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Gold, incentives and meh

let's practise in lyme regis

Virtual waiting rooms? Laptop GPs practising in Peckham-sur-Mer? Jobhunter is longing for the future

he future is E. No, the Government is not going to countenance the prescribing of ecstacy to alleviate stress in the workplace, but the consumers of primary care are going to reduce their own tension levels by consulting electronically. Everywhere I turn I read that the e-consultation is the way forward.

I have already (selectively and with complete prejudice) given some patients my e-mail address. There are obvious time-management advantages.

There could also be a wondrous effect on the job market. For starters, we won't need Cerberus on the front desk. If the punters are no longer staggering in with their bribes to beg for appointments, then we can dispense with receptionists and spend the staff budget at Armani.

The best bit, though, is that we can live anywhere: none of this residing on the patch and being pounced on in the frozen food section by constipated depressives.

Virtual waiting rooms will displace the current seething malodorous vestibules, and we can take down all those ghastly health promotion posters and replace them with a Hockney triptych.

And if we so please, we can live in Somerset and apply for a job in south London.

I may be a touch ahead of the game, but I do see this as a way forward. I'm entrenched in my London practice and accustomed to city costs and habits, but young doctors who want the challenge of social exclusion medicine may not be able to afford London house prices, and might feel nervous about Lambeth playground protocols. We could keep a core of three partners, because despite journalistic predictions I don't think we will entirely lose the bedside situation.

A sliver of human contact may have to be retained. Perhaps all patients are capable of photographing their own skin lesions and whizzing these via mobiles to our screens. Probably they can do their own smears and their own finger-prick HIV tests. Even now they can do their own pregnancy tests and treat their own upper respiratory tract infections, but do they ?

I foresee a couple of e-assistants. It won't matter if they have beards or hyperhidrosis. As long as they have a laptop they can reside in Barcelona, or even be on a three-year round-the-world jog. They can do all the boring target stuff, and they can offer skilled, informative, courteous, evidence-based advice to all those dreary, health-obsessed men who read medical journalists.

This e-consulting will also obviate translating trickiness, because the clever technology will switch Eritrean to Spanish and remove the confusion of body language error. This seems a gift for the young doctor who is not ready to settle. We will be advertising on eBay shortly.

Dr Sally Whittet is a GP in south London

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