Anyone who signs a certificate saying they have examined a patient who
has not carried out even the most cursory physical examination eg
looking at them) may have difficulty convincing a fitness to practise
panel (or the social security authorities) that they have made a true
statement. If you are going to issue med 3s on the basis of a telephone
consultation (and I suggest you do not) you should delete the statement
that says you have examined them and substitute "I have had a telephone
consultation".
It is not just the patient who will be be in trouble. You as a
practitioner will be accused that they a) should have known better and
b) are suspiciously dim c) possibly dishonest. The GMC is very hot on
dishonesty and an elegant defence that examination could include a
telephone inquisition may well make the situation worse. I strongly
advise anyone not to sign an unamended Med 3 unless they have physically
been in the presence of the patient.
Fay
Margaret wrote:
>> Are we able to issue a Med3 on the basis of a telephone consultation
>> by us - again something that I do.
>
> This is something I do as well Paul - a consultation is a
> consultation, surely, whether it's face to face or on the phone??
> If telephone consultations can't be used for this sort of thing what
> use are they?
>
> On the med3 form you state that you've examined the patient, but
> there's no detail about what that examination involved.
> You can examine someone with questions without laying a hand on them.
> For example, if someone has a very good story for a bad case of
> gastroenteritis which they've self-certified for for a week and they
> say they've still got diarrhoea and they work, say, as a chef, I'd
> take their word for it - I wouldn't necessarily "examine" them - I
> might send off a stool sample.
>
> And, would it be reasonable to do a med3 rather than a med5 if I "see"
> the patient in reception when they come to request a follow on sick
> note? - that's less of a consultation than a phone consultation, but
> I've officially "seen" the patient on the day of signing and
> "examined" them, well sort of, anyway in a cursory sort of way, from a
> distance. But then, how much do we "examine" patients each time they
> come in to get a sicknote, anyway. It varies from case to case.
>
> Margaret
>
>
>
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