Article in The Times today about a study of 1,000 rheumatology patients and clinicians inc. gps and how remote appointments affected them. I think it’s behind a paywall but found that “86% of patients and 93% of clinicians thought remote consultations were worse than face-to-face for accuracy of assessment and some reported misdiagnoses.” Also “90% of clinicians and 69% of patients felt it was harder to build a trusting relationship online or over the phone.” This was despite the fact that “60% said that telemedicine was more convenient “.
“Web or phone medical appointments ‘disastrous’ for s... - NRAS
“Web or phone medical appointments ‘disastrous’ for some patients”
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Bookworm55
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30 Replies
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No surprise there!
Telephone appointments with my consultant made it even easier for him to not listen to me and look only at blood test results. They may be fine for people in near remission, low disease activity and stable regimes but not for those flaring and suffering as meds stop working or developing new symptoms.
The rheumy is watching you from the moment you go in and sit down and get up etc., so fully understand how patients who aren’t stable on their meds need a ftf. My rheumy says I’ve to not to come in unless there is a real problem joint needing to be seen. I prefer telephone consult at the mo due to my own personal situation but ... you can’t feel the heat from a joint or swelling over the phone, so there are many RD patients who do need to be seen. x
So right J, they are. This is my concern with telephone consultations, especially as my bloods often don't reflect physical disease activity. How could they accurately amend my meds, as was needed in September? Following that appointment they weren't able to give my next appointment date but it came in the post yesterday stating in caps that I’d to attend the clinic, that this would not be a telephone appointment. I was slightly surprised but pleased given how the appointment had gone. Unfortunately it's with the same locum Rheumy, but he may have moved on by next September. I can only hope!
I hope you get another rheumy by that time! 🙏🏻💗 Agree totally you need to be seen when your bloods aren’t reflecting the state of your RA. x
Thanks. He was one of those who asked a question & fired another at you before you had chance to reply. So annoying. As a result the report to my GP was littered with inaccuracies. One of the worst is I have RD in joints I don't. I've also refused an op on my shoulder apparently. Grrr. x
Oh not one of those. Frustrating and stressful. 😑🤨 Have had very similar recently and some very important things the consultant got wrong and told my rheumy of (although I am sure she will have thought that’s not right!) and I thought in reading .. who said that as I didn’t?!
Can you drop a note in to your GP or post it and say some things were misinterpreted and state the things you disagree with and why? If it’s got a really important bearing on matters the GP needs to know. They need to know you’re not refusing ops! They often make patients sound like stroppy and difficult people! I have often written to update some consultants (had to recently) from my side and told them in a very polite way. Not my rheumy as she’s on the ball but she likes me to update her in a little report style of what’s going on in other areas of consultation as it’s useful to read before the phone call she says.
Had to do so to her re an immunologist misinterpreting many things and he threw quite a few spanners in the works. Then another one was so rude on the phone a couple of weeks ago as he abandoned our call to take another one from an estate agent and started moaning about his house not being sold and the cleaner being not up to scratch! 😳 I was not impressed he left me for ages waiting and then he said he was so busy he couldn’t answer a couple of things I asked. He had a poor phone manner and people skills it had to be said, but I appreciated the phone call. Just wish it had been with the previous guy who was nice ... but confused! It’s hard when you don’t know someone and you feel they are elsewhere ... like thinking of a dodgy cleaner and a house that won’t sell! 😑 xx
I will have to see a GP re tapering plan/doses when so will give him/her the list then. It doesn't help that I don't even know who is my allocated GP. Also not helpful is that I’ve not seen the same person twice since my Rheumy left over 2 years ago & no idea who I'm under. Nor have I seen a fully qualified one until this latest locum. Yes, It's frustrating & stressful, neither needed!
I’m so sorry you've encountered the same issues. Not wanted, not needed. The immunologist… well, swear words cover what I would like to say but for goodness sake! Home life doesn’t take priority over work life in work hours, unless a real emergency. He should have damn well asked him to call back, or return his call after your consultation rather than keeping you hanging on. Then to say he was too busy to answer a couple of questions. Wow! Just as well when you did have his attention is was helpful, I take it it was as you appreciated his call? x
Big grrr 😖
Exactly my rheumy nurse says my blood inflammation results are irrelevant as tcz masks the inflammation, they want to see joints and movement
I didn't know that, thanks E. Every day's a school day.
I didnt either all this time, she told me on my DAS meeting last week . I said I expect you think I'm OK as doc says my bloods are OK. She said , no the opposite , explained, got a very high DAS score
Glad your Rheumy's so on the ball & knowledgable. The one I had last looked at me as if I was stupid when I said my inflammation markers don't generally relate to reality.
Yes, exactly why people need their joints examining. I’m fine not to go at the moment but I’m sure down the line I’ll need to and will in time. x
Thankyou for highlighting this.I found this short publication from Cambridge University, who conducted the research.
It is behind a paywall but this is from Cambridge University, from which The Times have reported cam.ac.uk/research/news/per...
Snap !
Ooops, didn’t see you'd already provided it Marie.
I think we posted at the same time 😁
Ah, yes, there is only a minute between us. I did think only Lola had replied but as I typed under Bookworms I thought I’d missed yours. 🤔
Thank you! My old rheummy could tell how I was doing watching me walk up the corridor! Difficult to judge that sitting on my settee!
Exactly!
I think the way I see it my GP I am ok with telephone calls UNLESS I feel worried and I hope if I said something he felt was important he would see me. My call last night with my GP was a frank discussion and he felt based on my conditions that I was reporting and 2 photos and the fact I had RA and Fibro he was happy to diagnose me with Reynauds.
With regards to my consultant if I was steady and feeling ok I would be happy with a phone call. I have one this month re Barcitnib and my other issues that just keep being thrown at me so though my bloods are showing small levels of infalmmation there seems a lot more going on. I again feel that if I said or he felt I was needed to be seen I would get a face to face.
However I also feel the postcode lottery of care comes into play and right now I feel both teams have done me well in the past 18months but I know many are lacking the contact I have thro phone and email.
Having this problem as they say they will phone but don't. You wait all day for nothing. Then you phone them, get put to an answering machine which us never picked up........
Yes I’m chasing the rheum dept at the hospital atm - have to leave a message on the answerphone and they try to get back within 48 hours. Last (telephone) appointment was beg of January this year and was supposed to be reviewed in 9 months from then. Realised the other week that they hadn’t sent me an appointment. Luckily I’m fine atm but they don’t know that!
Indeed! Mine is a cancelled knee replacement last week with no future date, so trying to ask do I take the RA drugs but then if I get a date can't have the op for a month!! Grrr
Hurrah just got my operation new date 19 November!
Interesting too that more clinicians thought face to face important than patients.
Yes I think some people may prefer to have a telephone conversation with their consultant if they are at work and don't want to take time off. Others who are very stable or in low disease activity on their meds may find it a nuisance to have to travel for a F2F appointment and feel a remote one is adequate. I've never been in that fortunate position!!
I’ve still had most of my appointments face to face, and the telephone consultations I have had, were as good as they could be considering they couldn’t see me - if needed I was brought in. I know I am incredibly lucky to have a very attentive team. I’ve never not felt listened to f2f or virtually. It’s a shame that the service is not consistent nationally - I know my mum has a completely different experience 
A similar report was in yesterday's Daily Mail (no allegiance to any newspapers, it was a freebie from Waitrose!) based on a Cambridge University study.
Here’s a copy of the full paper (PDF format).
Open access so no infringement issues.
watermark.silverchair.com/k...
👍x
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