How Important Is Email/SMS With Your GP?

AusGP on 30/07/2018 - 23:22

After the success of the last AMA I did (and having now had an adequate rest from the deluge of questions!) I'm keen to reach out again and get genuine opinions re: all things GP related. (Recent change to username so if you've been paying attentuon you'll know who I am!)

To start, wanted thoughts on electronic communications:

  • How important is email communication with your GP? Would it bother you if it's only one way from your GP (No Reply / Do not reply email addresses). Ditto for SMS's

  • Would you pay for email communications? (E.g. monthly subscription vs per email request) - I.e. not replacing but supplementing normal consults

Just to highlight some limitations (and would like your thoughts):

  1. Emails not to be used for urgent matters
  2. Emails may get missed / junked
  3. Doctor may be on leave and no-one sees an important email
  4. Emails are only suitable for administrative, routine referrals/ scripts. Medical management in select cases when overseas.
  5. Someone may see the start of your email or SMS notification on your phone.

TL;DR
How important is it to you for your GP to move into the digital age with you?

Health & Beauty

Comments

  • spackbace on 30/07/2018 - 23:28
    +12

    How late will the average doctor be if they're replying to everyone's emails?

    It's not like they run on time with their current workload… Even if you're the first appt 😂

    • AusGP on 31/07/2018 - 19:21
      +1

      Emails would have to be answered on a non-urgent basis and in reality we currently already get interruptions but mainly via phone. We also get lots of people enquiring about things via reception (I need my certificate changed etc.)

      Email is just another form of communication but probably more efficient in that it doesn't necessarily always have to go via reception or admin.

  • trustnoone on 30/07/2018 - 23:54
    +2

    I kind of wish you could just get scripts for routine things, like if you have something that doesn't change at all I find it super annoying waiting hours and hours just to get a new prescription, when theres no change whatsoever, like literally nothing, nothing has happened since last we talked except I have a whole morning gone :( lol.

    I also don't really know what I'd be able to email about, I kind of feel like any questions I would have would be ones that a GP will likely tell me to come in for and not answer at all which will lead me to just checking webmd or similar.

    In saying that, I'd love there to be a place where I could just email a random GP questions, even if paid, just to get an understanding of whether I should be worried of X or should be going in for Y.

    I would like it if I got emails or sms of certain things though, like if I received a blood test you send me that stuff, the whole thing, not just a portion or the bits you want me to see. Or if you used it to tell me my appointment is coming up that I signed up for, or that I can apply for an appointment online.

    Other then a specific reason though, I'm not really sure I want communication with my GP, but that could just be a personal thing. I'm also the type of person that opted out of the MyHealthRecord so I might not be the type of person you're looking for.

    Another opinion though but you might want to look into country areas, a lot of places have little to no GPs around, and would probably love what you're talking about. Might even make more people in country areas get help faster which likely leads to earlier and higher likeliness of preventable health issues.

    • AusGP on 31/07/2018 - 19:29

      Thanks for the input. There are already lots of mixed billing clinics with mechanisms in place for script requests and a paid fee to renew scripts. The main reason for a fee is the doctor should still be opening the file and considering whether things are appropriate or whether there's a contraindications that's developed.

      I sometimes do send brief SMSs to patients regarding their results. I have been trialling emailing the results but only after discussing in person (people rather an electronic copy). I have started trialling emailing of results for 1-2 patients I've had a phone conversation about their results (because they're moving interstate or overseas).

      I think telehealth could be huge but for GP consults I don't think there is funding yet but I could be wrong.

    • Specialist Diaz on 01/08/2018 - 17:23

      In saying that, I'd love there to be a place where I could just email a random GP questions, even if paid, just to get an understanding of whether I should be worried of X or should be going in for Y.

      If you're in QLD, try calling 13HEALTH (https://www.qld.gov.au/health/contacts/advice/13health)

  • garetz on 31/07/2018 - 01:01
    +7

    The only emails i think doctors should do is when they want you to come in based on information that isnt urgent, or to send you blood test results. Anything else is just a waste of the doctors time, and should require a consult.

    • CheapskateQueen on 31/07/2018 - 10:41

      Yes, blood test results should be available to dl if you want.

