Why remote consultation with a doctor is difficult – and how it can be improved (Trish Greenhalgh, 31 August 2021)

Summary

With remote consultations with a doctor becoming more frequent, Trish Greenhalgh explores why this can be difficult and looks at the ways it can be improved.

Content

In a recent study, Trish Greenhalgh's team looked at why some remote consultations by video are efficient, effective and well-received but others are logistically cumbersome, technically inadequate and associated with deficiencies in care, such as missed diagnoses or a poor patient experience.

While it’s impossible to generalise, remote consultations seem to be less suitable for people who

• are very young or very old
• are very unwell with a high-risk condition, such as pneumonia
• have complex health or wider needs
• want or need a physical examination
• have difficulty communicating (though the hard-of-hearing may prefer a video link where neither party wears a mask)
• need supervised check-ups, for example, for controlled drugs
• do not own, or wish to use, technologies like smartphones
• lack privacy at home.

Her research has shown that GP consultations should not be remote by default, but that with attention to infrastructure, training and planning, remote consultations could become a realistic option for a much wider range of people than the healthy young professionals towards whom they were originally targeted.