GP Stories - E-Consult Worm

Since the pandemic, GP's have been under fire in the media for supposedly not seeing our patient's face to face, not understanding that most of the changes have come under direction of the higher authorities who requested we try other methods of primary care consulting given the covid pandemic. I can't speak for other practices, but in my area, face to face consultations were still going on if there was a clinical need following a telephone triage or online e-consult. E-consult is an online triage tool that many practices have used to increase access to primary care, there are many but e-consult is the one I am most familiar with. Patient's who complain may have likely forgotten pre-pandemic waiting times for a GP face to face appointment, which could sometimes be up to 3-4 weeks. In this current system, people can get a phone appointment on the day and have their issue resolved, or get a face to face consult within a few days of that if needed. The main difficulties have arisen for those who cannot use phones well (hard of hearing, language barriers) and those who cannot use some of the online consulting tools. 

Unfortunately we have been suffering from the success of the e-Consults. GP surgeries have been inundated with loads of e-Consults every day due to the ease of access to them. Patients have worked out that rather than go through the receptionist to contact the doctor, they can go online and contact them direct. E-Consults in theory would work well, but unfiltered (free) access to a doctor was bound to have dire consequences. Surgeries have been swamped with them, with some e-Consults having multiple problems on one form. Patients have been known to lie on the form just to avoid being kicked out of the online system. Surgeries can come in on a Monday with hundreds of online consults submitted over the weekend to go through. However one useful aspect of e-Consults have been the ability to send in photos, useful for rashes and other skin lesions. A great one I received the other day had great photo. 

"I have a new puppy for the last 2 weeks. I have noticed worms in his poo. Do I need to take any medicine for myself?" 

Included in this e consult was a lovely close-up of a worm with it's head poking out of dog faeces. I'm glad that our area is going to be turning off e-consults soon...