Book review - Using telephone consultations

A new book proves a good source of practical advice on phone consultations, writes Dr Lizzie Croton.

'The telephone is both a blessing and a curse to health professionals', states the author in his introduction.

GPs endeavour to distinguish the serious from the minor presenting conditions over the telephone, but at the same time must practise safely in their dealings with members of the public.

With the modern day focus on access to healthcare for patients, increasing numbers of practices are using the telephone with the aim of triaging calls and diverting patients to the most appropriate service.

This book is aimed at a broad range of healthcare staff; from doctors and nurses to receptionists and paramedics. The principles of telephone consulting in primary care are examined through reference to existing academic literature. We are taken on a trip down memory lane looking at the historical use of the telephone in the administrative and clinical domains of general practice.

Safe consulting
Dr Males has also taken care to provide a comprehensive review of how we communicate over the telephone and its obvious and not so obvious limitations.

Transcripts of actual telephone consultations are provided, involving different members of the healthcare team, and are critiqued with examples of effective and safe consulting and constructive suggestions for where consulting style could be improved.

The potential problems with language barriers and the use of colloquialism are also discussed. Two important areas of telephone consulting are also examined thoroughly: the limitations of the telephone as a consulting tool and the ethics of such consulting.

How do we decide when face-to-face consulting is more appropriate? How do we manage the issues of confidentiality when speaking to third parties about a patient? The latest GMC guidelines for the use of the telephone in consulting are discussed to provide practical advice to clinicians.

There is a helpful section on the differing telephone roles of team members such as doctors, nurses and receptionists. The section dealing with the GP's role is excellent and practical. The book deals comprehensively with daily problems such as how to triage cases and deal safely with medical problems over the phone.

A large chapter of the book is devoted to the individual management of common presenting conditions. It is a good stand-alone reference incorporating the information needed from the patient to make a safe decision and the follow up needed for each case. It is an appealing choice for all professions involved in telephone work.

Dr Croton is a salaried GP in Birmingham

Book giveaway
GP and the RCGP are giving away five copies of Telephone Consultations in Primary Care - A practical guide by Dr Tony Males, worth £24.95 each. For a chance to win a copy, email by 3 October 2008 or order a copy directly from the RCGP website (

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