      My mate got an auto text the other day saying her kid's bloods were fine. It was so cool. Why waste everyone's time, and government money, just to go in and have the dr say "everything's fine". ..oh okay great thanks.

      the issue is of course, if you don't get a text saying everything's okay, it might make you paranoid something is seriously wrong. But don't they normally call you if something's really bad anyway?

      • HighAndDry on 31/07/2018 - 12:34

        I assume security and privacy reasons. I wouldn't want to be the receptionist who accidentally "Reply:All"'d the blood result tests for a patient or patients.

        • AusGP on 31/07/2018 - 19:32

          Yes privacy is a huge issue. Most privacy mistakes are actually human error and sending it to the wrong number or patient

      • AusGP on 31/07/2018 - 19:31

        With the new MyHealthRecord the current idea is that test results are uploaded directly from the pathology provider. After 7 days you'll be able to see it.

        The 7 days is to allow your doctor time to catch up on the results before you inadvertently find out you have cancer or misinterpret a test result

        • UNO on 01/08/2018 - 20:28

          If only point of care tests were available on the MBS then you would only have to wait 2-3 mins for the test!

  • Zedsdeadbabyzedsdead on 31/07/2018 - 01:13
    +6

    Including every visit over the the last few years the doctor has spent an average 75% doing admin tasks. Anymore and they may as well become a highly qualified receptionist.

    • AusGP on 31/07/2018 - 19:35

      Yeah I wish I had less paperwork sigh.
      However I tend not to be doing too much admin during the actual patient consultation itself unless it's directly relevant. E.g. sometimes I will get a patient to leave a form with me to fill later (disabled parking permit etc).

  • chumlee on 31/07/2018 - 08:16
    +4

    Pay for email communication?? Do you offer bulk billing for it?

    Probably best to stick with current practices. As mentioned above GP's always running behind and time is a valuable commodity

    • AusGP on 31/07/2018 - 19:35

      The government doesn't pay for any non face to face time so there's no bulk billing at the moment but with the new Health Care Homes model being considered it may be possible

  • EightImmortals on 31/07/2018 - 08:42
    +4

    Would be nice if the receptionist (or your IT dept) could setup an automated system to SMS patients when the doctor is running late. That way we can get on with other things AND have to spend less time in the waiting room with all those sick people. :)

    Otherwise, unless there is some info relating to my health that I need to know about (you probably do that already though) now then I don't really need to catch up with the doctor between visits..unless he's feeling depressed and needs a coffee or something?

    • [Deactivated] on 31/07/2018 - 09:07
      +3

      My GP does this. My office does this.

      Of course neither is bulk billed nor cheap.

      The team is expensive. Software is expensive. If your decision of service provider is based on price, you will get barebones service. I can only afford to do that because I essentially employ an extra full timer to keep patients happy.

      • EightImmortals on 31/07/2018 - 09:17

        Wow, I didn't think it would take that much time? Can't you buy some kind of sms package deal with one of the telcos?

        • [Deactivated] on 31/07/2018 - 09:19
          +2

          The software does the messaging and they charge me per SMS. Of course they charge a premium.

          To have someone SMS everyone manually will take ages (inputting name and appointmemt times) and would likely result in frequent errors.

          So it's not really the SMS that's expensive, it's the software and someone trained to run the software.

        • EightImmortals on 31/07/2018 - 09:45

          @tshow: Gotcha. Can you train your patients to call first? I used to do that with my old doc that way I'd know what was going on. His last receptionist was a bit of a bitch though and wouldn't tell me. :) That would save you the expense and I'm sure most people wouldn't mind?

        • [Deactivated] on 31/07/2018 - 10:24
          +1

          @EightImmortals:
          Then I'll need a receptionist to be at the desk to answer at least two additional calls an hour. Severely hampers their ability to do other things like sterilization.

          I do have patients that call in first but that's becoming a rarity as my team is consistent with keeping patients informed via SMS.

          Also helps that the book master knows how much time to allocate and I rarely run late.

          Again, all boils down to how much the practice principal has invested in staffing and training.

        • AusGP on 31/07/2018 - 19:44

          @tshow:

          Hey Tshow how much does your practice charge for appointments? Sounds expensive to have a "book master" but this sounds like a great idea if economics stack up!

