When optimised, a great deal can be achieved through video consultation compared with telephone, but accessibility and clinical risk need to be carefully considered and managed. The article then discusses the advantages and disadvantages of telephone consultations from a social and policy perspective. To learn more about the advantages and disadvantages of stakeholders, you can post your legal need on UpCounsel’s marketplace. Where appropriate, the patient’s consent should be noted in the documentation of the consultation. Traditionally, individuals with a vested concern about how the company is run are considered stakeholders. Setting Twelve general practices in England. Telehealth services on the mobile can also be charged. Drawbacks of mobile telehealth services It requires a reasonably strong and reliable mobile internet connection for the video consultation to go smoothly. This has helped doctors gain a greater understanding of their patient’s health. Mr L made a claim against Dr S. Dr S knew he could not evaluate Ms L’s condition over the phone and admitted that he should not have relied on Mr L’s interpretation of his wife’s symptoms. The principal disadvantage of remote consultations is the limitations with regards to examination. A disadvantage would be that you require internet access. It is not appropriate for those with serious psychiatric illnesses. The internet has opened up new avenues for mental health treatment, but there are some pros and cons you should consider before you decide if e-therapy, also known as teletherapy,   is right for In the face of the social distancing measures required in our COVID-19 crisis, many in-person psychotherapies are becoming online out of necessity. Under the circumstances, he should have tried to exclude conditions that would have been life-threatening in the short-term; here aortic aneurysm was one of the possibilities and, had he interrogated the doctor, then he would have been aware of the fact that the signs and symptoms were all present. UpCounsel accepts only the top 5 percent of lawyers to its site. Inform the patient when recording a telephone consultation. Yet, with technology growing by leaps and bounds, telehealth is here and revolutionizing healthcare. Remote prescribing via telephone, video-link or online. Telephone consultations are a useful tool for the assessment and management of both acute and chronic conditions. Lawyers on UpCounsel come from law schools such as Harvard Law and Yale Law and average 14 years of legal experience, including work with or on behalf of companies like Google, Menlo Ventures, and Airbnb. Design Qualitative interviews with patients and carers. No non-verbal cues – missed hidden agendas or fears. You can take your time to write a detailed description of your condition. Online doctor consultations have a slight advantage than telemedicine. Defining booking slots for appointments ensures you would not need to answer patient calls round-the-clock. Let’s take a look at some of these in more detail. Telephone medical consultations rely on information gathered before a service rep will assess your health. Whether you are at home, office or vacation, you can get the expert medical advice and that too, in no time. Watanabe, Fairchild, Pituskin, Borgersen, Hanson and Fassbender (2012) found that rural family physicians were not aware of the virtual clinic despite advertising over the fax, telephone, internet and media. This may be a concern in areas with limited or poor network connection. Reduced opportunity for health promotion e.g. ... consultations, home hospice nursing visits, team meetings, and education for clients or healthcare ... despite advertising over the fax, telephone, internet and media. You should only discuss details with a friend or relative if you are sure that the patient has given their consent. This is particularly useful for providers for medical tourism, to consult with patients planning to visit them from other countries for medical care and for post-treatment follow-up. Specialty focus: Psychology – treating children, Being an employer – it's a risky business, Managing challenging patient interactions, First impressions count – triage in reception, Top five medicolegal hazards for junior doctors, Pick your placement: community service applications. There is little collaboration with the patient, and no mention of In order to book through an online booking system, your customers will have to have access to the internet. I think we are offering follow-up more frequently, when we are aware people are distressed, and again, this may be more convenient for patients. Telehealth on the mobile has made it easier for providers to communicate and engage with patients. The last few years have seen immense development in telehealth technology. Nonetheless, “depersonalisation” due to physical and mental factors, new and different processes of consultation, inability to perform the whole consultation due to technical difficulties and patients’ reduced confidence in healthcare professio… Telephone Interviews Telephone interviews are generally conducted by hiring managers in an effort to save time and quickly eliminate candidates who do not meet the organization’s requirements. Telephone technology has increased dramatically over the last few years, making this issue a little more complicated in the post smartphone world. Unlike a regular video call, telemedicine offers a reliable means of assessing health and treating patients remotely as it based on health data sharing and communication. VCs were considered superior to telephone consultations in providing visual cues and reassurance, building rapport, and improving communication. Not long after its appearance, physicians were answering the telephone even during consultations with other patients in the room, which, today, would breach