Tele-doctor ‘revolutionises care’
Published: September 6, 2005
To many it may seem like something from George Orwell’s novel 1984.
But to hundreds of cancer patients, the video doctor has provided an invaluable service over recent years.
With only 11 specialist cancer genetics units in the country, service is somewhat limited for people wanting to find out about the risk of them developing the disease.
Much of the north of London and Essex is covered by three consultants working from Great Ormond Street Hospital in central London.
It means that in the past consultants have spent almost a week each month running clinics in various hospitals across the area, spending valuable time travelling.
But since August 2002, the North East Thames Clinical Genetics Service - which also looks at diseases other than cancer - has been running “telemedicine clinics”, linking up cancer patients and consultants by video.
Lesley Gower, from Basildon, Essex, who took part in a video clinic for the first time last week, said the experience was “a little strange at first”.
“But in these consultations you concentrate so much on what is being said you almost become unaware of your surroundings.”
The 46-year-old, who has had ovarian cancer, carries a gene which makes her more susceptible to breast and ovarian cancer and had the testing done so she could see if her three sisters carried the same gene.
“You do discuss sensitive subjects, but it is not really a problem to talk to a doctor through a video,” she said.
“After all, we live in an age with webcams and pictures on mobile phones. It is the way things are going.”
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The success of the clinics, which use ISDN lines to link up hospitals in Basildon, Chelmsford, Colchester and Southend with the unit in London, has even surprised the cancer doctor behind them.
Consultant James Mackay said: “I would have thought patients would have been more cautious than they were.
“But they have been very positive. It takes some a little while to be at ease, but I don’t think I have had any complaints.”
During the consultations, which can last up to 40 minutes, patients can discuss sensitive topics, including whether to have breasts removed and the risk they face of getting cancer.
Before the video consultation patients are briefed by a nurse or counsellor who sits with them throughout the “chat” to the doctor.
Mr Mackay said now the clinics were up and running - the other two consultants who work at the unit are also trained - he is able to see many more patients. More than 400 have been seen since it was launched.
Sensitive subjects
“It is different from face-to-face interviews, by all means,” he said.
“For example, you would not tackle sensitive subjects at the start because it takes a while for patients to settle and you have to make sure there is no-one else in the room.
“But it is still providing patients with a quality service.
“When you think about it, I was having to drive up and down from London to Essex, whereas now I can just go to a suite. It means patients have better access to us.”
Mr Mackay also believes there is no reason why the system should not be used elsewhere.
Video link ups are common between doctors wanting to discuss treatment and for training purposes, but the Great Ormond Street scheme is thought to be the first doctor/patient link-up of its kind.
“A lot of work done at a consultant level, involves discussions and explanation,” Mr Mackay said. “Obviously, it wouldn’t work where there needs to be clinical examination, but for other occasions it is a way of making the NHS work better.”
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