The NHS in England is trying out an approach to Primary Care where the patient accesses the GP Practice website, completes an online questionnaire about their symptoms, has their identity checked by a member of staff on the phone, then receives a prescription for a drug.
This is pretty much what happened during the great swine flu epidemic, except I think they skipped the ID check – answer 4 questions online correctly and win a box of Tamiflu. Honestly, I thought Medicine had reached a new low at that point.
Here’s what I was taught at Edinburgh University then subsequently in GP training –
Start with the patient’s history. By the time you’ve taken the history you should have a diagnosis, or a differential diagnosis (a list of possibilities).
Next do a physical exam as needed to confirm the diagnosis
If you still haven’t confirmed the diagnosis, then ask…
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