Telephone consultations in primary care - Tony Males

The multi-professional environment of primary care requires a common set of skills, including the ability to communicate within and between professional groups. It is not only the patient who consults in primary care: nurses consult doctors and vice versa, paramedics may seek advice from the scene of an emergency and GPs often call upon their consultant colleagues as an alternative to referral. The telephone is ideally suited to these examples of inter-professional communication. The training that health professionals and their support staff receive in face-to-face communication skills may not be sufficient to prepare them for the unique medium provided by the telephone. The aims of this book are to: guide primary care professionals in the appropriate use of the telephone when speaking with patients, carers and colleagues; raise awareness of the limitations of telephone communication, and improve the accuracy of triage, diagnosis and advice-giving. The ten chapters comprising this book cover a range of telephone communication and consultation issues: factors that modify verbal and non-verbal communication in the absence of visual and other sensory cues and how these affect the diagnostic accuracy and decision-making behaviour of health professionals; educational interventions and patient-centred telephone consultation models that attempt to compensate for the relatively cue-less environment of the telephone; guidance on how to assess and manage common clinical problems presenting by telephone in the context of uncertainty; and the multidisciplinary and inter-professional nature of telephone medicine and other methods of conducting consultations at a distance. Readers are encouraged to take an active role in their professional development in this area by attempting the exercises in each chapter. Transcripts of telephone consultations appear in several chapters to facilitate learning. This book is intended for GPs, GP registrars, foundation year doctors in general practice, practice nurses and nurse practitioners.