That doctors are only doing phone call appointments?

[Yellowskies1988]

I'm generally fit and well but I've found what I can't determine if it's a spot or a lump high up on the inside of my right leg. It feels asif it goes down inside quite deep maybe I'm overthinking but it also seems like the same leg aches a little. The doctors offered a phone call appointment which I took. But I may as well have done the dreaded Google search instead.

Years ago an older lady visited his surgery with her friend. She looked awful and had a history of anaemia. Her previous GP had kept simply giving her iron tablets. FIL examined her, found suspicious lumps in breast or abdomen (can't remember which). Anyway, turned out she had advanced cancer.

So, this also happened pre-lockdown , not to mention years ago when telephone triage never happened, and this patient would have been presenting in person to the GP in question. So the example has nothing to do with the current sitaution.

Nothing in your post holds up.

I have had a few telephone appointments in ' nornal' times and they really are convenient, particularly for discussions about medication where no poking or prodding is necessary.

I can see why GPs are telephone triaging appointments. If they dont, people with coronavirus symptoms will just turn up.

If you are in Scotland you can get a video call so you could show the dr your lump

Our doctors you had to phone, a doctor will phone back. Then if necessary you send pictures or you have a video consultation.

Both of the GP surgeries where I live have been running their appointments system by phone for at least the past 3 years.

We cannot phone the surgery to make an appointment to see a doctor any more. All initial contact is by telephone, the doctor calls back and decides from that conversation whether or not a face to face appointment is necessary.

This system usually means that we have to initially tell the receptionist what the problem is, which sometimes we would rather not do. Also, it simply doesn't work for DH, who is deaf and has anxiety and can't use the phone.

So, YANBU if you find the telephone appointment system difficult or less than optimum. But YABU if you think GPs should be fully open and using the older, less efficient, appointment system during the coronavirus crisis.

@FreckledLeopard where does the OP say she has been refused outright to be seen in person?

Lovely anecdote, but irrelevant.

Would OP (or you?) prefer to be phone assessed then go to an in person appointment with no-one but the GP within 2m, or go and sit in a waiting room full of sick people, some with the virus?

Ring and ask. DH was investigated for a lump in his cheek over the last fortnight. He's had blood tests and scans so the system here was all working, just in a different way.

Freckledleopard

I’m a Dr- and one who was very sceptical about video/telephone consultations- and I think you are wrong. I think Dr’s doing them need to be thorough in their assessments to decide whether the patient needs a face to face consult, but there is no need to see everyone face to face for every little thing. There are some things that absolutely need to be seen in a face-face consultation to allow physical examination. This can usually be established via a telephone consultation first. Other things can very safely be managed via phone or video consultation. Your anecdote is an example of poor medicine, full stop. Iron deficiency anaemia should always be investigated fully and simply placing a patient on iron tablets without trying to find the cause is negligent, in my view. It has nothing to do with telephone/video consulting being good or bad because a dr who does not investigate IDA is unlikely to properly examine the patient even if they are in front of them.

GP surgeries are operating telephone triage for 2 reasons. 1) to ensure no-one who is likely to have covid-19 enters the surgery putting everyone who works there or comes in after them at risk (obviously asymptomatic/those in incubation period will not be picked up but you can’t do anything about that). It means high risk patients who need to go in can do so more safely- patients needing pre-chemo bloods or monitoring those taking certain medications for instance. Those who are likely to have covid who need medical review can still be seen but in a different way- procedures differ from place to place.
2) trying to reduce footfall through surgeries to a minimum for the protection of all patients and staff- this means patients who have to come in (for consult or essential planned care) have low risk of being exposed by a previous patients who do not obviously have covid.

It’s not perfect and I’ve no doubt some problems will arise. However, just as many (if not more) problems are likely to be caused by people not contacting their GP as they don’t want to bother them, or because they are worried about going out/going to the surgery and catching covid or being sent to hospital where they might catch covid or not be allowed visitors etc. Some of these people might well contact their GP if they thought they’d get a video consult, for instance, and then if Dr thought they required a face to face consult they could be reassured/persuaded to come in.

OP, you must be very worried, but try not to be. I'm sure the Dr will do an initial telephone consultation, then invite you to come in to see them.

Dh contacted our surgery yesterday morning, got through to reception very quickly and had a call back within minutes from the GP. He had a phone consultation which resulted in him being asked to send photos of his leg by email. The GP rang back later and discussed the problem and offered treatment if the problem persisted. Much better than trailing down to the surgery and risking catching COVID 19.

You need to get the initial phone conversation to then see them face to face.

My husband discovered a lump yesterday and contacted the health centre who put him on the list for a phone call from a doctor.

After a discussion during which my husband described the problem and answered various questions, the doctor said that there was no point in seeing him and that he would refer him for a scan at our local hospital, which he has done.

OP it's incredibly rare for what you're describing to be cancerous (I know because I had very similar recently - freaked out and did loads of research). It's much more likely to be a fatty lump, a muscle issue or just a spot which will disappear over time. Either way on the phone consultation the doctor will decide whethet further investigation is required and you'll be offered a face to face appointment if necessary.

