Telephone consultations

Released 03/07/2009

Advice on legal safeguards

GP phone consultations carry definite risks, warns an article in the current edition of Medical and Dental Defence Union of Scotland (MDDUS) magazine Summons.

Latest data suggests that between a tenth and a fifth of all daytime contacts between patients and GP surgeries are by phone, says the article, by GP and GP trainer Dr Malcolm Thomas.

"So do patients approve? The answer is probably ‘yes' but only just so long as they see the telephone as an addition to face-to-face service rather than as a barrier to access," says Dr Thomas. "Well-run telephone consultations are part of modern primary care."

Understanding of the clinical and medico-legal risks of phone consultations comes partly from experts and the reports of medical defence bodies like MDDUS and the NHS ombudsmen.

They highlight risks in GPs failing to see the patient, failing to pass on important information (e.g. a test result) and failing to advise when the patient's condition deteriorates.

"Minimise risks by talking slowly and clearly, asking lots of questions and ensuring that the patient clearly understands what is being said", says Dr Thomas.

"Seriously consider asking the patient to write down any management plan and what to do if things go wrong.

"If you or the patient remains unsatisfied, meet face to face. Even if you are going to meet anyway, be thorough on the phone: a two-hour delay can have clinical consequences."

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