patient confidentiality. The claim was settled for a substantial sum. In today’s busy world of primary care, constant demands for our attention come from many different directions. Though internet access is widespread these days, it remains true that one of the disadvantages of online booking systems are their reliance on an internet connection. Objective To understand patients’ views on a ‘telephone-first’ approach, in which all appointment requests in general practice are followed by a telephone call from the general practitioner (GP). The doctor-to-population ratio is estimated to be 0.77 per 1,000 but because the vast majority of GPs – 73% – work in the private sector, there is just one practising doctor for every 4,219 people. As with any OH assessment, it is good practice in telephone consultations to use a set of evidenced-based tools against which you conduct your assessment. The World Medical Association (WMA) states: “While the practice of telehealth challenges the conventional perception of the physician–patient relationship, there is a ‘duty of care’ established in all telehealth encounters between the physician and the patients as in any healthcare encounter.”7. A good internet connection and smartphone is all that is needed for volunteers or medical personnel to get help for patients in rural areas. As the 20th century evolved, however, the Lancet insisted that practitioners must make themselves available by telephone.1 In 1906 there was an entry in the Lancet stating how a man had phoned his doctor for professional advice and when the patient was billed for the advice he refused to pay. An increasing number of doctors are charging less for a telemedicine consultation than they would for an in-person visit. The Medical Protection Society Limited (MPS) is a company limited by guarantee registered in England with company number 00036142 at Level 19, The Shard, 32 London Bridge Street, London, SE1 9SG. Unfortunately attempts to stop the bleeding were unsuccessful and Mr Q died. Clinics, hospitals and health providers have started to adopt telemedicine and made it a part of their medical practice, extending a helping hand to more patients than ever before. Alan Frame from the MDDUS offers some tips on how to minimise the risks. 571-331-4666. 9 AM to 7 PM EST. On the question of whether or not it was proper to consult by telephone, the judge ruled that it was the doctor’s duty to decide whether he might safely give further instructions by telephone provided he had previously seen the patient. Recommendations were delayed due to lack of Request that the patient repeats advice given (several times throughout the consultation). In this environment, with a shortage of doctors and medical specialists in both rural hospitals and the referral centres, telephone consultations can help ease the pressure on doctors and allow them to help more patients without the patients having to travel from one area to another. What do junior doctors need to know about the Health Professions Act? To oncologists, radiologists, kidney specialists, surgeons etc.) Adequate follow-up in the event of no improvement, worsening symptoms or side effects should be made. It connected doctors and specialists who worked with the same patients. In the past 50 years, telephone consultations were one solution and occurred in 15% of ambulatory medical contacts ( 1). A major disadvantage of rural medical practice is the limited reserve of consultative options. During telephone and video consultations about a broad range of social and health concerns, you may become concerned that substance use is a At first glance, consultation models, some of which were derived decades ago, may seem irrelevant to modern general practice. Interactive Communication Telephone communication can link various people in an organization through audio conferencing sessions. Health advice is readily given during telephone consultations, as in a face-to-face situation. There should be robust procedures in place for storage, retrieval and transcription of the call. It can also help us to understand dysfunctional consult-ations and start to look at ways of addressing this prob-lem. There are many advantages and disadvantages to using the telephone as a method of communication and some of them are more or less pronounced depending on whether you are considering a land… These should cover both musculoskeletal and mental health tools and include a system, such as the flag system, to easily identify any causes for concern. In general terms, a stakeholder is any individual who has an interest in the success or failure of a business. Recommendations were delayed due to lack of reduce need for face to face consultations (50% in primary care) –Can help manage demand and capacity/workload –More appropriate outcomes i.e. Remote consultations (over the phone, via video link or online) have increased. This ensures that patients diligently check-in with their doctors without having to visit their clinic, Extends care to rural areas where accessibility to health services may be limited. In addition to being easy-to-use, access to Personal Health Records (PHR) during video consultation sessions gives doctors more insight into their patient’s health. Counselling by telephone enables therapists to work from several settings. When he arrived, Dr P saw Mr Q: he realised that the patient was sicker than he had thought and required an urgent laparotomy; Dr P’s working diagnosis was that the patient had a dissecting aortic aneurysm. He should have referred her to Dr K. The claim was settled for a low sum. Search results Jump to search results. Over the phone interpretation services have many advantages, however there are also some disadvantages to the translation service as well. Medical records: Which path will you take? It is not easy to make a record of what is