What should you expect during a virtual consultation?
I completed more virtual consultations in the first 2 weeks of the Covid-19 pandemic than in the preceding almost 2 decades since graduating medical school! This rapid transition to teledermatology has not been without challenges, however as we have gained more experience of working in this way it has become clear that teledermatology can work remarkably well and I am sure that this will lead to long term changes in the way that we practice.
Key advantages for patients include convenience - I can usually offer same-day or next-day appointments - and the avoidance of a journey into Central London, which naturally reduces the risk of acquiring Covid-19. The major challenge is a lack of face-to-face interaction, although this can be - at least to some extent - mitigated by video consultation. Other disadvantages include the inability to perform a full skin check for skin cancer and the absence of skin microscopy (dermoscopy) which I rely on for the assessment of suspected skin cancer.
Some important points to note
Suspected skin cancer can rarely be adequately evaluated without dermoscopy and for this reason I do not assess suspected skin cancer and concerning moles by remote consultation.
Occasionally a skin biopsy is needed to help with diagnosis - for example if there is uncertainty as to the cause of a rash or if you have hair loss where the cause is not clear. I can perform this procedure in central London, however if you live a long distance from London I would need to refer you to a local Dermatologist.
Some treatments such as phototherapy (which is commonly used to treat psoriasis, eczema and vitiligo) require repeated visits to the hospital. If you live far from London I am happy to refer you to a local facility.
Certain tablet medications - whilst generally very safe - do have the potential for side effects. An example is isotretinoin (roaccutane) which is used for the treatment of acne. In addition to a remote consultation I would need to assess you in person before prescribing these medications, however I would not charge extra for this.
High quality (in focus, good lighting) photographs are essential for an accurate diagnosis - video quality is rarely sufficient for this.
Before your consultation
Contact my secretary to arrange a time for your consultation and to decide whether you would like a video consultation or phone call.
Take clear photographs showing your condition (in focus, good lighting, showing all affected areas) and send to my secretary ahead of your consultation.
Write down any questions that you wish to discuss with me.
Make sure that you have a list of any current medications.
During your consultation
Ask me if there is anything that is not clear.
Discuss any questions that you have with me.
Don't worry about making notes as I will send you a detailed letter summarizing our conversation.
After your consultation
I will send you a letter summarizing the consultation, my opinion and the management plan.
I will issue an electronic prescription for any medication that is required.
My secretary will contact you or your insurance company to arrange payment.
Do not hestitate to contact my secretary if there is anything that was unclear during the consultation or if you have additional questions.
Contact my secretary to book a consultation with me either virtually or in person. My all-inclusive fee for a virtual consultation is £160. Almost all of the medical insurance companies are funding virtual consultations for the duration of the Covid-19 pandemic, although you should check in advance. If you are not sure whether your condition is suitable for virtual consultation please do not hesitate to contact my secretary to discuss further.