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I’ll handle the genitals if secondary care can face some patients


Continuity


So now that Covid isn’t officially a thing anymore – which is a bit odd given the eye-watering numbers and the fact that all our staff are off ill – we’ve been giving the punters full choice over remote v F2F. And they’ve been voting with their feet, specifically those feet that march them directly to the surgery.

Which is fine, because I’m really enjoying seeing patients again. I know that sounds like I’ve had a lobotomy and my frontals replaced by recycled RCGP-grade cardie-fluff. But it’s true. It’s great being able to put a face to a name, examine rather than rely on fuzzy descriptions or blurred images and have the patient onside enough to accept your diagnosis and management without that remote dissatisfied scepticism. It’s certainly much more worthwhile and less dangerous than medicine-by-phone-numbers.

As far as I can see, there are only two drawbacks.

One is that my patients seem to have developed a strange preoccupation with actual or perceived problems with their genitals. True, this is in Essex, though I’m not sure that fully explains it. Perhaps there’s a hitherto undiscovered link between Covid and genital dysmorphophobia. Or maybe lockdown led to a lot of navel gazing and that gaze just drifted unhealthily south a bit. Or maybe, you know, with all the boredom and isolation…but let’s not over-speculate – I think that can give you blurred vision. The fact is, I’ve been deluged with the vulval, vaginal, penile and scrotal, which I’m struggling to code because ‘face to face’ doesn’t do it justice.

And the other is that most of my F2F consultations not involving genitals comprise patients moaning about the lack of F2F consultations in secondary care. This is across the board, though the greatest venom is reserved for the musculoskeletal sector. Apparently, when you’re in agony with your back or your joints, a chat on the phone, a leaflet or link for some DIY exercises and a follow-up appointment in six months are seen as less than helpful. Funny, that, although MSK don’t see it that way. But then they don’t see anything.

So maybe secondary care should start waking up to the fact, as we have, that the laying on of hands, or at least eyes, adds disproportionate value to the consultation. I’ve got enough going on with my Privates Clinic, so it would be helpful if they could step up. If they don’t, I shall write to all hospital departments to complain. Better still, I’ll tell it to their faces.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

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READERS' COMMENTS [3]

Patrufini Duffy 29 March, 2022 4:50 pm

I find that a face to face is now a 30 minutes round trip. To mostly nothing land. The lump disappeared, the palpitations stopped (because it’s not a cocaine bingeing weekend) and they’re not so dizzy and anxious sitting in their gym gear with cappuccino in hand pre-Zumba class. And the bloating is funnily not there anymore because they passed wind in the courtyard, and the baby’s one day fever subsided because, it’s day two. Face to phone in the UK climate of 2022 “hotline” medicine, seems for now, the most efficient way to remain sane and free of communicable ill health and venereal risk. For the diagnostic doubters, certainly examine diligently, for the rest, they will be back again in a jiffy don’t worry, with their summer mole and ugly toenail. Addictions are hard to break. Particularly when they’re a free purchase.

Finola ONeill 3 April, 2022 10:03 pm

I’m with you. I find the practitioners dependence on face to face is inversely proportional to ability and experience. ie with decent knowledge and experience most can be done by phone. Econsults I find a massive, pointless pain in the ass. But I do like being able to bring in those patients I want/need to. And prefer the decision to be based on need not desire. There have been a subgroup monopolising GP time up until the Pandemic. The working people, less assertive, many of my younger patients, mental health patients; were all pushed aside by the worried well and some patients that just want a regular GP review. And I mean regular. Telephone triage has made access a lot more equitable and I’ve found accessing my own GP much easier since the Pandemic. Got a load of stuff finally seen to including a skin lesion lopped off. Don’t believe the Daily Mail bullshit about how much more clinically useful or safer a face to face is. Any type of consultation is only as safe as the ability of the clinician making it. Most of us know when we need to see and examine the patient. Leave it to the individual

Merlin Wyltt 4 April, 2022 3:34 pm

Don’t worry about cases numbers going up. The punters aren’t going to pay for COVID tests
( “I’ve already paid my stamps Guv” ). No test=No COVID.