Even before covid my surgery often did initial consultations by phone. It worked really well as often it saved people a trip in and it meant you didn't have to wait long when you actually did need to see a doctor face to face.

A good GP needs to be able to undertake a thorough physical examination. Obviously with Covid this has risks and PPE should be worn. But failing to offer face to face services is shocking.

They ARE still offering face to face services where necessary, they're just triaging people over the phone to avoid unnecessary visits to the surgery. But don't let the truth get in the way of a good froth.

OP prepare for the appointment, maybe write down a few notes for yourself eg positioning of the lump, visible or not, texture, shape and size of the lump, when you first noticed it, does the area feel unusually warm or cold to the touch compared to other parts of your leg. Does the lump feel as though it is attached or separate from the surrounding flesh.

All of this will help the Dr to make an initial assessment. The Dr will be able to make notes then decide the next step.

DD had a phone appointment with Dr for a persistent cough and felt that the appointment went better than face to face. Felt that she was listened to better and that the history and previous treatment was better acknowledged.

Our GP surgery has been doing this for at least a year. They always telephone initially and, if they need to they will see you f2f the same day or within 24 hours.

' relative has a lump and had a phone call appointment, followed by a f2f appointment and then a scan, and finally a phone call to give the all clear. If the GP needs to see you, they'll see you IME.'

This ^

There's such a lot of scaremongering online that GPS are shut or not seeing people. They are, just on a triage basis. So an initial phone call is needed. Urgent care, 111 etc it's all still there and available.

A friend found a breast lump, rang the Dr was seen and referred to the breast clinic as normal. Yes routine screening is on hold but that will all soon resume.

My DH had a phone appointment yesterday for mole like growth that has suddenly appeared on his nipple. They then called back to do a special video check and he now has a physical appointment today.

It is merely a wedding out process and if they need to see you then you will be called in.

YABU if you think this system is not how matters ahould be handled at the moment. Indeed it has worked so well for us we think they should actually carry on this system after lockdown!

grr autocorrect - weeding out!

I contact my surgery concerning my regular blood tests, and it was arranged similarly to normal. The main difference was waiting in the car park to be called rather than a waiting room.
Today I will have a telephone discussion of the results.
If necessary I would be seen f2f or referred to the hospital, or whatever as normal.

I've been a bit sceptical about phone triage in the past but I had a problem last week and rang my GP. The phone was answered much more quickly than normal and by a nurse practitioner who discussed my problem, decided a course of action and sent my prescription to the pharmacy. It was so much quicker and easier and meant I didn't have to wait for an appointment while in severe pain or sit in the waiting room worrying about what I might catch. If your GP thinks they need to see you they will do that. I understand you're scared about a lump but I'm afraid you are being unreasonable to expect them to see you straight away.

See how the telephone consultation goes. Unlike google, the Doctor will ask the relevant questions and if they’re concerned and need to do a face to face appointment they will. And will be able to tell you what to watch out for that means you need to contact them again. I wouldn’t call them back again until after you’ve spoken to the doctor and I wouldn’t expect them to offer face to face At the moment unless the doctor agrees it’s medically necessary.

I had a gum infection a couple of weeks ago, had a telephone consultation with my dentist who asked the relevant questions to diagnose and prescribed antibiotics remotely. He also advised me what should trigger me getting back in touch. Probably the best dentist experience I’ve ever had.

I know that anecdotes are not data but this has happened during the last two weeks......because my 78 year old father had a fever and exhaustion he rang 111 and was told to self isolate and manage at home. He got much worse and eventually paramedics were called. He has been to hospital three times in 12 days and sent home through the 111 service. Eventually he was given strong antibiotics and is now recovering from a very bad chest infection ( with no cough). People with fever have not been seen at the doctors and I understand why, but lots of conditions such as a uti and normal chest infection can present with a fever and are being missed. Going to hospital 3 times rather than the local gp probably put him at more risk of getting covid.
On the other hand, My gp has done phone triage for some time and I think it is a good idea in some cases, for maybe confident people who can present their case clearly on the phone or who can understand the video tech and have the equipment, and also maybe the worried well who can be reassured. Perhaps it doesn’t work so well for older people?

I can see both sides of the argument here but I am very concerned about the cancer treatments on hold, the investigative and scan work postponed and the general lack of hospital treatment and primary health care including dentistry and eyesight.

If I had an unexplained lump like the op I would also be very concerned.

My GP has offered telephone triage for about two years and for me, it's brilliant, I have often saved a trip to the drs to get some medication or check something relatively trivial.

However, I am concerned that yet again, the articulate middle-classes are the beneficiaries of this system. There are lots of people, especially the elderly, or those with brain injuries/damage, dementia or cognitive or communication difficulties or who are just deaf or find it hard to articulate their personal bodily problems on the phone. Yet again, those who know what they want and can answer questions quickly and easily will be the winners. Those with extensive support systems do better than isolated individuals.

That's how you end up with health inequalities, even though the NHS is supposedly accessible for everyone at the point of care.

I hope that the phone call triage is followed up by face to face care if necessary- it is at my surgery, and the district nurses are also out seeing patients as well in the community.