I'm sorry Fay, but I find it absolutely crazy that I can do a medical
consultation by phone, YET I have to actually physically see someone
to issue a stupid certficate. Surely things should move on? Is my role
to treat the those that are ill or dish out a sick note? Can we all
say with hand on heart that when we PHYSICALLY see our patients we are
any happier dishing out a certificate? In a time when we are improving
our telephone skills to cope with workload it seems that we have to
see patients to satisfy an archaic certification system. ? Time to
retire before I fall foul of the GMC as I have been issuing notes for
some time by phone following a phone consultation. I am sorry, but
seeing thes patients in the flesh would add nothing to the outcome of
what I think on the phone!

I suspect that I will not change, and feel sure that my partners work
in a similar fashion - as probably do many others out there in the
real world.

-- 
Best Wishes

Paul Bromley

www.floridaholidayvilla.biz
Superb Villa in Orlando with own pool - Free Internet & International
Phonecalls.

On 08/02/07, Fay Wilson <[log in to unmask]> wrote:
> 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
> >
> >
> >
>