          Unfortunately I run late often so interested to know how to keep patients informed as currently it's a bit hit and miss whether patients get notified depending on how busy the front desk is

        • [Deactivated] on 31/07/2018 - 20:12

          @AusGP:
          I use bulk billing as a guide and add 50%. Not much more than most private practices. The increase fees are generally carried by consults and reviews as that's generally where the need for an extra ancillary staff arrises.

          Book master is just an informal title. It's the person who has final say on the book. You'll have to learn to take a step back and just let the designated person do their job, make mistakes and learn from those mistakes. You'll also have to be more communicative and actually let reception know you're running late.

          Remember, reception isn't going to rush you. A good reception knows better than to do. Don't put them in a position where they have to guess your tardiness, stuff a patient's schedule day by moving their appointment just so you can still run late to for that later appointment.

          Let your front desk/book manager handle curve balls. Hire a junior, uni student, anyone cheerful to do the mundane card swiping, greeting, fill the forms kind of things. You won't need them all day, just peak hours. Maybe it will set you back $50k per year. Average out over 250 working days, that's 200 bucks a day. In a two full time equivalent practice, that's an additional short consult each.

        • AusGP on 31/07/2018 - 20:24

          @tshow:

          Yes I have to work out a better way to let reception know I'm running late for sure. At the moment it's hard to notify them (phones often rung off the hook, internal messaging often not picked up for at least 15 min.

          We don't normally adjust the book just send delay notices to patients so they can stay home longer or go have a coffee

          Sounds like a customer service role and that's actually a very interesting idea. I will stew over it a bit more before bringing it to the other practice partners.

        • [Deactivated] on 31/07/2018 - 20:30

          @AusGP:
          Sometimes, it is the layout of your practice too. If you have a traditional long corridor and a security door separating the reception, it's awkward.

          I custom built my practice. Apart from the rooms, it's open plan and the reception may as well be an Ikea desk - small and patients can (and unfortunately sometimes do) go behind. I just walk patients to reception and sneak behind to subtly convey my approximate lateness. Patient feels nice about the walk out and I make sure the message is received. Win win.

        • AusGP on 31/07/2018 - 20:46

          @tshow:

          Sounds quite a nice design! Yes everything you said is true (long corridor, doors x2 to get into reception)

    • AusGP on 31/07/2018 - 19:41

      We already have a template our receptionists can send out for delays although when reception gets busy this doesn't always happen. It's been brought up by our patients to have an automated system to notify delays but unfortunately we're not big enough to build a custom solution through paying IT to develop it.

      I'm hoping it gets developed by the software company but at the moment it's all manual.

      Haha always need a coffee!

      • [Deactivated] on 31/07/2018 - 20:14

        You wouldn't want to use an auto system to change appointment times. If reception/you forgets to trigger "patient out", it will trigger auto SMS. Once it's out, your day is F'ed!

        • AusGP on 31/07/2018 - 20:18

          Yeah true. So basically it's trying to build an auto system that has some fail-safes - which costs a lot as a custom build!

        • [Deactivated] on 31/07/2018 - 20:23
          +1

          @AusGP:
          I had a look into building my own practice management software. Got to the legalities of copywriting and fragmenting the project to individual components (to prevent plagiarism).

          Even subcontracting to India / Philippines makes it a no go. You'd have to sell at least a hundred copies at the typical price of an existing software, cut out a sales commission but still allowing for barebones IT support to make it feasible.

          I killed the project after running those figures and the thought of having to try and sell software.

  • HighAndDry on 31/07/2018 - 09:44
    +2

    As others have said, I think GPs have a high workload already and shouldn't distract themselves with extraneous extras - honestly the most useful feature might be appointment reminders, and doctors already to that (and I also don't need it because I can put stuff into my calendar like a normal person).

    Ok ok. Another useful feature I haven't seen anywhere else? A live ticker of how 'on-time' the Dr is with appointments. If I knew they're running 30mins late, I wouldn't get there 10mins early.

    • [Deactivated] on 31/07/2018 - 11:28
      +1

      It's sad that the perception is that doctors cannot be punctual. We indeed can be, with exceptions of course.

      A live ticker is a great idea but it's just encouraging bad time management. The issue shouldn't be method of communicating how late a doctor is going to run.

