Dr Bayana and Dr Kumar, Vice Presidents at Medic Mentor reflect on their experiences working on the frontline during the COVID-19 pandemic. Please note that we will be having a live discussion at 7 pm on Tuesday the 5 May during the Virtual Medical Society Meeting (VMS). If you have not yet joined the VMS, make sure that you have registered here to be issued with a password for the meeting tonight.
One of my neighbours is a GP and she has talked about the way she and some of her colleagues expect that there could be some significant long term changes with increased use of video and phone consultations. However, there is also a lot of concern that some patients aren’t speaking to a GP when they really should be at the moment so there could be some serious late diagnoses which may worsen the prognosis.
Personally, in the long run, I do feel that many symptoms and general illnesses can be addressed over video consultation. Which will be more efficient both for patients and doctors, since it will be more risk free and the chance for other patients with non-contagious symptoms will not be at risk or be exposed to patients who could transfer possible symptoms.
I think people are worried to go to the GP which is understandable however if someone isn’t diagnosed at an early stage for diseases such as cancer, it could be life threatening.
Yes which is why you should seek medical attention as you normally would in this case, however you should expect to be triaged by your GP and maybe even have an e-consultation rather than a face-to-face appointment.
some of the changes that have been made due to the coronavirus are some that could be beneficial to the healthcare system going forward, as both of the doctors were saying in the video, some of the changes have made the healthcare system more efficient. For example more use of video and phone calls for GP appointments. However, some people are not going and seeing anyone such as a GP or visiting A&E as they have the fear of catching the virus, or not being an “important” enough issue. This could cause problems for the healthcare system after the restrictions are lifted
I definitely know how there are people who feel like they will be a burden for going to hospitals if they have problems that aren’t covid related. I also have realised from family experiences right now that even if we had members who were struggling a lot with symptoms, they were worried to go into hospital with fears that the viral load there would be significantly higher and would make their condition worse. However, on returning home they realised how there was actually such a swift process in place and they came out of A and E much faster than the usual A and E timings and the usual masses of patients in waiting rooms. Perhaps people think that it is still as busy as before and therefore don’t want to come in.
Yes, but unfortunately it can be very dangerous if people don’t go to hospital. At the same time, it shows that the ‘stay at home’ public health promotion has worked very well – almost too well!
Dr Siva
Yes, this would be a big worry for doctors right now, especially for those with long term and chronic conditions that are unrelated to covid as well
I think from media we feel like right now beds would be extremely limited and staff as well but from this we can see that this is not the case. The main issue for doctors is probably more of PPE.
Yes the response from the government seems pretty good. The Nightingale hospital had only 20 patients this week despite being built to house 4000 patients!
Dr Siva
The government response has been pretty good, I agree. The main problems are PPE and people flouting lockdown rules. The lockdown isn’t strict enough, in my opinion. I don’t think funding is an issue, it’s more the fact that there is a finite supply of PPE and ventilators. I heard that some pupils will be going back to school in June. Doesn’t this risk a second peak, as it is a good 200-300 people in the same building at least.
It could do but they are also saying that young children are not as affected so it will be safer for them. Also by opening schools it receives pressure on parents too if they have to work from Home, and it prevents them from relying on grandparents for childcare, if the parents are called to work, because the grandparents are a vulnerable group
Dr Siva
What do you think about the safeguarding implications of using video consultations? What if you need to examine a patient and need a chaperone?
Dr Siva
I think by having video consultations, the risk of breaches of patient information is greatly increased. External people may have the ability to connect to these calls and so information about a patient’s age, address and health could be exposed. In regards to examinations, I think it becomes increasingly difficult to undertake for a patient may not know exactly what the doctor is looking for in examination. However, there may be cases where in fact there is no need for a physical examination and from simple observation, the condition can become apparent. I believe in future the type of consultation given should be dependent on the presenting complaint. If there may be a need for a physical examination then a face to face consultation should be used. In other cases, a video consultation may prove to be just as good. In regards to chaperones, the issue is complicated and for me, there is no clear substitute to face to face consultations in this scenario.
Excellent answer – how would you suggest that healthcare professionals overcome the safeguarding concerns?
Dr Siva
I believe that in regards to the security of information, this is a matter that needs to be developed throughout the NHS. When I wrote my article on Big Data in medicine for the most recent MM Magazine, I found that actually the NHS was crippled by a cyberattack in 2018. So this is actually an issue that perhaps does not get the attention it deserves. In terms of what healthcare professionals could do, I would say that there should be a form of consent or a confirmation of consent given each consultation to say that they would be willing to have video consultations and they understand the risks. This is key as we have to ensure that patients are aware of the risks of this type of consultation, in the same way, that we have to ensure a patient with a broken arm understands the risks of surgery to correct the issue, which I had when I broke both bones in my forearm!