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The Luxury of the Review Consultation

The Luxury of the Review Consultation

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Road to TemoraBy Dr Irwin Lim, Rheumatologist

Herman Lau and I have been working with telehealth for more than 1 year, supporting a few country towns in the New South Wales Riverina, more than 400km away. It's become quite obvious that patients really suffer with the tyranny of distance in rural Australia (read about TELERHEUMATOLOGY here).

I have now met quite a number of patients who did previously seek help for their condition and actually travelled hours to consult a rheumatologist at some stage. In some cases, the diagnosis had not been clear at that consultation.

What tended to happen is that the patient didn't return for follow-up because of the distances to be traveled or the costs involved with this distance (overnight stays, travel costs, time away from work, etc). The condition progressed and the "correct" treatment may not have been instituted.

This access problem is a big deal.

Working in a big city like Sydney, I, and my patients, have the luxury of the review consultation.

Your rheumatologist may not always know the diagnosis the first time he or she meets a patient.

In these cases, it really helps to be able to follow up the patient. Over time, things become clearer.

Living in the city, my patients can present when they have an acute attack or a new symptom. They have the luxury of presenting at short notice and they also have the luxury of presenting more often if needed.

It's not the same when you add in the tyranny of distance, but telehealth does have the potential to change this.

Having an easy and flexible review process allows me to be a more effective doctor.

What are your experiences as you wait to have a diagnosis clarified? If you are a rheumatologist, is this what you do?

Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here.
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