The treacherous telephone consultation

WHEN EXACTLY DID IT BECOME OK TO ASSESS AN OUT OF HOURS PATIENT BY TELEPHONE?

It used to be unacceptable except in exceptional circumstances. eg patients inhabiting the north pole.

It is now acceptable.

So it seems.

And when did it become “old hat” to examine patients?

Particularly patients in the acute setting?

When did the unacceptable become acceptable?

Why did the unacceptable become acceptable?

Diagnose septicaemia by telephone?

Come on!! Get a grip!!!

Sometimes the patient just says “I don’t feel well”

Imagine the patient is not an expert patient.

Imagine the patient does not say. “Hello, Health Care Practitioner, I have septicaemia and I need help. ”

How then will you diagnose septicaemia by telephone?

How?

Get the patient to do The Tumbler Test!

Self diagnosis.

Really?

Septicaemia seldom has a nice handy positive tumbler test.

Not all the nasty little microbes know about the handy tumbler test.

Do they?

Not one of these nasty little microbes here is a menigococcus.

Not one of these nasty little microbes is competent in obliging with a handy tumbler test rash.

So how do you diagnose septicaemia then?

Over the telephone.

The Crystal Ball?

The Book of Spells?

The protocol.

Ah, the protocol.

What protocol?

There must be one!

Where?

Huh?

Written on the back of your lottery ticket!!!

Ah. That’s where it is!

Winners and losers.

Gamblers all.

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