Telephone consultations are routinely used

Editor—Car and Sheikh investigated telephone consultations in health care.¹ We believe that patients in primary care are now routinely accessing care this way, with growing evidence to support this practice.²

Although the authors partly focused on the impact of telephone consultations on the use of healthcare resources, they did not cite work from primary care during office hours. Our unit has found that telephone triage for “same day” appointments in British practice can reduce demand for face to face appointments by up to 39%.³ This represents a substantial reduction in workload while also improving access for patients and retaining satisfaction with the service.

In discussing the potential for using the telephone in practice, Car and Sheikh do not mention the value of the telephone in triaging requests for appointments. Our data indicate that many patients requesting appointments in practice may be more appropriately managed by offering a service that does not require face to face consultation. Disappointingly, they did not address aspects of telephone consultations that are of immediate value to the provision of primary care services.

In looking ahead Car and Sheikh do not address remaining research questions about telephone consultations, including whether there are groups of patients who are less “enabled” by telephone consultations—for example, older patients, patients with hearing difficulties, and patients who approach the telephone consultation in anticipation of a home visit.⁴,⁵