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An invitation to insult us

E-consulting may be the next big thing, but Copperfield reckons it's just a prescription for patients to spew out e-garbage

E-consulting may be the next big thing, but Copperfield reckons it's just a prescription for patients to spew out e-garbage

My favourite piece of graffiti ever was spray-painted above the main entrance to our health centre. It was in full view of every patient as they walked in, and it stayed there for weeks. What it said was: 'F**k you, knobhead.' This was at a time when it was fashionable to have a mission statement. And I was only just outmanoeuvred - by a split vote - to make that ours.

We've never quite reached those dizzy graffitied heights since. Indeed, I've just checked what's daubed on the walls, and it's intriguing rather than insulting. Most notable, among the homages to the Hammers and claims that Sharon is a slag, is the statement, in huge letters: 'Ping pong willy.' Bizarre - is it a nickname, an STI or a novel way of playing table tennis?

Whatever. My point is that the local punters clearly have lots to say. Give them a blank canvas, and they'll say it - with spray paint. And that's one of the main reasons why I'm worried about the concept of e-consultations. An email is just another blank wall to invite insults or nonsense.

But some enthusiasts are already talking about using HealthSpace - Facebook for people with symptoms rather than friends - to encourage electronic communication between doctor and patient. E-consulting is the next big idea. It is, we're assured, the way we're heading.

Not in my health centre it isn't.

Okay, so it's easy for patients (no negotiating with receptionists and hanging around in the waiting room) and it's better for doctors (fewer face-to-face consultations and money saved on air-freshener).

More work

But stuff convenience. Such innovations don't save time, they create work. They simply give patients yet another forum in which to indulge their capacity for anxiety and dysfunction - that's not resolving a need, it's reinforcing a want.

Besides, emails are far too easy to send. Articles in the major journals elicit deranged responses from people who are much better at clicking 'send' than organising their thoughts. So we'll be dealing with e-garbage resulting from, say, patients being unhappy with a colleague's failure to prescribe amoxicillin or staggering home from the pub and deciding it is the ideal time to send an email about their Peyronie's, maybe with a picture attachment. And so on.

And much as I sometimes loathe seeing patients, I must admit it does help the diagnostic process to know if they actually look ill. Take that headache - it sounds like tension, but it's useful to see the axe sticking out of the back of the patient's head. And if the enthusiasts say emails aren't for diagnosis, they're just for administrative queries, well fine, they can be diverted to my practice manager then.

So call me a Luddite, but I'm going to resist this latest foray into patient pandering. Besides, if it's just an attack of ping pong willy, they already know how to get in touch with me.


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