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Rapport and gratitude: How telehealth won over this sceptical GP


Doug Hendrie


19/05/2020 4:30:12 PM

Telehealth means losing the strengths of a face-to-face consultation – or does it?

Dr Gillian Singleton
Dr Gillian Singleton wondered how seeing someone on a screen or over the phone could replace the nuances of face-to-face communication.

Before the pandemic, Dr Gillian Singleton was a telehealth sceptic.
 
How, she wondered, could seeing someone on a screen or over the phone replace the nuances of face-to-face communication?
 
The Melbourne GP and co-host of RACGP podcast Generally Speaking treats many refugee and asylum seeker patients, many of whom require an interpreter.
 
Dr Singleton has to be attuned to body language and emotional responses to help assess whether information is being translated in the best way.
 
But after she moved to telehealth to stay safe during the COVID-19 pandemic, Dr Singleton has become a ‘complete convert’. 
 
For the first time, she could see her patients in their own context and catch a glimpse of their lives.
 
‘The disadvantages are spoken about a lot in medical media, such as not being able to examine people, but I’ve found it beneficial. You’re able to speak to people in their homes and see how they live,’ she told newsGP.
 
Rapport can be formed more quickly, Dr Singleton has found, since people are usually more comfortable in their home environment. Cutting out travel and waiting time also puts people in a better frame of mind.
 
‘There are lots of obstacles to seeing us in person, and telehealth removes that,’ Dr Singleton said. ‘Over telehealth, people are more relaxed and comfortable.
 
‘A lot of people we see are already socially isolated, so taking time to call them and talking through their problems leaves them really grateful. That’s the biggest upside for me.’
 
The ease of telehealth appointments has meant Dr Singleton is now able to speak to patients more frequently – and not try to cram everything into one consultation because people have travelled far and waited for her to see them.  
 
‘It really helps from a time-management point of view. It’s less stressful,’ she said.
 
‘People haven’t been sitting in the waiting room, so I don’t feel the need to spend extra time if it’s not needed. It’s much easier to end when it needs to happen, and it’s much easier to have another consult.’
 
These days, if something non-life threatening comes up at the end of the consultation that might take some time to unpack, Dr Singleton asks her patients to book another consultation in a few days’ time.
 
It has also helped people who find it hard to take time off work to see their GP, she said.



Telehealth has even helped find unexpected solutions. 
 
Dr Singleton recently had a mother ask her why her four-year-old son kept getting parasitic worms, even after he had been treated. In the background of the video call, Dr Singleton could see many other young children.
 
It turned out the boy’s mother lived with several other families, whose children had been untreated.
 
Not everything is easier, however, with the inability to examine patients a constant bugbear.
 
Extra caution is also required when treating patients who live with a violent partner.
 
‘We have a number of patients who are victims of family violence,’ Dr Singleton said. ‘We make sure they are in a place where they can talk, whether they feel comfortable, or that their partner has left the house. It’s an important consideration.’
 
With millions of telehealth and telephone consultations now taking place weekly, Dr Singleton believes the new model will have a place in the future.
 
‘I hope we keep it,’ she said.

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