said during the call. One possible consequence of using tele-consultations or video link is a breakdown in the patient/healthcare professional relationship. It may be inappropriate to give out particularly sensitive information (eg pregnancy test results) on the telephone without being absolutely certain about the callers identity - certainly worth specifically covering in any telephone consultation protocols. Telephone consultations: Advice for GPs. You can consult a doctor virtually anywhere, anytime. Relevant legislation and regulations that relate to patient decision-making and consent should be applied to telephone consultations. The conversation is relatively private between you and the caller - although others might be able to hear what you are saying. BP, BMI etc. When calling a patient, remember not to breach confidentiality – be cautious about revealing your identity until you have confirmed that you are speaking to the patient. Disadvantages of telephone consultations. An authority on body language, James Borg says that human communication consists of 93% body language and paralinguistic cues, while just 7% consists of words.Body language speaks a lot louder than words; you can gain a much better understanding of how a candidate or client is feeling than you would otherwise be able to through other forms of communication. –Opportunity for management of long term 8. Raising and acting on concerns. Cost-efficiency. Info at your fingertips. Table 1 compares the advantages and disadvantages of face-to-face, video and telephone consultations. The benefits of telephone triage •For the clinician/health care system –Cost effective services i.e. Remote consultations (over the phone, via video link or online) have increased. No specialist equipment is needed. This may be a concern in areas with limited or poor network connection. This includes 38,236 doctors and 5,560 dentists.4 Scarcity of healthcare practitioners is experienced around the world, but the situation seems worse in African countries, as reported by the Department of Health. There are many advantages and disadvantages to using the telephone as a method of communication and some of them are more or less pronounced depending on whether you are considering a land… When gathering information on the caller’s problem, make sure you ask some open questions and closed questions, ensure that you are in a position to reach a sound clinical judgment, agree a plan of action with the patient, and check that they agree with it and understand it. When integrated with current systems VCs can provide a time-saving alternative to face-to-face consultations when formal physical examination is not required, especially for people who work. Paragraphs 1 – 17 – Raising a concern Paragraphs 19 – 26 – Acting on a concern. Fresh Skills 157 N Main St Suffolk VA 23434 United States. PDF | On Sep 1, 1989, R S Bhopal and others published Telephone consultations | Find, read and cite all the research you need on ResearchGate However, during the procedure Dr S became worried about the possibility of a bowel perforation; he requested that general surgeon Dr K perform a sigmoidoscopy. In addition to reducing time, mobile telehealth services also reduce healthcare costs. Each format has its own pros and cons, and candidates should be aware of the advantages and disadvantages in order to maximize their chances of success. This way they are able to see and talk to patients in real-time, view their health reports and make an assessment of their health. The realities of implementing alternatives to face-to-face GP consultations, such as telephone, email, online and video consultations, mean that hoped-for reductions in GP workload and increases in available appointments for patients might not be realised. There are possible disadvantages of telephone contacts with some reports suggesting that telephone triage of requests for same-day appointments may lead to an increase in subsequent surgery consultations and, therefore, costs — perhaps because the focused telephone call did not deal with all of the issues that the patient hoped to address. You should identify when you should see a patient in person, for example, if the symptoms aren’t clear or you can’t evaluate the patient over the telephone. With the rise of the internet, however, the practice of telemedicine has evolved into an experience that is very similar to what a visit to a local doctor’s office entails. A report issued in March 2008 highlights the fact that Africa carries 24% of the world’s disease burden with only 3% of the world’s health workers.5. Face-to-face conversation is one of the most popular and effective means of oral communication. our consultations logically; in turn, this may help us run to time in our pressurised 10-minute appointment slots. The General Medical Council (GMC), which regulates UK doctors, states that before you prescribe for a patient via telephone, video-link or online, you must satisfy yourself that you can make an adequate assessment, establish a dialogue and obtain the patient’s consent. Telephone interpretation services are not always appropriate for every situation that requires the aid of an interpreter. Advice on handling attention from the media, Aspects of confidentiality: When your patient is an impaired practitioner, Telephone consultations: Hanging up on the risks, www.southafrica.info/about/health/health.htm, Medical certificates - Avoiding the pitfalls, Aspects of confidentiality: A request from SARS, High reliability in healthcare: A personal failure, The challenges of treating Jehovah's witnesses, Aspects of confidentiality: High-profile patients, Followership: the forgotten part of leadership. from University of Exeter Medical School and the Universities of Oxford Introduction: Remote video consultations between clinician and patient are technically