THERE has been much discussion about a ‘new normal’ once lockdown ends, but I really fear what this will mean for general practice.
Since the pandemic struck, around 80 per cent of GP consultations have been conducted on the telephone or via a digital screen. Where patients are seen in person, the examination is more thorough than usual.
Personal, face-to-face communication and skilled physical examination is the bedrock of healthcare. I have lost count of the number of times where the absence of a face-to-face consultation would have resulted in the death of a patient.
Take, for example, the woman who called several times about her persistent cough. She was reluctant to be seen and even more reluctant to undress so her chest could be examined.
I found that she had fungating breast cancer (where the tumour is so advanced it grows out of the skin). The cancer had spread into her lungs, hence her cough.
Or the teenager whose parents called for advice about ‘flu’. When I visited, I found a few flecks of a purple rash on her wrist, signs of meningococcal meningitis, which would have killed her later that day had she not been raced to intensive care.
And it is not just about diagnosis; explanation and support is needed when treating patients with severe illness. Cancer, heart disease, chronic neurological conditions such as multiple sclerosis – all benefit from the human touch.
If we retain or expand the commitment to distanced medical care, the outcome will be dehumanising. Let’s hope it doesn’t become the new normal simply out of convenience.
As my boss would say when I was a trainee: "Telephones are for making appointments, not diagnoses."
© Solo dmg media