      The GPs would probably be rolling their eyes at this point but I do have consultant days where my patient turnover for the day is very similar to a GP. It can be done.

      • HighAndDry on 31/07/2018 - 11:55
        +3

        I honestly don't blame GPs themselves at all. Every one I've been to have been non-stop busy, and at that point, one patient taking longer than expected will throw all the other appts out of whack. And I'd rather the Dr spend enough time with a patient that needs it, than force themselves to be punctual. Punctuality is important, but not that important.

        • [Deactivated] on 31/07/2018 - 12:29
          +1

          Agreed. Punctuality is secondary to quality of care.

          I would still book in buffers. Buffers can be used to fill as emergencies if the day is going well. If the emergency is not taken, I'd buy the team some coffee and cake. It makes my day much more pleasant and there's no downside unless I'm chasing money.

          People who chase money will always be poor. They may be wealthy and still be poor.

        • HighAndDry on 31/07/2018 - 12:32

          @tshow: Yeah that seems like smart practice/patient/time management. At the same time, I know at least one local GP who used to do that… and then stopped because he'd be booked out months in advance with patients preferring to wait than see another GP.

    • AusGP on 31/07/2018 - 19:48

      Yeah we've had patients suggest this feature but unfortunately it's not available from a software perspective. I was on a tender subcommittee for hospital waiting room management systems and know this is easily built as a custom solution but for a small clinic it's not feasible for us to develop and just have to wait for softw are providers to catch up. Definitely need to keep suggesting this to software vendor.

  • bn152634 on 31/07/2018 - 11:36

    I had open chest surgery, spent 30 days in hospital.
    Cardiologist attended morning and night (2 visits each day) billed Health Fund minimum $300 per day x 30 days straight.
    On discharge I emailed a question re medication.
    He didn't reply.
    When I had next face to face appointment I asked about no reply.
    He said: "Where is Fee?"
    I was not well and his commercial approach defeated me.
    I changed Cardiologists.
    Compassionate health care is important.
    I wouldn't start emails unless it can be supported long term.
    Its a modern communication.
    I am amazed test results,documents and specialist refs are still faxed.

    • HighAndDry on 31/07/2018 - 11:58
      +2

      Compassionate health care is important.

      I take Dr House's approach. Would your rather a doctor who ignored you while they cured you? Or a Dr that held your hand as you died? (It'd suck if you had a Dr that ignored you while you died though…)

      Add to that: The time they're holding your hand? They could be treating someone else.

      Seriously, you talk about compassion but you don't seem to have any empathy yourself.

      Cardiologist attended morning and night (2 visits each day)

      Plus he played a part in saving your life. And you're complaining about the Dr wanting to be paid?

      Reflect on that a little.

    • AusGP on 31/07/2018 - 19:55

      Different doctors do it differently but I would like to think I'm on the side of replying for reasonable requests. Certainly my dad's cardiologist responded to his question about medications via email (that's before having done any procedures where he earns the big bucks). Having said that it may be a slightly biased situation…

  • johninmelb on 31/07/2018 - 14:15
    +1

    The clinic I go to has sms for appointment reminders and for test results. However my doctor usually only sends me an sms if he is not happy with a result and says make an appointment to come in. He doesn't give me the figures etc, eg for blood tests I have every 6 months. If I don't hear back from him, I know all is fine, and he will discuss actual results next time I go in.

    No emails, but if I have a general non-medical question, I just email the reception desk.

    This clinic uses Appointuit so you can book appointments online or on the app on your phone. Not all times are available. The doctors keep some back and you have to call at 8am each morning to try and get one of the reserved appointment times. They do this to cover unexpected illness, and also for people without access to computers, phones etc to book. I think you can only book standard appointments online as well. If you need a long appointment, you have to phone as they only do them certain days I suspect.

    As for doctors being late, that is a fact of life, maddening as it is. However, part of the problem is the patient. If you book a standard appointment then you need to stick to your 10 minutes - and I do realise that what seems like a simple matter can turn into a major problem. I always go in with a list of things I want to talk about, and I don't waste the doctor's time. When I know I have a couple of things to discuss, I always book a long appointment. That way I have his undivided attention, and he can provide the information and care I need.

    • AusGP on 31/07/2018 - 19:57

      What you describe is almost exactly how my clinic runs currently!

