment or tests or examinations need to be done from there. It works brilliantly at my surgery. I sent my email off on the Sunday night. The GP assessed it first thing on Monday morning and I had a blood test booked for later that afternoon with the nurse. Got the result back the next day. Not had to see a GP for my diabetes yet!
> 
> I did have a telephone consult with my diabetes specialist in October and I was dreading it because he is of Asian origin and I have difficulty understanding him in person sometimes let alone on the phone but actually it went exceptionally well and I didn't struggle at all. Having LibreView really helped though.


I use the extra info box when ordering prescriptions online all the time to tell my GP’s anything I think they ought to know, changes in insulin doses, any concerns or worries & questions. I do have to think carefully for the most concise posts though as there’s a limit on characters used & I usually get answers either by a phone call from the health centre or a note with my prescriptions when they’re delivered. I also found, even before these cv times, writing down everything I want to say very useful as appointment times have shrunk even further to just 5 minutes with the GP & just hand them that to read!


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## Sally71 (Apr 1, 2021)

LOL @Lanny - I’ve tried using the extra info boxes on prescription requests but it doesn’t work very well for me, if I try changing the quantity of things they just ignore it. I ordered lancets but still had Multiclix on the repeat which was replaced by Fastclix a couple of years ago I think, I had received a new lancing device but hadn’t got round to ordering the drums for it because I still had loads of the old ones left.  Finally got round to ordering the new ones, ticked the Multiclix box and put a note in saying they are replaced by Fastclix and yes we can use those, but what I got given were some entirely different ones not even made by the same company!  Had to sort that one out over the phone!  Other things work better online though, they have a system whereby if you need a sick note or doctors note for something or maybe advice that doesn’t really need a face to face appointment you can put a request in online and it’s quite efficient.  I tried to order insulin vials for my daughter and there was a stop on them saying that we couldn’t order any more without a review, sigh, so instead of ranting on the phone or making a f2f appointment which would have only needed a minute to solve I sent an e-message asking exactly what needed reviewing as type 1 diabetes doesn’t get better and my daughter will need insulin for the rest of her life, and then went on to explain that we are using a pump which is why we use vials rather than penfills but please leave the penfills on the repeat also as we have to have a few of those for emergency backup in case the pump fails.  Hey presto just a few hours later the insulin was reinstated and I was able to order them!

Our surgery has been doing telephone triage for quite a while before Covid came along, if you want an appointment they will get a doctor to call you back first, but if the doctor decides that it’s not the sort of thing that can be dealt with on the phone then he will make an appointment to see you in person.  Seems sensible, i think they are trying to minimise the number of people who make appointments and then don’t turn up which wastes a lot more time!  (I once completely forgot to go to an asthma checkup with the nurse, don’t know why, I don’t normally have a problem remembering appointments, and I felt so bad and would happily have paid a fine - well maybe not happily, but I would have deserved it and thought it was justified)


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## trophywench (Apr 1, 2021)

I downloaded and registered with the NHS App last week to enable me to order scrips online and now, cannot get back into it.  I think I know (probably) why, in which case I will have to register again, but it ain't exactly a rapid process on a laptop on your home wifi,  if it is anywhere else.


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