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Helen Salisbury: Teleconsultations for all

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3211 (Published 18 August 2020) Cite this as: BMJ 2020;370:m3211

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Re: Helen Salisbury: Teleconsultations for all

Dear Editor,

The pendulum has swung too far: pre-Covid there was perhaps too great an emphasis on the face-to-face consultation, but Matt Hancock's assertion, as quoted, fundamentally misunderstands the primary care presentation. Helen Salisbury states that it misses 'vital questions about quality, choice and relationships'. I would go further, and suggest that patient safety, the acquisition and maintenance of clinical examination skills, as well as professional satisfaction are all compromised.

The mutually trusting pre-existing (patient-doctor) relationship is vital to the success of remote consulting: this can uniquely be established by personal continuity of care, now only available if it is deliberately and carefully built into appointment systems taking into account sessional working. A succession of random clinical 'snapshots' incurs greater clinical risk and reduced professional satisfaction relative to 'clips of cine films'.

Stressed GPs counterbalance their pressure with job satisfaction: reduce the latter and more will depart their profession: perhaps it is fortuitous that Medical Schools will increase their intakes this autumn.

Competing interests: No competing interests

24 August 2020
Vernon H Needham
Retired GP
None
Andover