      I'm always on the lookout for better ways to do things though!

  • AlienC on 31/07/2018 - 15:09

    For me a complete digitally focused communication platform with my GP would be a godsend. Not having to go in for every single little thing would not only save time and energy but also having those documents stored digitally in my emails already ahead of time would save hours and as we all know time is money friend.

    • AusGP on 31/07/2018 - 19:58

      Yes a complete portal would be great and would result in less "waste" in the system. Hopefully the MyHealthRecord can eventually be expanded to be something much more than what it promises now…but I am not hopeful…

  • dogboy on 01/08/2018 - 16:19
    -1

    The only thing I am interested in is text updates to my appointment time. GPs are notorious for wasting people's time waiting often 30 mins to an hour past the pre-scheduled appointment time. It just seems to be accepted by society but if any other industry ran their business like this they would be out of business in a week. If I billed a doctor for my lost time waiting their eyes would pop out of their head. Must be on a good wicket if they don't even care about keeping their clients happy.

    • AusGP on 01/08/2018 - 16:57

      Yes I am guilty of this. Certainly will try and work out how to consistently notify people of delays!

      Having said that to run on time it does mean doctors would have to be ruthless with getting people out the door. I can think of a few occasions where spending extra time with patients did elicit serious concerns. However I do run late so have to balance not missing the serious illness that the patient didn't think relevant (or hid to the end) vs running on time.

      Fully understand the frustrations though. Patients have jokingly threatened to bill me!

      • UNO on 01/08/2018 - 20:43

        Maybe if patients could bill their GP for being late they would be on time more often. If you are continually late for appointments maybe you should reduce the number of patients you see in a day? Is each patient gets a 15-20 minute slot, rather than 10 mins?

        The way the health system is set up on a fee for service provides incentives for GPs to see their patients as much as possible.

        Most people don't want to see their GP (or any Dr unless they have to).

        Would you be happy waiting 30 mins or an hour to see an accountant or lawyer?

        • AusGP on 01/08/2018 - 21:35

          No not really. I guess though I run late not by being tardy or having a cup of tea but generally due mostly in my 15 appointments running closer to 20 for some patients because some patients bring complex issues. It's getting to where I do feel now I just have to be firm and say no to patients - you'll have to come back to deal with your minor issue another time.

          It seems like a lot of people are annoyed by this so maybe I'll have to bite the bullet and stop promoting preventative health when I don't have time…

  • itsdougie on 01/08/2018 - 19:09

    If the GP could give me a Medical Certificate email that would be good

  • Murdrum on 01/08/2018 - 19:28

    I don't see my GP often. Usually only when I'm sick, which is maybe a couple times a year.

    If my doctor was more proactive about monitoring my health then yeah I'd want SMS and email reminders. I want to book appointments using an app (which could be a web app), not by talking to a person who is tired of their job.

    • AusGP on 01/08/2018 - 21:36
      +1

      Hmm good point I might start emailing out pathology requests as a trial in the future for high risk patients.

  • Masterpupil on 01/08/2018 - 21:36

    Other than emailing results and minor things of that nature, I cannot see how this would work, unless you were paying 100% privately for the GP so they are billing privately for all their time.

    Certain professional services require gate-keeping, and whilst the gatekeeper could be administrative staff, the burden of that could become shocking, and probably represents a significant practice risk.

    Some medical professionals will give you their direct contact, but my perception is that is on a case by case basis, and typically only where they are sure they are not going to be unreasonably harassed. For example, obstetricians, psychologists and psychiatrists I am aware of who provide direct contact details, but again retained privately and I suspect somewhat selectively.

  • thechemist on 01/08/2018 - 22:53

    Just a few comments
    1. pathology companies could email you the result but they don't as the system is set up and rightfully for the GP to analyse the results and contact you when/if they see fit

    1. I've been late to GP appointments just because I knew they would be late and I am sure many people in the same boat. Either get first appointment or the last one is quite effective. I have to often wait for my hairdresser

    2. The quality of GPs is so variable so if you find a good one even if they don't bulk bill then see them every few months and have a list of questions ready and in between if you need a Script or medical cert then just see one of those bulk bill ones

    3. Just like other businesses my GP spams me as well just like any other company but that's to be expected

Login or Join to leave a comment
Login Join