He ‘Struggles with It'
I went to see my GP today for a routine matter. While in the waiting room, I saw that his practice utilizes a company that provides tele-physio. This is a practice where a physio calls a patient, has a discussion about the presentation and then gives advice and mails out a home program. That's it. One of my colleagues has a friend (former classmate) who for an entry-level job is doing this kind of work. She never actually sees patients, just follows an algorithm on what advice or exercises to provide. I think I would slit my throat if I had to do that job.
I asked my GP if he was satisfied with the service provided. He thought for a moment and said, "Well, I have two answers for you. Personally, I like the company and the treatment I've received. Of course I have private insurance and get actual treatment from a very good physio. I... I struggle with the idea of telephone triage of patients though." I do love the British ability to phrase everything so tactfully. Amazingly in nearly three years here, I still bray like a New York taxi driver. I really should try to pick up on the tact thing.
He went on, "I don't know how 10 minutes on the phone with a patient, particularly one who may be less eloquent, (again, beautiful tact) can give a meaningful intervention. I know that this is supposed to reduce waiting times and improve access to physio, but I'm not really clear on how good the outcomes are."
I'll tell you what the outcomes are... lousy! We see many people in our clinic who have had this type of intervention and wound up confused, unsatisfied, and some who have even hurt themselves. The NHS has worked hard to erase the criticisms it was known for in the 1980s such as ridiculous waiting times for treatment. However, this is not the appropriate answer. Improve access? Really? If anything, it seems to me to restrict access. This cost-cutting measure will wind up costing more in the long term as treatments are delayed, patients are misinformed and conditions requiring the skills of a hands-on intervention wait for longer than necessary.