The universal GP Training website for everyone, not just Bradford.   Created in 2002 by Dr Ramesh Mehay

Telephone Consultation Skills

the good, the bad and the ugly

A Workshop for GP Trainees
by Dr Ramesh Mehay

Telephone consultations made up about 10% of all GP consultations before COVID (2020).   During Covid, they because 95%.  And after COVID – telephone and remote consultations are now part of the new norm.     We reckon roughly 40% of all consultations will be face-to-face and 50% telephone and perhaps 10% remote video.  This will change as IT platforms improve.  The future, within 5 years, may well be 30% f2f, 30% telephone, 40% remote video.

So, this is a skill to learn, polish and master.   It’s here to stay.   We need to become more confident at data gathering, diagnosising and managing things remotely.   Once we are more confident, the fear of missing something or mismanaging a condition need not be so great. 

You will find all your resources for this workshop here.
In the future, if you want to come back to this page: Go to Bradford VTS > Teaching & Learning > Workshops by Ram

Exercises

black corded telephone
Exercise 1: Poll (Telephone experience)

Let’s see how many of you have had IMG experience and what it was like.

Exercise 2 - WordGram (FEELINGS about DOING telephone consultations)
Exercise 3 - Patient with Back Pain
Exercise 4 - WordGram (What percentage of the Diagnosis comes from History and Examination?))

10 Key Points

1: Keep desk clutter free.
2: Headsets make it easier.
3: Before you call, think of something nice & SMILE.
4: Patient annoys you? Stop your primitive brain.
5: Follow your natural curiosity.
6: Signpost throughout the consultation.
7: Empathise.
8: Objective scales 1-10 can help.
9: Explore the patient's circumstances.
10: If unsure of something - stay there and clarify.
Ram's 8-point Telephone Consultation Framework
  1. Opening
  2. Story & Clinical History
  3. PSO + ICE  (IE)
  4. Examination (preliminary)
  5. Diagnosis & Differentials
  6. Further Examination & Test
  7. Management Plan
  8. Safety Netting & FU

OSPEDEMS

Ram's EDF method of Safety-Netting

Ram’s EDF

  • EXPECTED natural course
  • DEVIATION from the natural course
  • FOLLOW-UP: what to do


FOLLOW-UP

  1. Who   (GP, A&E, 111, 999)
  2. How  (phone, go there, make appt)
  3. Time-frame  (next 3 days, 5 days, 7 days.  If within 2 weeks, 3 weeks, 4 weeks…)

Practise, practise and practise. Skills are only every acquired through repeated practise and reflection.

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How IT ALL STARTED
WHAT WE'RE ABOUT
WHO ARE WE FOR?

Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

So, we see Bradford VTS as  the INDEPENDENT vocational training scheme website providing a wealth of free medical resources for GP trainees, their trainers and TPDs everywhere and anywhere.  We also welcome other health professionals – as we know the site is used by both those qualified and in training – such as Associate Physicians, ANPs, Medical & Nursing Students. 

Our fundamental belief is to openly and freely share knowledge to help learn and develop with each other.  Feel free to use the information – as long as it is not for a commercial purpose.   

We have a wealth of downloadable resources and we also welcome copyright-free educational material from all our users to help build our rich resource (send to bradfordvts@gmail.com).

Our sections on (medical) COMMUNICATION SKILLS and (medical) TEACHING & LEARNING are perhaps the best and most comprehensive on the world wide web (see white-on-black menu header section on the homepage).

4th February 2024 

WHAT's HAPPENING?

Here are some updates planned over the next 6 months

  1. Updating the SCA exam pages with cases and videos.
  2. Clinical Specialty areas all being updated with current guidance and easy to understand diagrams and flow charts.
  3. Videos being created for some of the pages for those of you who prefer to watch than read.
  4. We’ve got some bradfordvts helpers to contribute and develop their own pages or areas of interest.  If you would like to be a bradfordvts helper, email me rameshmehay@googlemail.com
  5. We provide all of this for free. But it costs us money to run.  If you could kindly donate something, that would be great.  We do all of this for you.   Please hit the button below. xxx