Every clinic at Ystradgynlais Hospital is now by telephone. This has been the case since March. I always enjoyed this clinic in the past as the cases were all routine.
“The patients are warm and friendly and the nurse always brought tea and biscuits on a regular schedule”.Gwyn Samuel Williams – Consultant Ophthalmologist Swansea
Whilst the nurse still brings tea and biscuits at a satisfying frequency the patients alas are no longer physically present. In fact one turned up once and before I had been made aware of it he had been politely but firmly shooed away home. I do not know when we will be allowed by the NHS Politburo to start seeing patients in person again but until then here is a simple guide on how to conduct telephone conversations in as efficient a manner as possible.
Tip 1: Usefulness of telephone consultations
Do not be fooled into thinking that what you are doing is clinically useful. Knowing this simple fact saves you a lot of heartache. It is impossible to know intraocular pressures, measure vision and/or conduct any meaningful tests whatsoever. If you accept that what you are doing is at best a diplomatic exercise that reassures your patients that you have not forgotten about them then you will be at peace with your conscience.
Tip 2: Do not try and make new diagnoses over the phone.
Patients often try and tell you about vague pains, odd visual phenomena and such, but do not use this information to dictate treatment. The only reason to listen to your patients describe things that you can never corroborate over the phone is to decide whether they need to come to eye casualty as an emergency or not. If you start saying ‘ah that’s probably the drop stinging your eyes’ you will be held to this when the patient does eventually attend hospital with rip-roaring pre-septal cellulitis.
Tip 3: Be prepared
Have the notes ready before you pick up the phone. This will save a lot of fumbling when the patient picks up and make you look skilled and professional. If you don’t do this you’re at risk of the patient hearing you leaf through voluminous notes as you try and find the right place to write.
Tip 4: Check who you are talking to
Check the person on the phone is indeed the person you are expecting to speak to. It’s easy to lose track during telephone clinics on where you’re meant to be. I have. You can’t get an answer with one person then call another but the notes of the first are still in front of you; before you know it Mrs Jones is shocked to be learning that she has glaucoma whilst all along she was under the impression that it was diabetic retinopathy. Sometimes it is possible to diplomatically reverse your position if you discover your error early enough; but usually it is not. Also check it isn’t a relative of the patient on the phone rather than the patient themselves.
Tip 5: Difficult situations
Give up on heavily deaf individuals. It is an error to think talking louder still or holding the phone right up to your lips will make a difference. If you can’t make yourself understood at the highest level of normal conversational volume screaming into the phone is unlikely to advance the consultation.
Tip 6: Organising a clinic for telephone consultations
Be aware that telephone clinics are not shorter than face to face clinics. They just aren’t. Some patients talk so much that it’s impossible to end the phone call without causing offence and a huge segment of the population has been deprived of all human interaction for months.
There are I am sure many other things that can be added to this list. This is however a simple guide to the main six points that I have myself found useful. Good Luck!
Gwyn Samuel Williams – Consulant Ophthalmologist Swansea & well published writer
Edited by EyeduationUK
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