How Covid has helped GPs find a different way of working – Dr Andrew Cowie

Phone and video consultations have helped some patients be seen more easily and quickly, writes Dr Andrew Cowie.

Wednesday, 16th September 2020, 4:45 pm
GPs have been taking advantage of video conferencing but some patients still do need to have a face-to-face appointment (Picture: Daniel Leal-Olivas - Pool/Getty Images)

I often lament that a GP’s work is never done. It’s not to garner sympathy, it’s not to preach “look at how busy I am” – it’s simply just a fact of life when you’re a GP.

I know people will be surprised to hear that I’m still seeing patients: my practice never stopped doing so throughout the pandemic, even when it was at its very peak. Many people – my own patients included – assumed we were closed, which is mostly down to unhelpful rumours and reports that circulated mainly on social media, and often in newspapers too.

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And each time we get more anxious phone calls from patients to make sure we are still open – and that actually adds to the difficulty of the job we’re already doing. Yes, right now we are asking that patients speak to a GP over the phone before making an appointment to come in.

For obvious reasons, we simply cannot return to the days of crowded waiting rooms full of a mixture of people with coughs or other Covid symptoms, and vulnerable patients.

It was odd at first, my waiting room being almost eerily quiet, but we soon got used to this new way of working and found that in many cases we were able to deal with many issues over the phone. We are using new technology to help, sometimes with the aid of photographs emailed into the practice or by videoconferencing with the patient in their home. But when I – or indeed the patient – feel that a face-to-face consultation is necessary, we are still doing these, every day.

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Phone and video consultations in this “new normal” do have their advantages – a lot of patients are able to have their concerns answered quickly and effectively without leaving the house. For example, in my practice patients now have direct access to the physiotherapist and mental health teams, who are increasingly becoming available to communities.

Last year it wasn’t uncommon for a patient to have to wait a week for an appointment with me, in order for me to refer them to physio for example, and then have another long wait before getting to see them. Now, however, they can phone the practice, and arrange their consultation with the physio or mental health team directly, without having to wait for a consultation with a GP.

That being said, whilst the digital consultations are, right now, necessary in order to reduce footfall within practices as much as possible to keep the risk of Covid low, they don’t come without complications.

Not everyone has the technology to carry it out effectively. Yes most people will have a phone of some sort, but not everyone has access to a camera on their phone, or the internet in their home, or a laptop or tablet to carry out video calls – it’s not a perfect system.

Then of course there are people who rely on visual signals to communicate, or rely on lip reading because they have hearing difficulties; we know that telephone consultations are extremely difficult for them.

That’s why it is important for us to get back to face-to-face consultations as much as possible – patients still have new and chronic illnesses that need managed, and often these are best managed in person. On top of this the level of mental distress and anxiety we are seeing doesn’t seem to be going away, and for many of these patients they need face-to-face contact.

There’s still a long road ahead but if we work together we can get through this: so on a final note, please follow the advice and wear masks in public as much as possible. Thank you!

Dr Andrew Cowie is deputy chair of the BMA’s Scottish GP Committee and a GP partner in Dundee

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