possible and increasingly acceptable. Both providers and patients can connect and engage with each other at any time, wherever they may be to ensure that the patient’s health parameters are being tracked. Seeking online health advice is proving to be of great use to patients around the world., it’s an effective means of getting professional medical advice. Unlike other online consultations, video consultations on mobile allow providers to have audio-visual communication with their patients. Clinicians are also wary of providing telephone based care, however, and this unease is fuelled in the main by an awareness of the potential risks of missing a serious condition.3 w5 Many doctors also express some dissatisfaction with communicating by telephone, citing concerns such as the absence of visual cues and an inability to confirm the diagnosis with an examination. This article will discuss some of the more common consultation models in use today and their relative advantages and disadvantages. Follow-up: check existing medication when prescribing new medication, explain to patients what they should expect by way of improvement, significant symptoms to report, or when to phone back if they are not getting better. Are telephone consultations a safe alternative to face-to-face consultations? Background There is evidence that telephone consultations in general practice are typically shorter than face-to-face consultations and that fewer problems are presented in them. As with any new technology, there are often benefits and limitations associated with it. Using remote consultations supports with coronavirus response by: There have been several advantages and disadvantages found within telephone counselling concerning the personal experience of both the therapist (counselor) and the client. The size of the mobile screen sometimes makes it a challenge for providers to properly view and assess their patient and review their health records. The COVID-19 pandemic has changed how we work in paediatrics with increasing use of virtual consultations. By using this site, you consent to the use of cookies. We will send an email to your health provider letting them know about the Virtual Practice platform through which they can connect and engage with patients like yourself. The lack of visual cues and inability to examine the patient are key disadvantages that necessitate careful consideration whether phone consultation is safe and effective.3 7 Phone consultations tend to narrowly focus on presenting symptoms, and patients are often not comprehensively assessed.8 A recent Cochrane review underlines the lack of training in phone consulting … Cons of Telephone Medical Consultation It’s Prone to Errors One of the most common pitfalls of telephone medical consultations is that the assessment is not accurate. Therapist cannot respond to crisis situations e.g. Document the consultation accurately and contemporaneously. It is easier for doctors who have an understanding of the patient’s history to provide treatment suggestions. Try to take the call in a quiet room on your own. These electronic sound files form part of the patient’s records and can provide useful information in the event of a complaint or claim. Technical problems, however, were common. Telephone consultations are typically used by patients to deal with a limited range of single-issue concerns, whereas a wide range of different problem types is dealt with in face-to-face consultations. We can use video consultations to get over this.” In today’s society, face-to-face conversations have become less common due to technology such as email, texting and cell phones. In March 2012, 165,371 qualified health practitioners in both public and private sectors were registered with the HPCSA. Also, you can submit your previous and current medical reports. Some hospitals record incoming and outgoing telephone calls. Four days later, however, Ms L’s husband contacted Dr S directly with concerns over the pain his wife was suffering. Body Language. Recently, with the expansion of the internet use, electronic mail (email) communication has been gaining importance as a tool for communicating with the physician, continuing the office visit and developing interpersonal relationships ( 2 ). Each telephone call lasted an average of four minutes, amounting to 2.6 hours per day on the telephone. Evidence-based information on telephone consultations from hundreds of trustworthy sources for health and social care. Today, telephone consultations are widely used by GPs and patient satisfaction is high. You get immediate feedback to things you say. It can be argued that telehealth services reduce human interaction and that assurance that comes from a doctor’s touch. Organizational Advantages and Disadvantages in Telephone Counselling; Accessibility . Aim To compare the communicative practices of doctors and patients in face-to-face and telephone consultations, in order to understand the contrasts between the two consulting modes. This service allows patients access to specialist care (Eg. Due to the mobility it offers, it helps providers manage their time better and also see more patients. They can also prescribe new medication and provide treatment advice which will be emailed to the patient as a consultation summary after the session, to reduce non-adherence and improve health outcomes. A full clinical assessment is not possible by telephone, but if the limitations of the telephone consultation are recognised, and a careful history taken and documented, patients can be managed in a reasonable, appropriate and safe way. Occupational health, unlike other forms of diagnosis, relies 100% on assessing an employee’s functional capability with regards to the impact of work on health and health on work. Although not all this information was initially passed on to Dr P, he