Telephone vs. face to face

Telephone Face-to-face
  • History only
  • No previous relationship
  • Knowledge of past medical history
  • Not necessarily talking to patient
  • More difficult to establish rapport
  • Easier to put people off
  • Easier to push dr's agenda
  • Difficulties of being recorded (this changes the very nature of the consultation)
  • More difficult to assimilate information
  • Difficulty interpreting symptoms & signs
  • Deal with a greater workload
  • Easier when patients only want reassurance
  • May speed decision making in acute situations
  • Patient expectation - people expect visits
  • Misunderstandings may occur
  • What if no phone?
  • Difficulties less if own dr.
  • Face to face
  • Opportunity to examine
  • Body language / physical pointers
  • Easier to communicate wheh have all other aspects (visual contact etc.)
  • Harder to avoid the problem
  • Easier to establish rapport & empathy
  • Can observe other aspects (social / family)
  • ? Encourages dependence on face to face contacts whereas advice may encourage self-reliance

Telephone triage- flu - an example

Improving triage techniques

Using telephones in primary care Peter D Toon BMJ 2002;324 1230-1231