Remote consulting

Remote care is a feature of contemporary general practice but brings additional challenges for GP registrars. Communication and rapport are more challenging in telephone calls. They can be enhanced through strategies such as the use of open questions, active listening, summarising and clarifying next steps. Remote clinical assessment can be complemented by using video, texted photos or home instruments such as thermometers, blood pressure machines and pulse oximeters. Decision making can be affected causing over or under investigation, referral or prescribing. If a condition is failing to resolve or to progress as expected following an initial remote consultation, subsequent encounters should be in person. Effective remote consulting needs to be supported by adequate infrastructure and practice processes. Solutions are required for patients whose needs mean that remote consulting is less appropriate. Quality of care may be compromised, particularly in long-term conditions.