Doctor Inbetween: How much of your time does your GP really need?
My app Doctor Inbetween is in Beta testing and is available here (WhatsApp) +61477164873
This is an example of the note my app generates after texting with the patient. This note gets sent to the doctor once the patient approves it.
As a doctor I really don’t like sitting in waiting rooms waiting to see other doctors when I am their patient. It’s not personal. I don’t hold any animosity towards the treating team. I don’t feel like I’m entitled to be treated quickly. I just feel awkward sitting around in the waiting room doing nothing while I watch all the other doctors work.
Recently I attended an outpatient appointment where I knew that the surgeon would offer me an operation to have my gallbladder removed and I’d already decided that I would turn him down and opt for non-surgical management. I also knew that there was no need for a physical examination because I’d been examined in the emergency department, and I examined my own abdomen before I went to see him.
When I walked into the clinic there was not even a place to sit because there were so many patients waiting to be seen. The receptionist made an announcement that the clinic was running behind and they would see every patient they possibly could in the next three hours and then at 5:30pm they would close shop and anyone who had not been seen would be rebooked.
Therefore, when I reached the front of the line I said the magic words to the receptionist:
Would it be okay if my appointment was changed to a telehealth appointment?
The receptionist asked me if I was sure that the appointment was allowed to be telehealth, and I said yes. She said that was excellent. From her perspective there was now one less patient crowding the waiting room. If I didn’t get seen today, I would get called a few days later. No problem.
I jumped back on the tram headed home, continue to work from home, and I received a call two hours later and spoke on the phone with a doctor for five minutes. He ordered me a scan and rebooked me to see him in three months. I was left with the impression that our appointment had been conducted more efficiently and in less time than if I had gone to see the doctor in person.
In my own job I do an enormous amount of telehealth. I spend between 6 and 12 hours a day talking on the phone with patients and managing them remotely. Many of my patients are fly in fly out (FIFO) workers, or they are from small towns where it takes three weeks to get an appointment with the general practitioner. I specifically use the service UpDoc, and I do similar work to doctors who use services like InstantConsult or 13Sick. When I’m having a good day, I can see 50 patients. When I’m having a great day, I can see 100. Most importantly I can see that number of patients and I know that I’m seeing them safely and they are receiving a high standard of care without compromise.
This is how we do it:
1. First of all, there is no set appointment time. The patient requests to be seen and then they are seen as soon as I am available. In the meantime, they sit in a queue. The patient does not mind being in this queue, because it does not interrupt their life at all. Just like me they are going about their business. I call when I call.
2. Before seeing me, the patient has to declare what they want out of the appointment. They also have to declare what their symptoms are. Based on their request intention and their symptoms and AI generates five key questions that are sent to the patient by text message. The patient can then answer these questions and then their answers get sent to me so I can read through them before speaking to the patient. This speeds up my appointment considerably because the questions are the specific questions that need to be answered for me to fulfil the request legally and safely.
3. When I talk to the patient it is from my mobile phone to their mobile phone. No video calls. No special apps. Just a standard phone call.
4. When I prescribe, the prescription goes through to the patient as an e-script. I sign it on my end with a password and the patient shows the QR code to the pharmacist and that unlocks the medication for them. I don’t print anything, and I don’t pick up a pen.
5. Referral letters are generated on my system and sent as a signed email.
6. Medical certificates are generated the same way and contain a link so that any third party can verify that it is a legitimate medical certificate generated by my platform.
7. When I speak to the patient on the phone the call is recorded. A transcript is generated in the background. AI reads the transcript and generates a possible written note for me. I review the note, I make my changes and additions, and then I sign it, and save it as my documentation.
All of these time-saving methods are useful to me. But nothing is more useful than the AI generated questions.
The fact that I am viewing the patient’s raw responses to these questions means that there is nothing lost in translation. The AI is not interpreting the patient’s answers to those questions. I am. The patient knows that I have seen exactly what they have written. That is the way that AI works on UpDoc.
The application I am personally developing converses with the patient in more depth, and with more flexibility, and generates a summary that the patient reviews and then has the option to confirm should be sent to me.
In that sense the patient works more like I do. The AI generates a possible note, and the patient is the gatekeeper of what the AI is allowed to publish to me, the doctor. If the patient believes that the note is correct then I am allowed to see it. If the note is not correct then I will not see it.
My application Doctor Inbetween is currently in beta testing. It can be used by messaging the following number on WhatsApp.
+61477164873