Doctors: Diagnosis By Phone

[Ondine]

I've been with Melbourne Grove about 12 years and like others was suspicious of the change, but I have to say I've been impressed so far.

I got a home visit recently when one of my kids had what turned out to be v bad tonsilitis - because I'd followed the triage model and taken advice from NHS Direct and pharmacist, I got rapid call back from GP who was happy to visit. I was proactively phoned to book an appointment for a smear, and the receptionist was incredibly helpful about working around my diary (not how I remembered them being!). And most recently, during one of the winter vomiting type episodes, I had a telephone consultation with a nurse clinician - it was similar to NHS Direct except she had my daughter's notes and didn't have to work through a script. She gave very good advice, and guaranteed a GP appointment if I continued to have concerns.

Disappointing that it has required such a drastic step to improve the service, but setting aside politics, I really can't complain - my family's service has improved.

[Sonners]

I had my first experience today - rang at 10am and was told that I would be called back for a clinical diagnosis between 3 and 4pm. I didn't mind that too much but then no call came so I called again at 4.45pm and was told that they would call me shortly... Finally got a call at 6.55pm, by which time I was googleing other doctors' surgeries in the area. To be fair that lady was helpful and offered me an appointment on Wednesday, which isn't great but my issues aren't life threatening so I don't mind.

Will wait and see how the service is once I am there!

[Boris Karloff]

Yes - your notes follow you, which allows continuity of care. This process can take several weeks, but does happen.

Nunhead Grove and the Gardens are good GPs

[cate]

I too am with Melbourne Grove. Have had a nurse call me back to discuss symptoms and then make appointment. To be fair the call came when they said, within a couple of hours. They are also open very late some evenings for people who work, up until 9 or 10 pm. Have had an 840 pm appt. before. Have also been able to email one very kind female doctor who works where when laid up with hideous hallucinating flu at beginning of year. As long as they have enough people to call you back in a couple of hours it should theoretically work......

[Cassius]

I rang this morning to find out the results of my x-ray to be told that the doctor would ring me between 10.30 and 11.30 - my mobile is not working which meant I was more or less tied to my desk. At 12.00 I called the surgery again to be told that the doctor was at the moment trying to ring me (not confirmed by the receptionist at work). It is now 12.45 and I haven't heard from my doctor and I have had to keep my legs firmly crossed whilst I have waited over 2 hours for a telephone call. It is very hard to know what to do in these circumstances.........

[Nero]

Wait for the call, thank the doctor, and then ask why s/he did not ring you at the correct time. The idea that we can't treat doctors like any other person is ludicrous. They are not gods and deserve no more or less respect than anyone who is doing you a service (unless they physically save your life).

[ratty]

My wife phoned this morning at 8:30am. Was phoned back by a doctor within 20 mins, had an appointment at 11 and is now feeling very much better at home having at last been listened to about her complaint, being given the correct medication and been referred to the Hospital for follow up!

Excellent service today from Melbourne Grove and I cannot thank them enough!

[Cassius]

Lucky you ratty - I called them again to be told that the doctor HAD rung me and couldn't get through. I have given up now.

[ratty]

Seems hit and miss at the best of times then. Twas easy for my missus this morning cos she was at home, so she coul dsit by (lie on) the phone and wait for the call. Sorry you is having a tricky time with it!

[first mate]

I have been with Melbourne Grove for many years and it went through a dodgy period under the previous Doc in charge, then the new bunch came in and everything got very much better only to slip again when Concordia came into the equation.

To make matters worse I have heard rumours that the best Doctor there, that is the one who makes time for her patients and has bedside manner in spades, is leaving (forced out because one of team had to leave, presumably cost cutting again) .

I get the impression that efforts to "modernise" and save money are getting in the way. Having to input notes etc into the computer takes ages. What was wrong with the old paper method? Faster, cheaper, and of course, much more confidential since only the immediate surgery staff had access to the notes. Now presumbaly any old Tom, Dick and Harry around Southwark and loosely tied to Health Care, can get into the notes not to mention various government agencies and so on. Just feels like another example of technology creating more problems than it solves.

[Cassius]

I had a late night appointment there a couple of weeks ago and had to wait an hour - now I fully appreciate that when you are at the end of the day you may well have to wait - however, the computer system went down at 9.30 so all the patient notes for appointments after that time had to be printed out. This is not Melbourne Grove's fault but seems to me to be a bit of a problem (albeit that the last appointment was meant to be at 8.50). This wouldn't have happened with paper notes.

[jollybaby]

Cassius - I sympathise with your plight - it sounds like you've had a pretty shoddy service from your practice and deserve an apology for your inconvenience.

But Nero to say that doctors should be treated like other service professionals 'unless saving lives' is a little off the mark. Firstly a lot of the work does involve 'saving lives' whether directly by jumping on someones chest or indirectly by responding to a grossly abnormal blood result . You have to prioritise and sometimes the less urgent jobs do get pushed to the bottom of the list. Also a detailed explanation is not always possible in this business. I've had many a time when a patient has complained about being kept waiting and I've wished I could have turned around to them and said 'well actually it's because I've just had to tell the 25 year old patient before you that her breast cancer has spread to her brain ok- now let's get back to your haemorrhoids'.

Don't get me wrong I am by no means a fan of the 'diagnosis by phone system', I hate crap service and disorganisation, poor communication but in medicine it's not always the doctor's fault - sometimes these pesky patients can be a little unpredictable.

[cate]

first mate Wrote:

-------------------------------------------------------

> I have been with Melbourne Grove for many years

> and it went through a dodgy period under the

> previous Doc in charge, then the new bunch came in

> and everything got very much better only to slip

> again when Concordia came into the equation.

