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Paediatricians have a (hopefully) justified reputation for being accessible to their patients and responsive to their needs. In order to achieve this, various systems have been employed to encourage, or at least permit, patients to communicate with the medical team in between hospital appointments. Patients value being able to contact their doctors,1–3 yet doctors are often concerned that if they make themselves too available they will be overwhelmed by patient requests (table 1).4 ,5
I am a paediatrician working in a general hospital in Hertfordshire, UK. The majority of my work is with children with continence issues, and in the overlap between health and psychology, for example, children with conversion disorders, school attendance issues and chronic fatigue. I am also the named doctor for safeguarding children. For the last few years, I have used email extensively to allow my patients to communicate with me. This article describes my journey to email and the challenges and benefits encountered on the way.
Outpatient clinics suffer from appointment congestion. There is increasing demand for appointments, without the associated increase in provision. The inevitable consequence of this is that the system has limited flexibility and responsiveness. Follow-up appointments are arranged at a specific time in the future regardless of whether this will coincide with the time when the patient needs or wishes to be seen. Limited clinic time makes it difficult to schedule additional appointments. Unfortunately, there seems little determination to improve the system so that clinic appointments can be arranged by need rather than calendar.
Until this system changes, dealing with problems between appointments remains a challenge. If a treatment plan is not working as expected, if the patient wants some clarification or …