Telephonic Consultation: A Family Physician’s Perspective

(From a discussion held at a recent IMA meeting in Ahmedabad)

Telephonic consultation is a day-to-day situation that every doctor faces in one way or another. However, most doctors remain confused on how to handle this.

Problems related to telephonic consultation

  • Asian Doctor With PhoneCalls can come anytime, anywhere; the doctor may not be prepared or free to take the call.
  • Such consultations are time-consuming, as some patients take lots of time to explain the problem.
  • The OPD routine gets disturbed, as communication with the next patient in the clinic OPD at that time suffers.
  • It is often difficult to recollect patient history on the spot, or doctors simply may not have access to it at the time of the call.
  • It is not financially rewarding, as there is no formal concept for it, and most patients do not want to pay for this kind of consultation.
  • Serious mistakes can be made in patients hearing the names of prescribed medications, and this can put patients at risk.

Practical aspects and problem areas

  • It is a necessary evil.
  • Patients prefer to call and talk to a doctor rather than visiting them for minor ailments or giving them updated reports, etc.
  • It saves patients time and money.
  • Reaching the doctor over the telephone is quite helpful when the patient is travelling or on holidays when the clinic is closed.
  • Mobile phones have created havoc, as they are often being misused by patients as an “inquiry service.”

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Tips and tricks to manage this

  • Discourage telephonic consultation in general. This can never replace the value of an in-clinic consultation.
  • Define a stipulated time when patients can call, and the doctor will be relatively free to talk. This can be utilized to share reports or follow up on queries.
  • Make telephonic consultation chargeable, either at par with in-clinic charges or more.
  • Make the conversation short.
  • Restrict telephonic prescriptions to routine drugs only. One should ask the patient to reach a nearby chemist to whom the doctor can directly dictate the drugs; this saves time and avoids errors in interpretation.
  • Make a point for the patient to visit the doctor next day if possible.
  • Ask your assistant to screen the calls first, this way primary inquiry calls can be avoided.
  • Routine calls for sharing of reports or inquiry can be answered by doctor later by calling back at his free time.

Legal angle

To the best of my knowledge:

  • You can only consult with patients whom you have seen (in person) in the past.
  • The legal responsibility of the doctor is the same over the phone as it is with seeing the patient in person.
Vachharajani Dr. Vachharajani is an experienced practicing family physician in Ahmedabad, Gujarat, with a special interest in obesity and lifestyle-related disorders. With a genuine passion and enthusiasm for healthcare information technology (HIT), he has championed the cause of using HIT in day-to-day clinical practice. In addition to his, MBBS, he holds a post-graduate certificate in environmental and occupational health (PGDMCH).

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3 Comments

  1. P.M.Manmohan Reddy
    Posted Jul 2014 at 3:00 am | Permalink

    CONGRATULATIONS!
    All the advantages and disadvantages are nicely described! I fully agree with them.
    I recommend that every practising doctor should read it!

  2. Anant Joshi
    Posted Jul 2014 at 8:14 am | Permalink

    I rarely use the phone and discourage patients from doing so. In fact, if a patient responds to his phone while consulting me, he is discreetly fined! I never respond to phones during consultations or when in surgery , not even on blue tooth. I am appalled at how many surgeons talk on the phone while operating! Multi tasking is an absolute no no when dealing with decision making for your patients.

  3. Anant Joshi
    Posted Jul 2014 at 8:16 am | Permalink

    Ask patients to email or SMS to avoid making mistakes in your prescriptions. No ever prescribe orally on the phone.

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