should have excluded it prior to having accepted Mr Q. Pros of online consultation: 24x7 Consultation No location hurdles is a major benefit of online health consultation. Are you considering online therapy? Organizational Advantages and Disadvantages in Telephone Counselling; Accessibility . Medical Records in South Africa: A Medical Protection Guide, Where allowing access might be permissible, Appendix 1: Retention and disposal of records, Appendix 2: Ownership and transfer of records, Appendix 3: Paper records – environmental risks, Consent to Medical Treatment in South Africa: A Medical Protection Guide, Appendix 1 - Key legislation referred to in the text, Appendix 2 - Links to relevant information, Appendix 4 - Children's Act (38 2005): General regulations regarding children, Common Problems: Managing the Risks in General Practice in South Africa, Maintaining an open mind – being willing to revise an initial diagnosis, Keeping comprehensive and contemporaneous clinical records, Appendix 1: List of ethical rules, regulations and policy guidelines published by the HPCSA, Appendix 2: Assessing decisional capacity, Common Problems: Managing the Risks in Hospital Practice in South Africa, Understanding your legal and professional responsibilities, Appendix 3: Sources of guidelines, research and evidence-based care. Telephone technology has increased dramatically over the last few years, making this issue a little more complicated in the post smartphone world. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. Limits the volume of phone calls, text messages, and emails that providers often need to address from patients. Storing data online means less large, space taking file cabinets, folders and shelves. reduce need for face to face consultations (50% in primary care) –Can help manage demand and capacity/workload –More appropriate outcomes i.e. MPS® and Medical Protection® are registered trademarks. In addition, employees who … MPS is not an insurance company. Disadvantages of telephone: Expensive for video call and SMS The telephone is a little bit expensive for video calls and SMS on the other hand voice call, video calls, sending SMS through the internet is very cheap and this is the great facility of the internet. This includes owners, shareholders or members (in the case of limited liability companies or LLCs), and investors in the company. In light of these considerations it considers what the liability implications are for phone consultations. © 2010 - 2020 The Medical Protection Society Limited. Are telephone consultations a safe alternative to face-to-face consultations? Introduction Remote video consultations between clinician and patient are technically possible and increasingly acceptable. However, video consultation is a useful alternative that is straightforward to learn and, with experience, user friendly. Insurance coverage for video consultations and telemedicine has still been a matter of debate. Mobile telehealth services prevent patients from falling ill by limiting their exposure to infections which they may otherwise encounter during hospital visits. –Opportunity for management of long term Instead of advising Mr L to take his wife to see Dr K, Dr S reassured him that the symptoms were in fact normal and that Ms L was probably improving. The realities of implementing alternatives to face-to-face GP consultations, such as telephone, email, online and video consultations, mean that hoped-for reductions in GP workload and increases in available appointments for patients might not be realised. Such conference calls can be used in conjunction with video conferencing to view presentations, ask questions over … 3. The site may also include cookies from third parties. GET IN TOUCH WITH US Specialized screening and diagnostic devices, cameras, monitors and sensors, all of which feeds patient data and health metrics into telemedicine software. Telephone consultations do not give a doctor the opportunity to assess clinical signs. No matter where you work, you will encounter people who are using substances and risking their health. Telephone Interviews Telephone interviews are generally conducted by hiring managers in an effort to save time and quickly eliminate candidates who do not meet the organization’s requirements. The problem in the case really revolved around the referral of a patient with an acute abdomen where Dr P was not immediately available. The modern form of telemedicine began in the 1950s when some hospital systems began to share information over the telephone. One of the disadvantages of telephone consultations is the lack of non-verbal cues. outbursts of anger between parties in the session as in face-to-face consultations. The Lancet then proposed a rule that “calling up the doctor on the ‘phone should be limited to urgent cases”. Conclusion The visual component of VCs offers distinct advantages over telephone consultations. Physical Damage Car J, Sheikh A, Telephone consultations, Brand South Africa country portal, Healthcare in South Africa –. The main advantage of telephone consultation (see figure 2) was reported to be no travel time (34/40; 85%), closely followed by the child not requiring time off school (33/40; 82.5%). The telephone has been used as a tool for delivering healthcare since 1876 when Alexander Graham Bell invented the device. HELP: I've received a complaint - now what? Benefits and drawbacks of telehealth services going mobile. Surgeon Dr S performed a laparoscopy on Ms L for suspected endometriosis. As with any OH assessment, it is good practice in telephone consultations to use a set of evidenced-based tools against which you conduct your assessment. Delivery of clinical care via telephone is becoming more common but the practice carries unique risks to both doctor and patient; Charlotte Hudson looks further into the issue.