I LEARNED on the radio that our general practitioners are moving towards consultations via the internet. It is a far cry from the days of Doctors Cameron and Findlay, whom you may remember were local general practitioners with local knowledge of the families they looked after.

I remember too that we were sometimes told as medical students that a diagnosis can be made as the patient walks into the consultation room. There is no doubt that some consultations can be managed online, with figures of 60% and 75% being quoted as possible in one radio programme.

Much time and money can be saved in dealing with appropriate cases. We are used to triage in A&E departments. At least there, we can feel safe with the professional and friendly face of the triage nurse. Over the years, much has been delegated to nurses and pharmacists to lighten the load on our GPs. We are used to that now.

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Before I go any further, let me say that it is not only the patient whose views are important here. The doctors themselves will need to be comfortable and confident if they are to continue to obtain satisfaction in their work. Also, I have heard no mention of consultations on behalf of infants and young children. Another question, perhaps the proverbial elephant in the room, is the role of responsibility in these days of litigation and defensive medicine.

We are fortunate at this address to have very attentive doctors who have got to know us. Living in the county with an inadequate bus service and a long walk to the bus stop, we are blessed even with home visits when necessary. Nonetheless, for most people it is an anxious time when suddenly taken ill and trying to make the initial contact with their doctor. Trying to do this online may be a call too far.

One patient I heard on a radio phone-in took a photograph of the lump on his head and was prescribed the appropriate treatment. A happy ending. Another happy ending concerned the man who went to his doctor with a cough. The doctor, on “listening” to his chest as they do, spotted a malignant melanoma on his back. Early treatment presumably saved his life.

My own anecdote, as an ear, nose and throat doctor with perhaps no more consultation time per patient than a GP, concerned a middle-aged lady whose presenting symptoms I now do not remember but there must have been something that did not quite fit with her story. I therefore saw her again at the end of my clinic when I would have been able to take more time.

She was then able to confide in me that, since her husband had died some months before, she had been unable to talk to anyone about how she felt and had not wept even once. She then burst into uncontrollable tears. That was the treatment and she was either cured or at least was able to continue with a more normal process of bereavement. She was lucky, I think, and I was lucky to have had the opportunity to help.

All our anecdotes will help the consultation and debate and will not halt progress, but let us not go too fast. “Festina lente”, as we learned at school. Remember that we are fast approaching the day when our National Health Service will be owned and managed by the United States of America. Then we can be sure of more money for our general practices, all of us with access to the internet to tell our symptoms to our trusted doctor or possibly even to artificially intelligent robots who will take photographs to a high professional standard.

All this will enable our doctor – if s/he is still there – to provide, with confidence and job satisfaction, a meaningful consultation and treatment, with a life saved or quality improved. Perhaps it is too much to expect that our bus services will be improved for us to reach the doctor’s surgery on the rare occasion that can be arranged.

Robert Mac Lachlan