heart of the matter

FRANK DUNN
FRANK DUNN

The Royal College of Physicians and Surgeons of Glasgow has ‘Members’ and ‘Fellows’ scattered all over the world.

We try to visit those out with the UK when possible, usually structuring the visit around a conference.

It is important that we also remember those within the UK. They assist with educational events, run exams and often have to come considerable distances to attend meetings in Glasgow.

We have had a number of roadshows over the past year and the most recent was in Inverness.

I headed off on the early morning train from Lenzie which took me to Inverness, via changes at Stirling and Perth. I had forgotten the magnificent scenery, particularly on leaving Perth, and especially enjoyed viewing picturesque towns such as Pitlochry, Dalwhinnie and Kincraig, between the inevitable cat naps.

The clinical science centre in Inverness is most impressive. There are excellent facilities for students, including a state of the art library and clinical skills area. It is one part of Scotland where the population is increasing, as a result of investment and the quality of life.

The theme of the meeting was remote and rural medicine. The attendees were from a range of health professionals. Part of the reason for the visit was to ascertain more what we could learn from remote and rural health rather than the converse and there was much for us to learn.

Video and teleconference facilities are used to great effect, and help to ease the difficulties of delivering health care.

One memorable example was in speech therapy. Most of the consultations were by video sometimes via SKYPE. Speech therapists undertake such impressive and rewarding work, and to see patients with strokes benefit from consultations, despite being many miles away, was gratifying.

Another example of video medicine was in outpatients. Interviews can be held, and symptoms elicited over a video consultation, followed by nurse-led exercise testing, with the cardiologist reviewing the outcomes from a distance.

Skin rashes can be diagnosed by video and appropriate advice and treatment transmitted through the local pharmacist. There were many other examples of innovative practice.

There was a presentation from a GP in a rural practice. He described how they ran a small hospital as well as providing primary care.

They covered all out of hours work and found it much easier to decide who to send to a larger hospital, because they knew the patient so well.

He made the point that a decision to send a patient to Glasgow or Edinburgh was a major exercise, and therefore had to be thought through, because of the disruption to the patient and their families.

He emphasised how varied and satisfying the work was.

It is of interest that recent reports on training young doctors have emphasised the importance of having some doctors who are trained in aspects of both primary, and hospital based care.

We can certainly develop tele and video medicine more effectively in the urban setting. It could provide a way of partially replacing outpatient visits, which can be quite a chore for the frail elderly.

It could also be used to support patients with chronic illness in their homes, and to provide advice as needed.

The trip back down from Inverness gave me food for thought. Sadly, it was the only food I was to get, as I was informed that catering was not on offer, and that this information was made available to customers when purchasing tickets.

Message to self. Always read the package insert.