>

> To make matters worse I have heard rumours that

> the best Doctor there, that is the one who makes

> time for her patients and has bedside manner in

Are you talking about Dr. Brew-Graves? I hope not!

> spades, is leaving (forced out because one of team

> had to leave, presumably cost cutting again) .

>

> I get the impression that efforts to "modernise"

> and save money are getting in the way. Having to

> input notes etc into the computer takes ages. What

> was wrong with the old paper method? Faster,

> cheaper, and of course, much more confidential

> since only the immediate surgery staff had access

> to the notes. Now presumbaly any old Tom, Dick and

> Harry around Southwark and loosely tied to Health

> Care, can get into the notes not to mention

> various government agencies and so on. Just feels

> like another example of technology creating more

> problems than it solves.

[first mate]

Cate,

Yes, I've heard it's Dr Brew-Graves and the rumour is that the team there had to be pruned and she is the one to go. Perhaps she's glad to get out of there but what a terrible loss to the surgery. As I said, the best Doctor by far and many, many people would second that I'm sure.

The real motivation for diagnosis by phone becomes clear. Money, money , money ......for Concordia's poches! Not patient care (would love to see a list of the shareholders).

[ratty]

Emeline is a legend - will be distraught to see her go! :(

[cate]

I certainly hope it is just a rumour and not true. I understood that the surgery is owned by Dr. Simon Fradd, who also owns another one in the Midlands. So where does Concordia fit it. Forgive me for sounding ignorant.

[Ladygooner]

Love Dr Brew-Graves - may have to change surgeries if its true

[first mate]

Cate,

As I understand it, Concordia Health is a private company that has taken over Melbourne Grove. I believe that Fradd is the Chairman, so guess he is on the board of the company? Sorry, don't have more detail, others here may be able to fill in the blanks.

I too desperately hope the news about Dr. Brew-Graves is nothing more than a rumour, but my sources are pretty certain it is true. Perhaps we could find out where she is going and defect en masse? Or if someone from Concordia reads these posts and sees how much we the clients value her, they may reconsider and make it worth her while to stay on!

[Zebedee Tring]

I, too, would be very concerned if Dr Brewe-Graves were to leave. She was incredibly kind and supportive in relation to a recent tragedy that our family suffered and she spotted something that a rather poor locum missed.

The rest of the doctors and nurses at the practice have been very professional and attentive, a massive improvement from the old regime a few years under the somewhat mercurial senior partner who managed to alienate most of the rest of the staff.

At the time of the Concordia Health takeover, I offered my support to the doctors if they want to resist the proposals. However, I now fear that the possible departure of Dr Brewe-Graves and the new telephone diagnosis system are the thin edge of the wedge and that the practice's big improvement has now gone into reverse.

[Cassius]

Zeberdee - I think perhaps you are being a bit unfair about the 'somewhat mercurial senior partner'. She was a very competent doctor and was exceedingly good to me at a difficult point in my life. I guess she was a bit 'old school' and had no patience with those she considered 'swinging the lead', however if she thought you were genuinely ill she would move whatever needed moving to help. However I do agree that her attitudes to other staff was less than professional at times!!

[Zebedee Tring]

Cassius, I'm afraid that the problem with the 'somewhat mercurial senior partner' was that when one saw her sometimes, she displayed the finest bedside manner; however, on another occasion, she was difficult, to the point of being objectionable. There seemed to be no reason for that, other than that her treatment of patients seemed to correspond with her mood and not whether or not one was 'swinging the lead'. When you're ill, the last thing that you want is to be faced with a moody medic.

However, this is ancient history, and my concerns are now directed towards the future of the NHS, in particular the practical consequences of the flogging of the NHS to the likes of Concordia Health. When people say, 'Just imagine we could be faced with a Tory Government very soon', I am inclined to say 'But how would you classify the present Government, which is encouraging the privatisation of the NHS? That seems very much a Tory policy to me'.

[Zebedee Tring]

Today I have had some experience of the wonderful phone diagnosis system at Melbourne Grove.

I've been at home ill today after feeling rough most of the weekend. At about 10 today, I arranged with the practice for a named doctor to ring me at home between about 1.30 and 2.30. As I heard nothing from this doctor, I rang the practice a number of times between 4 and 4.45, only to receive a consistently engaged signal. I finally got through at about 5.10, only to be put in a queue. I was told that I was fifth in the queue - ten minutes later I was still fifth in the queue. I then put the phone down in frustration.

In principle, the idea of phone diagnosis is ridiculous, since it is well nigh impossible for a doctor to diagnose the bug or virus or whatever I've got, or indeed most illnesses, without a physical examination.

Things have certainly deteriorated since Concordia took over the practice. Like so many private companies involved in the so-called public sector, they clearly have found ways to make a profit and these have not been to the benefit of patients. There are numerous other examples, such as the company that now owns Thames Water, Virgin Rail etc etc.

[cate]

I have been trying to ring the surgery today and it is constantly busy! Not even put in a queue. Heavens!

[first mate]

I recall a receptionist at Melbourne Grove saying that the diagnosis by phone etc.. was part of a pilot. Now I wonder if we could find out who is monitoring the pilot and perhaps urge them to read this or forward them the link?!

[cate]

Good idea First Mate, to find out if it is a pilot. It is so hard to know who to speak to there. I have questioned other things there and have never received replies. One problem I have had is trying to book an appointment with the osteopath. They are supposed to release appointments for him 4 weeks in advance but it never works like that. You can't even put yourself on a waiting list. I have registered several queries about this at reception but no one ever gets in contact with me. Think I wwill have a mosey down there tomorrow.