I gently refuse to give opinion if someone asks my ‘quick feedback’ based on just a single report or a single symptom. And give them the option of a detailed assessment.
If they’re family or a close friend, I try getting the whole picture over phone call, and for this they have to wait till I’m free.
For anyone else, they have to call the appointment number and follow the process. If they feel my advice would be valuable enough to justify the fee and the wait, they follow the process. If they don’t, they stop asking me random questions, and keep looking for some other willing soul.
After the consultation, it’s easy if my Assessment agrees with that of the other doctor. But if there’s conflict, there’s no easy way out of it..
I often ask my patients to record their measurements at home in a diary, and bring them to the next appointment. I find that this improves the self-efficacy of the patients and their family members in taking care of their illnesses, and helps us doctors take better care of them! At the same time it’s an ideal, and reality loves to wash away our best laid plans..
Some patients do check their parameters, some don’t. Some of those patients who do go to the trouble of measuring them regularly, may not record them! And those who diligently record them may forget to bring those readings when they come for a follow-up consultation! And some of those who keep meticulous records, stop after a few months.
I often tell my patients, “Your proper treatment will only start when you start maintaining a record, till then we’re just playing with your illness!” And truly, the home record is vital in adequately managing Hypertension and Diabetes Mellitus, and I’ve found it useful in other illnesses too, like Typhoid fever, and Food allergies.
I keep wondering how to inspire patients and family members to keep better records. I think I got some answers last year..
As doctors we often get cornered by people we know, in various social settings, asking for our “quick advice” on this rash, or that pain, or in recent times, the abnormal lab report that has been bothering them. 🥴
Without digging deeper, it’s not possible to determine whether they have already discussed this issue with another doctor (and only seeking a “harmless” quick second opinion from someone they trust). Or this is the first time they’ve ever disclosed this to any doctor! 👩🏻⚕️
We don’t want to answer these queries with limited information, as that would be a big disservice to the patient. Most conditions need a painstaking gathering of history, a scrupulous examination, and often some quick referencing of guidelines or other resources. Quick answers are usually wrong in medicine! 🙊
A Registered Medical Practitioner is entitled to provide telemedicine consultation to patients from any part of India
The RMPs should exercise their professional judgment to decide whether a telemedicine consultation is appropriate in a given situation or an in-person consultation is needed in the interest of the patient.
The RMP shall uphold the same standard of care as in an in-person consultation but within the intrinsic limits of telemedicine.
Here’s Some Unsolicited Advice from a Docpreneur..
1. For a fresh MBBS graduate, the best option is to become a Family Physician and start your own clinic. The pendulum is swinging from specialists and corporate hospitals to primary care and small clinics. A lot of doctors started their practices right after MBBS, and are doing phenomenally great!