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Look to the past to see why electronic consulting isn’t the future


fruit and veg prescription


So here I am in journal club (it helps to fill in those sad empty hours between surgeries), about to present a paper from 1989 (to show how cutting edge I am) when I notice the news on my phone, (because I’m not really paying attention).

How marvellous! Those lovely people at eConsult are introducing ‘demand management’ features because they recognise we GPs are overwhelmed. Well, with work, yes, but now with joy! Though I have to say that putting the electronic consult link on a page of our website that no one ever visits (‘How to help your doctor’) manages demand quite well, as does not putting it on the website at all.

Still. I suddenly realise that the archaic paper I’m presenting is bang on the money. Because it features this unbelievable stat: for every 40 symptoms a patient experiences, only one is presented to the GP.

And no, not because the other 39 kill them before they get to us – whoever said that, see me after journal club. No, it’s because most symptoms are trivial and transient. They resolve into distant memory before the patient can negotiate the minor hurdles of delays getting an appointment, unimpressed receptionists etc. Thank the Great God of general practice, we’d say, for these benign barriers – without them, we’d be 39 times busier.

Fast forward to now, and that’s exactly how we feel: electronic consulting means tonight’s temporary symptom blips – through whimsy, neurosis or a need for instant gratification – are, whatever the time, at the click of a mouse, tomorrow’s workload dump. And it’s been hell.

Not any more. At last, it seems the enthusiasts have realised what we all knew – e-consulting doesn’t spread work, it generates it. I knew they’d see sense eventually. But frankly, I could have told them this long ago. 32 years, to be precise.

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

READERS' COMMENTS [6]

Patrufini Duffy 2 August, 2021 3:15 pm

(M)e-Consult. It’s all about Me and my insecurities. You fix Me and I don’t do. Me me me. Not sure if Pulse can get an FOI on eConsult procurement’s and profits so we can all be clear on who is benefiting from hypochondriasis…oh everyone, bar the GP.

Douglas Price 2 August, 2021 5:11 pm

now that econsult and the hurley group are in charge of both key positions within the RCGP i don’t think it’s going anywhere. Oh well, when we’re all too knackered to carry on at least there’ll be a resilience service waiting for us

James Cuthbertson 3 August, 2021 1:06 pm

Perhaps electrodes wired in to peoples brains that can immediately highlight to the GP symptoms as they come in, obliviating the tiresome need to open the econsult page on the iPhone.

Mercedes Franco 3 August, 2021 4:36 pm

And yet, we are not allowed to restrict the hours that eConsultaiton is open.
24 hours a day to ask questions, 40 hours a week to answer them……. Silly? wait until something serious happens!!

David Evans 4 August, 2021 6:29 pm

The reality is that total triage ,which e- consult does not provide,works,creates headroom and allows a GP driven service to flourish.
The alternative is to allow general practice to collapse this winter with the inevitable consequence of being micromanaged by NSHE.

Paul Cundy 8 August, 2021 10:31 am

And yet, we are not allowed to restrict the hours that eConsultaiton is open.
24 hours a day to ask questions, 40 hours a week to answer them……. Silly? wait until something serious happens!!

Err…….. not correct. Issue them with an Article 28 notice to stop processing. Simple.