Abstract Body

Telephone consultations are regularly used to triage calls, patients can also be diagnosed by doctors this way and this practice has been inceasing since last year due to corona pandemic situation . However, the key issue is to recognise when this mode of consultation is not sufficient to properly assess the patient and address the problem, and to arrange a face-to-face consultation instead.

During my last emergency duty i came accross a 50 years old female patient with diagnosis of hipertention and treatment with Enalapril 10 mg. One week before visiting the emergency room, the patient presented with a headache and had noticed high levels of tension in the arm blood pressure monitor at home, therefore she had spoken with her family doctor and finally her doctor increased the dose of medication without seeing her in consultancy. However, despite increasing the dose, the patient continues to have a headache and high blood pressure, so she finally dicided to visit to emergency doctor. En emergency room she was normotensive and the cause of her headache was her state of anxiety about a family matter .

Difficulties can arise when doctors try to reach a diagnosis and treat it via the telephone when the complexity of the patient or the condition means a face-to-face consultation is required.

What we can’t see in a telephone consultation are the obvious and sometimes subtle facial expressions, gestures and postures that often provide evidence as to an individual’s true thoughts and state of mind, that help us to reach to the appropiate diagnosis.