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.
About the Editor Tony Males is the senior partner of a city practice in Cambridge, one of six partners in a paper-light purpose-built surgery operating the advanced access system alongside nurse telephone triage. He developed his interest in telephone consultation through the now disbanded Fenland Research Group and focussed on the out-of-hours aspects of doctor-communication through this medium in his MSc dissertation in 2000. Tony is also employed part-time by the University of Cambridge in the General Practice Education Group sharing responsibility for the development and delivery of the undergraduate primary care curriculum. Tony contributes to the practice-based teaching of Cambridge medical students and is a trainer. He was successfully nominated a Fellow of the Royal College of General Practitioners in 2004. Tony is married to Becky, also a GP, and they have three children.
Introduction Part 1 - The principles of telephone consultation in primary care The history of telephone use in primary care Communication theory in the telephone consultation Limitations of the telephone consultation Part 2 - Telephone consultations and the primary care team The role of the receptionist/call handler in telephone consultations The role of the nurse in telephone consultations The role of the GP in telephone consultations Inter-professional telephone consultations Part 3 - Clinical management by telephone The management of common conditions presenting by telephone Analysis of telephone consultation recordings Telemedicine - alternatives to telephone consultation Summary